Transoral Robotic Surgery (TORS): Glottic Microsurgery in a Canine Model

OBJECTIVES/HYPOTHESIS: We hypothesize that bimanual, three-dimensional robotic surgery will prove valuable for glottic microsurgical procedures. STUDY DESIGN: To test this hypothesis, we developed and optimized a canine model for glottic microsurgery using a commercially available surgical robot. Methods Using a da Vinci Surgical Robot (Intuitive Surgical, Inc., Sunnyvale, CA), glottic microsurgery was performed with a hydrodissection technique in a canine model. The experiments were performed on two orotracheal intubated mongrel dogs under general anesthesia in the supine position on a standard operating room table. A videoscope and two, 360-degree rotating, 5- and 8-mm, wrested-end effector instruments were introduced transorally with three robotic arms. The surgeon performed the actual procedures while positioned at a robotic system console that was located across the operating room suite. The procedure was performed in duplicate and was documented with still and video photography. RESULTS: Glottic microsurgery was successfully performed using the da Vinci Surgical Robot, with both 5- and 8-mm instrumentation. The smaller, 5-mm instruments afforded greater visualization of the operative site and increased maneuverability, which resulted in reduced operative time. The robotic system provided excellent visualization as well as controlled and delicate microdissection at the vocal cord level. CONCLUSIONS: Robotic laryngeal microsurgery is technically feasible in the canine model and warrants consideration for evaluation in controlled human trials.     

Shock Hugoniot for Biological Materials

This paper presents shock Hugoniot compression data for several bio-related materials by using flat plate impact experiments. Shock pressure covered in this study ranges at least up to 1 GPa. It is emphasized here that spatial and temporal uniformity of pressure distribution behind a shock wave front is very important and it can be realized in these materials by the impact method, and their precise shock propagation characteristics have been obtained by the application of the procedure developed previously by our group. Hugoniot measurements for different and systematic data for various samples are compared with shock Hugoniot curve for water. Samples used in the experiment include water gel of gelatin, NaCl aqueous solution, and finally chicken breast meat. Several samples with different initial density were used for gelatin and NaCl solution. Shock Hugoniot function for all the specimens tested can be summarized as u _s =A+B u _p , B ~ 2Value of the intercept of the relationship, A, which has the meaning of the sound velocity, is apparently dependent on the material and ambient temperature. Physical meanings of the obtained results have been discussed.     

神经内镜下单鼻孔经蝶窦入路垂体瘤切除手术的临床体会

目的 探讨神经内镜下单鼻孔经蝶窦入路垂体瘤切除的手术方法及疗效。方法 2011 年3 月至2013年6 月收治 的垂体瘤患者共53 例,均行神经内镜下单鼻孔经蝶窦入路垂体瘤切除手术,对患者的手术效果、术后并发症、住院天数等指标进行回顾性分析。结果 神经内镜下单鼻孔经蝶窦入路垂体瘤完全切除49 例（92.4%）,次全切除4 例（7.6%）,术后平均住院天数6.2d,无手术死亡病例。术后出现并发症5 例（9.4%）,1 例患者术后出现鞍内出血及额叶血肿,1 例患者麻醉清醒后视力下降,2例出现一过性尿崩,1例出现脑脊液漏。结论 神经内镜下单鼻孔经蝶窦入路垂体瘤手术具有创伤小、术后并发症少及恢复快等优点,是治疗垂体瘤较为有效的术式。