Training pathway for a novel smart surgical system (FlexDex™) – a video vignette

Abstract

The interpretation of the scales is done in accordance with the EORTC-QLQ-C30 guidelines. The result shows a moderate clinically relevant difference with a difference of more than 10 points, 5-10 points indicates a small difference and fewer than 5 points no clinically relevant difference. To the third point, as we wrote in our introduction a stoma is shown to have a negative effect on body image and sexual function. Recently published data on female sexuality found sexual problems after treatment for colorectal cancer correlated with a permanent stoma and radiotherapy [1]. The current study only covers quality of life from the EORTC-QLQ-C30 questionnaire and an anchor question regarding the impact on QoL of bowel function/stoma. Finally, to the fourth point, in multivariate analysis LAR patients showed lower global health status, and higher occurrence of constipation and diarrhoea, when adjusted for gender and neoadjuvant therapy. In spite of a significantly larger proportion of APE patients receiving neoadjuvant radiotherapy, this did not affect QoL in these patients. In addition, 51 (10 %) of our LAR patients with tumours less than 10 cm from the anal verge were taken out of this analysis because they ended up with a permanent stoma. We certainly agree with our colleagues that our findings in this cross-sectional study should be interpreted with caution. We encourage colleagues to inform patients with low rectal cancers about life with a stoma and the risk of LAR syndrome in order to enable patients to make an informed decision.

ArtiSential® Articulated Wrist-Like Instruments and Their First Application in Pediatric Minimally Invasive Surgery: Case Reports and Literature Review of the Most Commonly Available Robot-Inspired Devices

“…This device has a quite unique user interface in which the shaft of the instruments is connected to the user's forearm via a bracelet linked to the frame of the tool, thus the structure described places the wrist articulation axes at the center of the surgeon's wrist (Figure 3B) [5][6][7][8][9]. The surgeon's wrist deflections are mapped to wrist effector deflections inside the patient by two strips determining a parallel mapping.…”

Placement of pelvic mesh prior to pelvic radiotherapy using FlexDex™ – a video vignette

“…The FlexDex system (FlexDex Surgical, Brighton, Michigan, USA) is a solely mechanical articulating device that converts a surgeon's hand, wrist and arm movements into corresponding movements of the instrument's end-effector inside the patient [6]. It is a single use device that, with some prior training [7], enables ergonomic and accurate suturing via standard laparoscopic ports and without the need for any additional equipment. In the associated video (Video S1) we show the concept and practice of this device in assisting the correct placement of a mesh in a patient with prostatic cancer prior to therapeutic radiation.…”