CA : A Cancer Journal for Clinicians

A loading unit for use with a surgical stapling apparatus is provided and includes a tool assembly having a cartridge assembly and an anvil assembly that are movable in relation to one another; a surgical buttress releasably secured to a tissue contacting surface of the anvil assembly and/or the cartridge assembly, wherein each surgical buttress is secured to the anvil assembly and/or the cartridge assembly by at least one anchor; a release assembly associated with the anvil assembly and/or the cartridge assembly; and a drive assembly slidably translatable through the tool assembly between proximal and distal positions, wherein the drive assembly actuates the release assembly to thereby release the anchor to free the surgical buttress from the anvil assembly and/or the cartridge assembly.

Surgical Stapling Apparatus

An apparatus for forming an anastomosis between adjacent intestinal sections of tissue is provided. The apparatus includes a circular surgical stapler having an anvil assembly with an anvil shaft and an anvil, the circular surgical stapler further having a tubular body portion with an annular knife and a body portion shaft selectively attachable to the anvil shaft; and a seal structure for deposition between the intestinal sections of tissue including a hub configured to engage attachment structure on at least one of the anvil shaft and the body portion shaft. The attachment structure is positioned so that the seal structure is located between the intestinal sections of tissue when the circular surgical stapler is disposed within the intestinal sections of tissue.

Annular adhesive structure

Multilayer structures including a porous layer and a non-porous layer are useful as buttresses when associated with a surgical stapling apparatus.

Buttress and surgical stapling apparatus

A surgical stapling instrument is provided having systems for securing buttress material to the anvil and staple containing cartridge associated with the surgical instrument. The system includes a retainer configured to engage the anvil or the staple containing cartridge and capture the buttress material between the retainer and the anvil or staple containing cartridge. The disclose retainer engages the anvil or staple containing cartridge in snap fit or friction fit fashion. The buttress material includes a circumferential perforation line enabling the center of the buttress material to be stapled to tissue while the remainder of the buttress material remains with the anvil or staple containing cartridge.

Staple buttress retention system

Aims Proof of concept and feasibility study for preoperative diagnostic use of mixed reality (MR) holograms of individual 3D heart models from standard cardiac computed tomography angiograms (CTA) images. Optimal repair for complex congenital heart disease poses high demands on 3D anatomical imagination. Three-dimensional printed heart models are increasingly used for improved morphological understanding during surgical and interventional planning. Holograms are a dynamic and interactive alternative, probably with wider applications. Methods and results A 3D heart model was segmented from CTA images in a patient with double outlet right ventricle and transposition of the great arteries (DORV-TGA). The hologram was visualized in the wearable MR platform HoloLens® for 36 paediatric heart team members who filled out a diagnostic and quality rating questionnaire. Morphological and diagnostic output from the hologram was assessed and the 3D experience was evaluated. Locally developed app tools such as hologram rotation, scaling, and cutting were rated. Anatomy identification and diagnostic output was high as well as rating of 3D experience. Younger and female users rated the app tools higher. Conclusion This preliminary study demonstrates that MR holograms as surgical planning tool for congenital heart disease may have a high diagnostic value and contribute to understanding complex morphology. The first users experience of the hologram presentation was found to be very positive, with a preference among the female and the younger users. There is potential for improvement of the hologram manipulation tools.

/pdf/mixed-reality-holograms-for-heart-surgery-planning-first-5ah76wf4ch.pdf

Mixed reality holograms for heart surgery planning: first user experience in congenital heart disease

The use of robots in health care has increased dramatically over the last decade. One area of research has been to use robots to conduct ultrasound examinations, either controlled by a physician or autonomously. This paper examines the possibility of using the commercial robot UR5 from Universal Robots to make a tele-operated robotic ultrasound system. Physicians diagnosing patients using ultrasound probes are prone to repetitive strain injuries, as they are required to hold the probe in uncomfortable positions and exert significant static force. The main application for the system is to relieve the physician of this strain by letting the them control a robot that holds the probe. A set of requirements for the system is derived from the state-of-the-art systems found in the research literature. The system is developed through a low-level interface for the robot, effectively building a new software framework for controlling it. Compliance force control and forward flow haptic control of the robot was implemented. Experiments are conducted to quantify the performance of the two control schemes. The force control is estimated to have a bandwidth of 16.6 Hz, while the haptic control is estimated to have a bandwidth of 65.4 Hz for the position control of the slave and 13.4 Hz for the force control of the master. Overall, the system meets the derived requirements and the main conclusion is that it is feasible to use the UR5 robot for robotic ultrasound applications.

/pdf/an-ultrasound-robotic-system-using-the-commercial-robot-ur5-59m3e6mwiu.pdf

An Ultrasound Robotic System Using the Commercial Robot UR5

Pablo Lamata1,2, Wajid Ali3, Alicia Cano1, Jordi Cornella3, Jerome Declerck2, Ole J. Elle3, Adinda Freudenthal4, Hugo Furtado5, Denis Kalkofen6, Edvard Naerum3, Eigil Samset3, Patricia Sanchez-Gonzalez1, Francisco M. Sanchez-Margallo7, Dieter Schmalstieg6, Mauro Sette8, Thomas Studeli4, Jos Vander Sloten8 and Enrique J. Gomez1 1Universidad Politecnica de Madrid, Spain 2Siemens, United Kingdom 3University of Oslo, Norway 4Delft University of Technology, Netherlands 5Medical Centre Ljubljana, Slovenia 6 Graz University of Technology, Austria 7Minimally Invasive Surgery Centre Jesus Uson, Spain 8University of Leuven, Belgium

/pdf/augmented-reality-for-minimally-invasive-surgery-overview-1cdv92bibb.pdf

Augmented Reality for Minimally Invasive Surgery: Overview and Some Recent Advances

Supplementary Material: An Ultrasound Robotic System Using the Commercial Robot UR5

We have used acceleration sensors to monitor the heart motion during surgery A three-axis accelerometer was made from two commercially available two-axis sensors, and was used to measure the heart motion in anesthetized pigs The heart moves due to both respiration and heart beating The heart beating was isolated from respiration by high-pass filtering at 10 Hz, and heart wall velocity and position were calculated by numerically integrating the filtered acceleration traces The resulting curves reproduced the heart motion in great detail, noise was hardly visible Events that occurred during the measurements, eg arrhythmias and fibrillation, were recognized in the curves, and confirmed by comparison with synchronously recorded ECG data We conclude that acceleration sensors are able to measure heart motion with good resolution, and that such measurements can reveal patterns that may be an indication of heart circulation failure

Ole Jakob Elle

Papers

Mixed reality holograms for heart surgery planning: first user experience in congenital heart disease

An Ultrasound Robotic System Using the Commercial Robot UR5

Augmented Reality for Minimally Invasive Surgery: Overview and Some Recent Advances

Supplementary Material: An Ultrasound Robotic System Using the Commercial Robot UR5

Measurements of heart motion using accelerometers