This paper examines the literature on computer games and serious games in regard to the potential positive impacts of gaming on users aged 14 years or above, especially with respect to learning, skill enhancement and engagement. Search terms identified 129 papers reporting empirical evidence about the impacts and outcomes of computer games and serious games with respect to learning and engagement and a multidimensional approach to categorizing games was developed. The findings revealed that playing computer games is linked to a range of perceptual, cognitive, behavioural, affective and motivational impacts and outcomes. The most frequently occurring outcomes and impacts were knowledge acquisition/content understanding and affective and motivational outcomes. The range of indicators and measures used in the included papers are discussed, together with methodological limitations and recommendations for further work in this area.

A systematic literature review of empirical evidence on computer games and serious games

A surgical stapling device particularly suited for endoscopic procedures is described The device includes a handle assembly and an elongated body extending distally from the handle assembly The distal end of the elongated body is adapted to engage a disposable loading unit A control rod having a proximal end operatively connected to the handle assembly includes a distal end extending through the elongated body A control rod locking member is provided to prevent movement of the control rod until the disposable loading unit is fully secured to the elongated body of the stapling device

Surgical Stapling Apparatus

A surgical stapling instrument (1) comprises a body portion (2, 3), a handle (4) and a staple fastening assembly (8). The staple fastening assembly (8) includes a curved cartridge (10), which comprises at least one curved open row of staples, and a curved anvil (22), which is adapted to cooperate with the cartridge (10) for forming the ends of the staples exiting from the cartridge (10). The staple fastening assembly (8) is adapted to allow unobstructed access towards the concave inner faces of the cartridge (10) and the anvil (22). The cartridge (10) can be moved towards the anvil (22) from a spaced position for positioning tissue therebetween to a closed position for clamping the tissue. Preferably, a knife is contained within the cartridge (10) and is positioned such that there is at least one row of staples on at least one side of the knife.

Surgical stapling instrument

Newness and distinctiveness is claimed in the features of ornamentation as shown inside the broken line circle in the accompanying representation.

Display screen or portion thereof with graphical user interface

A surgical instrument can comprise a channel configured to support a staple cartridge and, in addition, an anvil pivotable between open and closed positions relative to the channel. The surgical instrument can further comprise a cutting member configured to incise tissue positioned captured between the staple cartridge and the anvil and, in addition, means for stopping the cutting member prior to a distal end datum, wherein the distal end datum can be defined by the distal-most staple cavity in the staple cartridge. In such embodiments, the incision within the tissue may not extend beyond the portion of the tissue that has been stapled.

Surgical stapling instrument with an articulatable end effector

The present invention provides a system and single or multi-functional element device that can be inserted and temporarily placed or implanted into a structure having a lumen or hollow space, such as a subject's abdominal cavity to provide therewith access to the site of interest in connection with minimally invasive surgical procedures. The insertable device may be configured such that the functional elements have various degrees of freedom of movement with respect to orienting the functional elements or elements to provide access to the site from multiple and different orientations/perspectives as the procedure dictates, e.g., to provide multiple selectable views of the site, and may provide a stereoscopic view of the site of interest.

Insertable device and system for minimal access procedure

Transvaginal laparoscopically assisted endoscopic cholecystectomy: a hybrid approach to natural orifice surgery.

Single port access surgery (SPAS) presents surgeons with added challenges that require new surgical tools and surgical assistance systems with unique capabilities To address these challenges, we designed and constructed a new insertable robotic end-effectors platform (IREP) for SPAS The IREP can be inserted through a O15 mm trocar into the abdomen and it uses 21 actuated joints for controlling two dexterous arms and a stereo-vision module Each dexterous arm has a hybrid mechanical architecture comprised of a two-segment continuum robot, a parallelogram mechanism for improved dual-arm triangulation, and a distal wrist for improved dexterity during suturing The IREP is unique because of the combination of continuum arms with active and passive segments with rigid parallel kinematics mechanisms This paper presents the clinical motivation, design considerations, kinematics, statics, and mechanical design of the IREP The kinematics of coordination between the parallelogram mechanisms and the continuum arms is presented using the pseudo-rigid-body model of the beam representing the passive segment of each snake arm Kinematic and static simulations and preliminary experiment results are presented in support of our design choices

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Design and Coordination Kinematics of an Insertable Robotic Effectors Platform for Single-Port Access Surgery

The skills required for laparoscopic surgery are amenable to simulator-based training. Several computerized devices are now available. We hypothesized that the LAPSIM simulator can be shown to distinguish novice from experienced laparoscopic surgeons, thus establishing construct validity. We tested residents of all levels and attending laparoscopic surgeons. The subjects were tested on eight software modules. Pass/fail (P/F), time (T), maximum level achieved (MLA), tissue damage (TD), motion, and error scores were compared using the t-test and analysis of variance. A total of 54 subjects were tested. The most significant difference was found when we compared the most (seven attending surgeons) and least experienced (10 interns) subjects. Grasping showed significance at P/F and MLA (p < 0.03). Clip applying was significant for P/F, MLA, motion, and errors (p < 0.02). Laparoscopic suturing was significant for P/F, MLA, T, TD, as was knot error (p < 0.05). This finding held for novice, intermediate, and expert subjects (p < 0.05) and for suturing time between attending surgeons and residents (postgraduate year [PGY] 1-4) (p < 0.05). LAPSIM has construct validity to distinguish between expert and novice laparoscopists. Suture simulation can be used to discriminate between individuals at different levels of residency and expert surgeons.

Construct validity for the LAPSIM laparoscopic surgical simulator

This paper presents a novel design and preliminary kinematic analysis of an Insertable Robotic Effector Platform (IREP) for Single Port Access (SPA) Surgery. The IREP robot can be deployed into body cavity through a O15mm skin incision to perform SPA procedures. It consists of two snake-like continuum robots as slave surgical assistants for tissue manipulation, two parallelogram mechanisms for the continuum robots' placement, and one controllable stereo vision module with integrated light source for depth perception and tool tracking. Design considerations and alternatives, calculations and preliminary simulations of this 17-DoF surgical robotic system are presented in this paper. The overall control system hierarchy for tele-manipulation using the IREP robot is also presented.

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Dennis L. Fowler

Papers

Insertable device and system for minimal access procedure

Transvaginal laparoscopically assisted endoscopic cholecystectomy: a hybrid approach to natural orifice surgery.

Design and Coordination Kinematics of an Insertable Robotic Effectors Platform for Single-Port Access Surgery

Construct validity for the LAPSIM laparoscopic surgical simulator

System design of an Insertable Robotic Effector Platform for Single Port Access (SPA) Surgery