Collecting system percutaneous access using real-time tracking sensors: first pig model in vivo experience

Purpose: Precise needle puncture of the renal collecting system is an essential but challenging step for successful percutaneous nephrolithotomy. We evaluated the efficiency of a new real-time electromagnetic tracking system for in vivo kidney puncture. Materials and Methods: Six anesthetized female pigs underwent ureterorenoscopy to place a catheter with an electromagnetic tracking sensor into the desired puncture site and ascertain puncture success. A tracked needle with a similar electromagnetic tracking sensor was subsequently navigated into the sensor in the catheter. Four punctures were performed by each of 2 surgeons in each pig, including 1 each in the kidney, middle ureter, and right and left sides. Outcome measurements were the number of attempts and the time needed to evaluate the virtual trajectory and perform percutaneous puncture. Results: A total of 24 punctures were easily performed without complication. Surgeons required more time to evaluate the trajectory during ureteral than kidney puncture (median 15 seconds, range 14 to 18 vs 13, range 11 to 16, p ¼ 0.1). Median renal and ureteral puncture time was 19 (range 14 to 45) and 51 seconds (range 45 to 67), respectively (p ¼ 0.003). Two attempts were needed to achieve a successful ureteral puncture. The technique requires the presence of a renal stone for testing. Conclusions: The proposed electromagnetic tracking solution for renal collecting system puncture proved to be highly accurate, simple and quick. This method might represent a paradigm shift in percutaneous kidney access techniques

Collecting system percutaneous access using real-time tracking sensors: first pig model in vivo experience

Purpose: Precise needle puncture of the renal collecting system is an essential but challenging step for successful percutaneous nephrolithotomy. We evaluated the efficiency of a new real-time electromagnetic tracking system for in vivo kidney puncture. Materials and Methods: Six anesthetized female pigs underwent ureterorenoscopy to place a catheter with an electromagnetic tracking sensor into the desired puncture site and ascertain puncture success. A tracked needle with a similar electromagnetic tracking sensor was subsequently navigated into the sensor in the catheter. Four punctures were performed by each of 2 surgeons in each pig, including 1 each in the kidney, middle ureter, and right and left sides. Outcome measurements were the number of attempts and the time needed to evaluate the virtual trajectory and perform percutaneous puncture. Results: A total of 24 punctures were easily performed without complication. Surgeons required more time to evaluate the trajectory during ureteral than kidney puncture (median 15 seconds, range 14 to 18 vs 13, range 11 to 16, p ¼ 0.1). Median renal and ureteral puncture time was 19 (range 14 to 45) and 51 seconds (range 45 to 67), respectively (p ¼ 0.003). Two attempts were needed to achieve a successful ureteral puncture. The technique requires the presence of a renal stone for testing. Conclusions: The proposed electromagnetic tracking solution for renal collecting system puncture proved to be highly accurate, simple and quick. This method might represent a paradigm shift in percutaneous kidney access techniques.

Tribunal Constitucional: hora de cortar nas PPP’s, contratos futuros-swap…

Veja-se aliás a recente indagação formal da Procuradoria-Geral da República junto do Governo para colocar, se necessário for, em Tribunal, todos os contratos futuros swap. A maior parte dos quais com fortes prejuízos para o Estado português. Vide art.s 227º, 334º, 437º, 762º, entre outros, do Código Civil português. Abstract: See moreover the recent formal inquiry of the Attorney General's Office with the Government to place, if necessary, in court, all future swaps. Most of them with heavy losses to the Portuguese State. See art.s 227, 334, 437, 762º, among others, the Portuguese Civil Code.

“Primeiro-Mnistro defende que a investigação, ciência e inovação é ‘decisiva’ para o crescimento económico”…

Afinal, ficamos a saber que a austeridade, tantas vezes chumbada no Tribunal Constitucional, era uma estratégia para investir na Investigação, Ciência e Inovação europeias! É uma boa altura para aumentar, de modo justo e proporcional, todos os orçamentos de todas as universidades e politécnicos portugueses, os quais têm relações privilegiadas com África, Brasil e parte da Ásia, uma evidente mais-valia para a União Europeia! Abstract: After all, we learn that the austerity so often sinker in the Constitutional Court, was a strategy to invest in Research, Science and European Innovation! It is a good time to increase, fair and proportionate manner, all the budgets of all Portuguese universities and polytechnics, which have a special relationship with Africa, Brazil and parts of Asia, an asset apparent to the European Union!

Palavras para os presos e desprezados

Lembremo-nos de vez em quando dos presos, que não se podem manifestar, nem têm sindicato relevante em termos de Estado de Direito social, democrático, livre e verdadeiro. Presos pelas mais diversas razões: desde o crime de roubo sem feridos nem mortos, até aos crimes mais bárbaros. Agora que se fala em perdão por outras razões das quais não queremos falar hoje aqui, logo nos lembramos que o perdão não tem sentido se não houver arrependimento. E logo nos lembramos dos presos também. Somente em Portugal, são milhares. E estão presos neste momento em que escrevemos. Certo que também não nos podemos esquecer das vítimas. Sempre tivemos uma preocupação profunda por estas. § Let us remember from time to time the prisoners, who can not speak or have a relevant union in terms of rule of law social, democratic, free and true. Arrested for various reasons: from the wounded without theft crime or dead, even the most barbaric crimes. Now we talk about forgiveness for other reasons which do not want to speak here today, then we remember that forgiveness is meaningless if there is no repentance. And then we remember the prisoners as well. Only in Portugal, thousands. And we're stuck in this time of writing. Also certain that we can not forget the victims. I have always had a deep concern for these.

Assessment of Laparoscopic Skills Performance: 2D Versus 3D Vision and Classic Instrument Versus New Hand-Held Robotic Device for Laparoscopy

Introduction and Objectives. Laparoscopic surgery has undeniable advantages, such as reduced postoperative pain, smaller incisions, and faster recovery. However, to improve surgeons’ performance, ergonomic adaptations of the laparoscopic instruments and introduction of robotic technology are needed. The aim of this study was to ascertain the influence of a new hand-held robotic device for laparoscopy (HHRDL) and 3D vision on laparoscopic skills performance of 2 different groups, naïve and expert. Materials and Methods. Each participant performed 3 laparoscopic tasks—Peg transfer, Wire chaser, Knot—in 4 different ways. With random sequencing we assigned the execution order of the tasks based on the first type of visualization and laparoscopic instrument. Time to complete each laparoscopic task was recorded and analyzed with one-way analysis of variance. Results. Eleven experts and 15 naïve participants were included. Three-dimensional video helps the naïve group to get better performance in Peg transfer, Wire chaser 2 hands, and Knot; the new device improved the execution of all laparoscopic tasks (P < .05). For expert group, the 3D video system benefited them in Peg transfer and Wire chaser 1 hand, and the robotic device in Peg transfer, Wire chaser 1 hand, and Wire chaser 2 hands (P < .05). Conclusion. The HHRDL helps the execution of difficult laparoscopic tasks, such as Knot, in the naïve group. Three-dimensional vision makes the laparoscopic performance of the participants without laparoscopic experience easier, unlike those with experience in laparoscopic procedures.