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During the last 10 years, robotic researchers have designed different models for stereotactic interventions, orthopedic preparations, endoscopic and laparoscopic assistance, and teleoperative remote surgical procedures. Recently, a new approach to enhance future options in microsurgery was introduced. In cooperation with NASA and MicroDexterity Systems, the Robot Assisted MicroSurgery workstation was developed in the Jet Propulsion Laborato-ries. Robot Assisted MicroSurgery (RAMS) workstations were originally developed for microsurgical procedures of the eye, ear, brain, face, and hand.Robotic researchers are exploring several new medical applications, including robot-assisted stereotaxic interventions (imaging-guided biopsy), orthopedic preparations by robot (precision joint replacements), endoscopic and laparoscopic assists (minimally invasive procedures), teleoperative re- ABSTRACTThe purpose of this study was to introduce a new robotic system for microsurgical procedures of the eye, ear, brain, face, and hand. The design and main features of the Robot Assisted MicroSurgery (RAMS) work station are described. In addition, compatibility with the operating-room table is assessed.The engineering components of the RAMS work station consist of a laptop computer, a joystick, a mouse, slave robot, VME and amplifier chassis, and safety control box. The mechanical part of the RAMS, the slave robot, is designed to simulate movements of the human upper extremity, which has five joints and six degrees of motion. The robot has a zero backlash in five joints, and can sustain full extension of loads over three pounds. The arm measures 2.5 cm in diameter, and it is 34.6 cm long from its base to its tip. The arm and its base weigh 2.5 kg. Motors and encoders on the robot are easily removable, allowing for the arm to be sterilized in an autoclave. Assessment of robotic positioning, time for setup, relative precision, and possible problems in the operating field are compared with human-assisted microsurgical procedures.Robotic arm positioning on the operating-room table differs for each type of procedure. For those involving the hand and upper extremity, the robotic arm base occupies 35 percent of the operating table; this is only 10 to 15 percent for human-assisted procedures. The setup time for robot-assisted procedures is longer than for human-assisted surgery. However, microsurgical manipulations with the RAMS are more rapid than the surgeon's motions. Therefore, depending on the type of procedure, the total operating time is comparable to human-assisted procedures. The movement of the RAMS was found to be more precise, in attempting to perform vascular and neural anastomoses. Downloaded by: Universite Laval. Copyrighted material.

EEG power measurement has the potential to provide a sensitive neurophysiologic correlate of cancer treatment-related fatigue and cognitive dysfunction.

This study investigated whether the sensory-to-motor reinervation of the muscle flap provides a better sensory recovery of an overlying skin graft. Fifty-four animals were studied in three groups of 18 rats each: group I (control): 1 cm of the gastrocnemius muscle motor nerve was excised and no repair was performed; group II (motor-to-motor repair): the motor nerve of the gastrocnemius flap was transected and repaired; group III (sensory-to-motor repair): the motor nerve of the gastrocnemius muscle and sural nerve were transected and their distal and proximal ends, respectively, were repaired. At follow-up periods of 6, 12, and 24 weeks, evaluation of hair growth, muscle atrophy, and sensory evoked potentials was performed. Somatosensory evoked potentials (SSEP) at 6 weeks in the sensory-to-motor repair (group III) revealed a significant (P < 0. 05) increase (104.4% +/- 22.9) in the relative response of peak-to-peak potentials when compared with group I (46.6% +/- 19) and group II (51.8% +/- 14.0). Muscle flap stimulation was most prominent at 6 weeks in sensory-to-motor reinvervated flaps (group III 133.1% +/- 25.4; group I 84.9% +/- 20.2). In this study, sensory-to-motor nerve repair significantly improved the sensibility of skin flaps at 6 weeks. Denervated flaps presented with 3 months of sensory recovery delay.

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