In adult mannequins, videolaryngoscopy improves glottic visualization with lower force applied to upper airway tissues and reduced task workload compared with direct laryngoscopy. This trial compared oropharyngeal applied forces and subjective workload during direct vs indirect (video) laryngoscopy in a neonatal mannequin. Methods We conducted a randomized crossover trial of intubation with direct laryngoscopy, straight blade videolaryngoscopy, and hyperangulated videolaryngoscopy in a neonatal mannequin. Thirty neonatal/pediatric/anesthesiology consultants and
Transcarotid Artery Revascularization (TCAR) is typically performed by manual catheter insertion and implies radiation exposure for both the patient and the surgeon. Taking advantage from robotics and artificial intelligence (AI), this letter presents a robotic ultrasound (RUS) platform for improving the procedure. To this purpose, ultrasound (US) imaging is considered both in the pre-operative stage for procedure planning and in the intra-operative stage to track a catheter. 3D vascular volumes can be precisely reconstructed from sequences of 2D images exploiting robotic probe manipulation and AI-based image analysis. The method proved a median reconstruction error lower than 1 mm. Pre-operative information are mapped to the intra-operative scenario thanks to a US-based registration routine. The automatic probe alignment on the target vessel demonstrated to be as precise as 0.84°. The reconstructed 3D model can be exploited to automatically generate a catheter trajectory based on user inputs. Such trajectory enabled automatic insertion of a magnetic catheter steered by an external permanent magnet actuated by the RUS platform. Our results demonstrate a catheter tip target reaching error of 3.3 mm. We believe that these results can open the way for the introduction of robotics and AI in TCAR procedures enabling precise and automatic small-scale intravascular devices control.
Urinary bladder cancer is the tenth most common cancer in the world with an incidence of approximately 550,000 new cases each year [1]. Non-muscle invasive tumors are locally removed with trans urethral resection or chemotherapy, while invasive tumors (30% of cases) are generally treated with the surgical removal of the entire bladder and the urethra (radical cystectomy) to avoid recurrence [2]. Following cystectomy, uretero- cutaneostomy (i.e., urine drainage from the kidneys to an external container) or neobladder reconstruction with autologous intestine are possible solutions. Although they are standard clinical procedures, they present several complications including possible onset of infections, rupture of the neobladder, tumor recurrence, as well as low patient’s quality of life [3]. This scenario motivates the development of alternative solutions to restore bladder functions, i.e., urinary continence and controlled micturition. Over the years, researchers moved towards the development of fully implantable bioartificial [4] and artificial [5] bladder systems. Considering the Valsalva maneuver (i.e., abdominal torsion) as a possible voiding strategy, two functions are crucial for a complete bladder system: urine collection and fullness sensitivity. In this regard, some preliminary sensing systems have been proposed in literature. However, the solutions are closely related to specific and not bio-inspired geometries [5] or suitable only for small animals [6]. In this framework, we propose a novel biorobotic organ composed of a soft hexagonal-shaped artificial bladder (AB) coupled to a resistive textile sensors-based volume monitoring apparatus. The foldable structure of the AB together with the small thickness and flexibility of the embedded sensors make the system compact and suitable for implantation. The design and fabrication processes are here shown together with a preliminary validation of the sensorized AB.
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