Archive for the ‘surgery’ Category

A robot surgeon has been taught to perform a delicate procedure—stitching soft tissue together with a needle and thread—more precisely and reliably than even the best human doctor.

The Smart Tissue Autonomous Robot (STAR), developed by researchers at Children’s National Health System in Washington, D.C., uses an advanced 3-D imaging system and very precise force sensing to apply stitches with submillimeter precision. The system was designed to copy state-of-the art surgical practice, but in tests involving living pigs, it proved capable of outperforming its teachers.

Currently, most surgical robots are controlled remotely, and no automated surgical system has been used to manipulate soft tissue. So the work, described today in the journal Science Translational Medicine, shows the potential for automated surgical tools to improve patient outcomes. More than 45 million soft-tissue surgeries are performed in the U.S. each year. Examples include hernia operations and repairs of torn muscles.

“Imagine that you need a surgery, or your loved one needs a surgery,” says Peter Kim, a pediatric surgeon at Children’s National, who led the work. “Wouldn’t it be critical to have the best surgeon and the best surgical techniques available?”

Kim does not see the technology replacing human surgeons. He explains that a surgeon still oversees the robot’s work and will take over in an emergency, such as unexpected bleeding.

“Even though we take pride in our craft of doing surgical procedures, to have a machine or tool that works with us in ensuring better outcome safety and reducing complications—[there] would be a tremendous benefit,” Kim says. The new system is an impressive example of a robot performing delicate manipulation. If robots can master human-level dexterity, they could conceivably take on many more tasks and jobs.

STAR consists of an industrial robot equipped with several custom-made components. The researchers developed a force-sensitive device for suturing and, most important, a near-infrared camera capable of imaging soft tissue in detail when fluorescent markers are injected.

“It’s an important result,” says Ken Goldberg, a professor at UC Berkeley who is also developing robotic surgical systems. “The innovation in 3-D sensing is particularly interesting.”

Goldberg’s team is developed surgical robots that could be more flexible than STAR because instead of being manually programmed, they can learn automatically by observing expert surgeons. “Copying the skill of experts is really the next step here,” he says.

https://www.technologyreview.com/s/601378/nimble-fingered-robot-outperforms-the-best-human-surgeons/

Thanks to Kebmodee for bringing this to the It’s Interesting community.

by Andrew Griffin

The scientist who claims to be about to carry out the first human head transplant says that he has successfully done the procedure on a monkey.

Maverick neurosurgeon Sergio Canavero has tested the procedure in experiments on monkeys and human cadavers, he told New Scientist.

Dr Canavero says that the success shows that his plan to transplant a human’s head onto a donor body is in place. He says that the procedure will be ready before the end of 2017 and could eventually become a way of treating complete paralysis.

“I would say we have plenty of data to go on,” Canavero told New Scientist. “It’s important that people stop thinking this is impossible. This is absolutely possible and we’re working towards it.”

The team behind the work has published videos and images showing a monkey with a transplanted head, as well as mice that are able to move their legs after having their spinal cords severed and then stuck back together.

Fusing the spinal cord of a person is going to be key to successfully transplanting a human head onto a donor body. The scientists claim that they have been able to do so by cleanly cutting the cord and using polyethylene glycol (PEG), which can be used to preserve cell membranes and helps the connection recover.

The monkey head transplant was carried out at Harbin Medical University in China, according to Dr Canavero. The monkey survived the procedure “without any neurological injury of whatever kind,” the surgeon said, but that it was killed 20 hours after the procedure for ethical reasons.

It isn’t the first time that a successful transplant has been carried out on a monkey. Head transplant pioneer Robert J White successfully carried out the procedure in 1970, on a monkey that initially responded well but died after nine days when the body rejected the head.

https://en.wikipedia.org/wiki/Robert_J._White

The newly-revealed success is likely to be an attempt to help generate funds for the ultimate aim of giving a head transplant to Valery Spriridonov, the Russian patient who has been chosen to be the first to undergo the procedure. Dr Canavero has said that he will need a huge amount of money to fund the team of surgeons and scientists involved, and that he intends to ask Mark Zuckerberg to help fund it.

While the scientists behind the procedure have published the pictures and the videos, they haven’t yet made any of their work available for critique from fellow scientists. That has led some to criticise the claims, arguing that it is instead “science through PR”, and an attempt to drum up publicity and distract people from “good science”.

Peers have criticised the maverick scientist for making the claims without allowing them to be reviewed or checked out. But Dr Canavero claims that he will be publishing details from the study in journals in the coming months.

http://www.independent.co.uk/news/science/head-transplant-has-been-successfully-done-on-a-monkey-maverick-neurosurgeon-sergio-canavero-claims-a6822361.html

Thanks to Kebmodee for bringing this to the It’s Interesting community.

 

Roger Batchelder knows what it means to be truly thankful.

The 74-year-old LaPorte City, Iowa, retired fire fighter has been a patient at University of Iowa Hospitals and Clinics since Halloween, when a tree-cutting accident resulted in the complete removal of his right hand and wrist.

Thanks to the quick action of paramedics on the scene, the air ambulance crew, UI Hospitals and Clinics plastic surgeons Jerrod Keith, MD and Brad Coots, MD, orthopedic surgeon Todd McKinley, MD, and a full complement of emergency department and surgical personnel, Batchelder’s hand was saved and reattached, and he may regain some use eventually.

“Words don’t even express how grateful I am,” says Batchelder. “The fact that the doctor assembled his surgical team so quickly sped the whole thing up and helped save my hand.”

Keith and Coots led a surgical team that worked for eight hours to reattach Batchelder’s hand, as well as reconnecting tissue, muscle, nerves and tendons.

“We quickly and efficiently talked to Roger in the emergency department to let him know what his options were,” Keith said.

He said they told Batchelder they could reattach the hand but there would be risks: it was a long surgery, there was no guarantee the hand would regain any function and because the surgery would cause a large loss of blood and need for transfusion, it could be potentially life-threatening.

“I didn’t even have to think about it,” Batchelder said. “For me, I thought it would be better than a hook.”

Accident in the field

Batchelder was helping a friend prepare a field to be cleared for farming in the early afternoon of Oct. 31. He said there were about eight trees that had to be cut before the bulldozer could come in to remove the stumps, and they had to be cleared that day.

“When I started there wasn’t much wind at all,” he says. “A bit later I noticed the wind started to pick up so I adjusted my work a little.”

Batchelder is experienced with a chain saw and has been clearing trees and brush from areas for years. When it’s time to remove a tree he cuts a wedge on the side of the tree that will bend and fall, and cuts a pair of slices in the other side to help it along.

He had already gotten five trees down, but the sixth tree was being a bit difficult. Usually when he cuts the wedge, he says, the tree starts to move toward the fall. This time, however, the tree didn’t budge. He went to the other side and cut the slits – but nothing happened.

“The wind was blowing the wrong direction, it was kind of holding the tree up,” Batchelder says.

That lasted just a few seconds before things suddenly turned dangerous. The tree started falling toward the slits rather than the wedge – and right toward where Batchelder was standing.

“I saw the tree starting to come at me so I started to back up,” he says.

He backed up to get away from the tree but stepped in a hole and got stuck. The tree, he said, fell on his arm, right above his wrist. He thought the tree crushed his arm against the stump.

“The tree hit me in the chest and I fell to the ground. I pitched the chain saw off to the side so I wouldn’t land on it,” he says.

Batchelder’s wife, Patty, was just a few yards away with the couple’s truck when she saw the tree begin to fall. She immediately drove over to where he husband was lying.

“There was the tree, the chainsaw, Roger and there, by the tree, was his hand,” she says.

Roger Batchelder never lost consciousness. His wife applied pressure and told him to hold it, and she drove to a neighbor’s house to call 911.

“We didn’t have cell phones with us,” she said.

At the hospital

Keith said Patty Batchelder’s quick thinking, the air ambulance crew salvaging the hand and keeping it on ice and the inclusive nature of UI Hospitals and Clinics, which allowed him to pull a surgical team together within minutes, combined to make reattachment possible.

“You typically have a five- to six-hour window from time of trauma to surgery to have a successful reattachment of the forearm,” he says. “The longer it is kept on ice, the better the chances.”

Though amputated fingers and even hands have a longer window of time before surgery, the fact that this included part of the forearm complicated the surgery, Keith said, and shortened that time availability. While Batchelder was still in the emergency department, Keith and Coots took the hand to the operating room to begin preparing it for surgery, which included identifying all of the nerves, tendons, and tissues.

“The team atmosphere makes this successful and possible,” Keith says. “That is the key to success, having everyone involved.”

Though Roger Batchelder’s age could have been detrimental to the procedure, his health and activity level aided in the successful surgery, as well.

“He’s out there cutting down trees and farming,” Keith says. “As soon as I saw him I knew he could handle it.”

Batchelder’s first surgery was immediate and lasted a little more than eight hours. He’s had two more surgeries to remove dead tissue.

Keith is optimistic that the reattachment was a success, but says he’s not sure how much use Batchelder will get from the hand even after physical therapy.

“We’ll start looking at rehabilitation and what kind of function he may get back,” Keith says.

Batchelder isn’t concerned with the level of use he will get from his hand, he’s just glad to have it reattached.

“Anything that nature gives you is better than something that’s made by man,” he says. “Even though I may not be able to use it as it used to be, I’ll be able to use it as it was meant to be.”

http://www.uihealthcare.org/Newsarticle.aspx?id=236423