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European Journal of Trauma and Emergency Surgery

Published in:

01-06-2011 | Original Article

Telesurgical evaluation of stable thoracic trauma patients: a feasibility study

Authors: P. D. Bhatia, D. A. Bottoni, R. A. Malthaner

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2011

Abstract

Background

We evaluated a robotic telesurgical platform in managing thoracic trauma in an animal model.

Study design

The da Vinci^® robot was used to evaluate and treat a random number of blinded injuries in ten porcine thoraces.

Results

Ninety-five percent of injuries were correctly identified. The median survey time was 20.5 min (range 16–63 min). The mean time to repair lung lacerations was 19.8 min (range 14–27.5 min) and to evacuate the hemothoraces, it was 5.3 min (range 4.5–6.5 min). Diaphragmatic lacerations required repositioning of the ports and the robot. Only two out of five lacerations were successfully repaired (mean time 38.8 min, range 32.5–45 min). All aortic injuries were correctly identified. One subject died of a pre-existing pneumonia.

Conclusions

A robotic telesurgical approach to the evaluation of stable thoracic trauma patients is safe and feasible in a porcine model. Diaphragmatic injuries can be repaired but require repositioning of the robot.

Bellamy RF, Maningas PA, Vayer JS. Epidemiology of trauma: military experience. Ann Emerg Med. 1986;15:1384–8.PubMedCrossRef

Bellamy R, Safar P, Tisherman SA, Basford R, Bruttig SP, Capone A, Dubick MA, Ernster L, Hattler BG Jr, Hochachka P, Klain M, Kochanek PM, Kofke WA, Lancaster JR, McGowan FX Jr, Oeltgen PR, Severinghaus JW, Taylor MJ, Zar H. Suspended animation for delayed resuscitation. Crit Care Med. 1996;24(2 Suppl):S24–47.PubMed

Green PS, Hill JW, Jensen JF, Shah A. Telepresence surgery. IEEE Eng Med Biol. 1995;14:324–9.CrossRef

Bowersox JC, Cordts PR, LaPorta AJ. Use of an intuitive telemanipulator system for remote trauma surgery: an experimental study. J Am Coll Surg. 1998;186:615–21.PubMedCrossRef

Ficarra V, Cavalleri S, Novara G, Aragona M, Artibani W. Evidence from robot-assisted laparoscopic radical prostatectomy: a systematic review. Eur Urol. 2007;51(1):45–55.PubMedCrossRef

Rassweiler J, Safi KC, Subotic S, Teber D, Frede T. Robotics and telesurgery—an update on their position in laparoscopic radical prostatectomy. Minim Invasive Ther Allied Technol. 2005;14(2):109–22.PubMedCrossRef

Sebajang H, Trudeau P, Dougall A, Hegge S, McKinley C, Anvari M. The role of telementoring and telerobotic assistance in the provision of laparoscopic colorectal surgery in rural areas. Surg Endosc. 2006;20(9):1389–93.PubMedCrossRef

Ballantyne GH. Robotic surgery, telerobotic surgery, telepresence, and telementoring. Review of early clinical results. Surg Endosc. 2002;16:1389–402.PubMedCrossRef

McClure RS, Kiaii B, Novick RJ, Rayman R, Swinamer S, Kodera K, Menkis AH. Computer-enhanced telemanipulation in mitral valve repair: preliminary experience in Canada with the da Vinci robotic system. Can J Surg. 2006;49(3):193–6.PubMed

10.

Meehan JJ, Elliott S, Sandler A. The robotic approach to complex hepatobiliary anomalies in children: preliminary report. J Pediatr Surg. 2007;42:2110–4.PubMedCrossRef

11.

Abolhoda A, Livingston DH, Donahoo JS, Allen K. Diagnostic and therapeutic video assisted thoracic surgery (VATS) following chest trauma. Eur J Cardiothorac Surg. 1997;12(3):356–60.PubMedCrossRef

12.

Manlulu AV, Lee TW, Thung KH, Wong R, Yim AP. Current indications and results of VATS in the evaluation and management of hemodynamically stable thoracic injuries. Eur J Cardiothorac Surg. 2004;25(6):1048–53.PubMedCrossRef

13.

Pickard LR, Mattox KL. Thoracic trauma and indications for thoracotomy. In: Mattox KL, Moore EE, Feliciano DV, editors. Trauma. Norwalk: Appleton and Lange; 1980. p. 315–20.

14.

Prabhakar G, Graeber G. Chest Trauma. In: Yim APC, Hazelrigg SR, Izzat MB, Landreneau RJ, Mack MJ, Naunheim KS, editors. Minimal access cardiothoracic surgery. London: WB Saunders; 2000. p. 308–15.

15.

Beall AC Jr, Bricker DL, Crawford HW, Noon GP, De Bakey ME. Considerations in the management of penetrating thoracic trauma. J Trauma. 1968;8:408–17.PubMedCrossRef

16.

Beall AC Jr, Crawford HW, De Bakey ME. Considerations in the management of acute traumatic hemothorax. J Thorac Cardiovasc Surg. 1966;52:351–60.PubMed

17.

Coselli JS, Mattox KL, Beall AC Jr. Reevaluation of early evacuation of clotted hemothorax. Am J Surg. 1984;148:786–90.PubMedCrossRef

18.

Culiner MM, Roe BB, Grimes OF. The early elective surgical approach to the treatment of traumatic hemothorax. J Thorac Cardiovasc Surg. 1959;38:780–97.PubMed

19.

Milfeld DJ, Mattox KL, Beall AC Jr. Early evacuation of clotted hemothorax. Am J Surg. 1978;136:686–92.PubMedCrossRef

20.

Ochsner MG, Rozycki GS, Lucente F, Wherry DC, Champion HR. Prospective evaluation of thoracoscopy for diagnosing diaphragmatic injury in thoracoabdominal trauma: a preliminary report. J Trauma. 1993;34:704–10.PubMedCrossRef

21.

Sosa JL, Pombo H, Puente I, Sleeman D, Ginzburg E, McKinney M, Martin L. Thoracoscopy in the evaluation and management of thoracic trauma. Int Surg. 1998;83:187–9.PubMed

22.

Pons F, Lang-Lazdunski L, de Kerangal X, Chapuis O, Bonnet PM, Jancovici R. The role of videothoracoscopy in management of precordial thoracic penetrating injuries. Eur J Cardiothorac Surg. 2002;22:7–12.PubMedCrossRef

23.

Lang-Lazdunski L, Mouroux J, Pons F, Grosdidier G, Martinod E, Elkaïm D, Azorin J, Jancovici R. Role of videothoracoscopy in chest trauma. Ann Thorac Surg. 1997;63:327–33.PubMedCrossRef

24.

Alexander AD. Impacts of telemation on modern society. In: Proceedings of the First CISM-ITOMM Symposium. 1972; vol. 1, p. 121–36.

25.

Rayman R, Croome K, Galbraith N, McClure R, Morady R, Peterson S, Smith S, Subotic V, Van Wynsberghe A, Primak S. Long-distance robotic telesurgery: a feasibility study for care in remote environments. Int J Med Robot. 2006;2(3):216–24.PubMed

26.

Marescaux J, Leroy J, Gagner M, Rubino F, Mutter D, Vix M, Butner SE, Smith MK. Transatlantic robot-assisted telesurgery. Nature. 2001;413:379–80.PubMedCrossRef

27.

Rayman R, Croome K, Galbraith N, McClure R, Morady R, Peterson S, Smith S, Subotic V, Van Wynsberghe A, Patel R, Primak S. Robotic telesurgery: a real-world comparison of ground- and satellite-based internet performance. Int J Med Robot. 2007;3:111–6.PubMed

28.

Anvari M, McKinley C, Stein H. Establishment of the world’s first telerobotic remote surgical service: for provision of advanced laparoscopic surgery in a rural community. Ann Surg. 2005;241:460–4.PubMedCrossRef

29.

Butner S, Ghodoussi M. Transforming a surgical robot for human telesurgery. IEEE Trans Robot Autom. 2003;19:818–24.CrossRef

30.

Anvari M, Broderick T, Stein H, Chapman T, Ghodoussi M, Birch DW, McKinley C, Trudeau P, Dutta S, Goldsmith CH. The impact of latency on surgical precision and task completion during robotic-assisted remote telepresence surgery. Comput Aided Surg. 2005;10(2):93–9.PubMed

31.

Hanley EJ, Miller BE, Herman BC, Marohn MR, Broderick TJ, Shih SP, Sterbis JR, Doarn CR, Harnett B, Hasser CJ, Talamini MA, Meireles O, Moses GR, Marchessault R, Schenkman NS. Remote stereoscopic robotic telesurgery using the public internet. In: Abstracts of the 10th World Congress of Endoscopic Surgery and the 14th International Congress of the European Association for Endoscopic Surgery, Berlin, Germany, 13–16 September 2006. Surg Endosc. 2007;21(Suppl 13):S1–294.

32.

Rayman R, Primak S, Patel R, Moallem M, Morady R, Tavakoli M, Subotic V, Galbraith N, van Wynsberghe A, Croome K. Effects of latency on telesurgery: an experimental study. Med Image Comput Comput Assist Interv Int Conf Med Image Comput Comput Assist Interv. 2005;8(Pt 2):57–64.

33.

Reznick R, Regehr G, MacRae H, Martin J, McCulloch W. Testing technical skill via an innovative “bench station” examination. Am J Surg. 1997;173(3):226–30.PubMedCrossRef

34.

Rothlin MA, Schob OM, Schlumpf R. Telepresence for the laparoscopic surgeon. In: Zucker KA, editor. Surgical laparoscopy. 2nd ed. New York: Lippincott, Williams & Wilkins; 2001. p. 797–802.

35.

Satava RM, Jones SB. Preparing surgeons for the 21st century. Implications of advanced technologies. Surg Clin North Am. 2000;80:1353–65.PubMedCrossRef

36.

Zajtchuk R, Sullivan GR. Battlefield trauma care: focus on advanced technology. Mil Med. 1995;160:1–7.PubMed

37.

Lee AL, Inculet RI, Fortin D, Malthaner RA. Video assisted thoracic surgery lobectomy—total endoscopic/closed chest dissection: technique and initial results. Can J Surg. 2006;49:29. Abstract #74.

Title: Telesurgical evaluation of stable thoracic trauma patients: a feasibility study
Authors: P. D. Bhatia
D. A. Bottoni
R. A. Malthaner
Publication date: 01-06-2011
Publisher: Springer-Verlag
Published in: European Journal of Trauma and Emergency Surgery / Issue 3/2011
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-011-0094-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Telesurgical evaluation of stable thoracic trauma patients: a feasibility study

Abstract

Background

Study design

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Study design

Results

Conclusions

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