Quoi de neuf en chirurgie [Novelties in surgery in 2013?].

Multidisciplinary management of colorectal liver metastases allows an increase of about 20% in the resection rate of liver metastases. It includes chemotherapy, interventional radiology and surgery. In 2013, the preliminary results of the in-situ split of the liver associated with portal vein ligation (ALLPS) are promising with unprecedented mean hypertrophy up to 70% at day 9. However, the related morbidity of this procedure is about 40% and hence should be performed in the setting of study protocol only. For pancreatic cancer, the future belongs to the use of adjuvant and neo adjuvant therapies in order to increase the resection rate. Laparoscopic and robot-assisted surgery is still in evolution with significant benefits in the reduction of cost, hospital stay, and postoperative morbidity. Finally, enhanced recovery pathways (ERAS) have been validated for colorectal surgery and are currently assessed in other fields of surgery like HPB and upper GI surgery.

"Yo, robot" o las tribulaciones de un robot kantiano

Las tres leyes de la robótica no son más que los principios esenciales de una gran cantidad de sistemas éticos del mundo... ¿qué aspectos bioéticos nos devela esta película?.

Laparoscopie abdominale: possibilités et limites [Abdominal laparoscopy: an update]

Laparoscopic surgery has become a standard approach for many interventions, including oncologic surgery. Laparoscopic instruments have been developed to allow advanced surgical procedure. Imaging and computer assistance in virtual reality or robotic procedure will certainly improve access to this surgery.

Totally implantable robot to treat chronic atrial fibrillation

Chronic atrial fibrillation affects millions of people worldwide. Its surgical treatment often fails to restore the transport function of the atrium. This study first introduces the concept of an atrial assist device (AAD) to restore the pump function of the atrium. The AAD is developed to be totally implantable in the human body with a transcutaneous energy transfer system to recharge the implanted battery. The ADD consists of a motorless pump based on artificial muscle technology, positioned on the external surface of the atrium to compress it and restore its muscular activity. A bench model reproduces the function of a fibrillating atrium to assess the circulatory support that this pump can provide. Atripump (Nanopowers SA, Switzerland) is a dome-shaped silicone-coated nitinol actuator 5 mm high, sutured on the external surface of the atrium. A pacemaker-like control unit drives the actuator that compresses the atrium, providing the mechanical support to the blood circulation. Electrical characteristics: the system is composed of one actuator that needs a minimal tension of 15 V and has a maximum current of 1.5 A with a 50% duty cycle. The implantable rechargeable battery is made of a cell having the following specifications: nominal tension of a cell: 4.1 V, tension after 90% of discharge: 3.5 V, nominal capacity of a cell: 163 mA h. The bench model consists of an open circuit made of latex bladder 60 mm in diameter filled with water. The bladder is connected to a vertically positioned tube that is filled to different levels, reproducing changes in cardiac preload. The Atripump is placed on the outer surface of the bladder. Pressure, volume and temperature changes were recorded. The contraction rate was 1 Hz with a power supply of 12 V, 400 mA for 200 ms. Preload ranged from 15 to 21 cm H(2)O. Maximal silicone membrane temperature was 55 degrees C and maximal temperature of the liquid environment was 35 degrees C. The pump produced a maximal work of 16 x 10(-3) J. Maximal volume pumped was 492 ml min(-1). This artificial muscle pump is compact, follows the Starling law and reproduces the hemodynamic performances of a normal atrium. It could represent a new tool to restore the atrial kick in persistent atrial fibrillation.

Applications de la chirurgie robotique transorale dans les tumeurs de la sphère ORL [The role of transoral robotic surgery in head and neck cancer].

Since 2000 and the commercialisation of the Da Vinci robotic system, indications for robotic surgery are rapidly increasing. Recent publications proved superior functional outcomes with equal oncologic safety in comparison to conventional open surgery. Its field of application may extend to the nasopharynx and skull base surgery. The preliminary results are encouraging. This article reviews the current literature on the role of transoral robotic surgery in head and neck cancer.

Improvement of rehabilitation possibilities with the MotionMaker (TM)

"MotionMaker (TM)" is a stationary programmable test and training system for the lower limbs developed at the 'Ecole Polytechnique Federale de Lausanne' with the 'Fondation Suisse pour les Cybertheses'.. The system is composed of two robotic orthoses comprising motors and sensors, and a control unit managing the trans-cutaneous electrical muscle stimulation with real-time regulation. The control of the Functional Electrical Stimulation (FES) induced muscle force necessary to mimic natural exercise is ensured by the control unit which receives a continuous input from the position and force sensors mounted on the robot. First results with control subjects showed the feasibility of creating movements by such closed-loop controlled FES induced muscle contractions. To make exercising with the MotionMaker (TM) safe for clinical trials with Spinal Cord Injured (SCI) volunteers, several original safety features have been introduced. The MotionMaker (TM) is able to identify and manage the occurrence of spasms. Fatigue can also be detected and overfatigue during exercise prevented.

Closed loop electrical muscle stimulation in spinal cord injured rehabilitation

The effect of motor training using closed loop controlled Functional Electrical Stimulation (FES) on motor performance was studied in 5 spinal cord injured (SCI) volunteers. The subjects trained 2 to 3 times a week during 2 months on a newly developed rehabilitation robot (MotionMaker?). The FES induced muscle force could be adequately adjusted throughout the programmed exercises by the way of a closed loop control of the stimulation currents. The software of the MotionMaker? allowed spasms to be detected accurately and managed in a way to prevent any harm to the SCI persons. Subjects with incomplete SCI reported an increased proprioceptive awareness for motion and were able to achieve a better voluntary activation of their leg muscles during controlled FES. At the end of the training, the voluntary force of the 4 incomplete SCI patients was found increased by 388% on their most affected leg and by 193% on the other leg. Active mobilisation with controlled FES seems to be effective in improving motor function in SCI persons by increasing the sensory input to neuronal circuits involved in motor control as well as by increasing muscle strength.

Experimental Results and Evaluation of SmartBox Stimulation Device in a P2P E-learning System

In this paper, we present the experimental results and evaluation of the SmartBox stimulation device in P2P e-learning system which is based on JXTA-Overlay. We also show the design and implementation of the SmartBox environment that is used for stimulating the learners motivation to increase the learning efficiency. The SmartBox is integrated with our P2P system as a useful tool for monitoring and controlling learners¿ activity. We found by experimental results that the SmartBox is an effective way to increase the learner¿s concentration. We also investigated the relation between learner¿s body movement, concentration, and amount of study. From the experimental results, we conclude that the use of SmartBox is an effective way to stimulate the learners in order to continue studying while maintaining the concentration.

Contact force transitions in regrasp tasks of planar objects

This paper presents a simple and fast solution to the problem of finding the time variations of the forces that keep the object equilibrium when a finger is removed from a three contact point grasp or a finger is added to a two contact point grasp, assuming the existence of an external perturbation force (that can be the object weight itself). The procedure returns force set points for the control system of a manipulator device in a regrasping action. The approach was implemented and a numerical example is included in the paper to illustrate how it works.

Kaukokäyttöliittymä liikkuvalle robotille

Lappeenrannan teknillinen yliopiston Tietotekniikan osaston Tietojenkäsittelytieteen laitoksen tutkimuskäytössä olevaan liikkuvaan robottiin toteutettiin tässä työssä graafinen kaukokäyttöliittymä. Työlle on motivaationa laajennettavuus, jota olemassaoleva suljetun lähdekoodin käyttöliittymä ei pysty tarjoamaan. Työssä olennaisin on olio-ohjelmointitekniikalla toteutettu robotin datamallin, ja sen graafisen esityksen arkkitehtuurillinen erottaminen. Lisäksi tarkastellaan lyhyesti liikkuvien robottien kaukokäyttöliittymien teoriaa, ja WLAN-tekniikan soveltuvuutta robotin ja käyttöliittymän välisen yhteyden toteuttamiseen.

Scene representation for object monitoring

In robotics, having a 3D representation of the environment where a robot is working can be very useful. In real-life scenarios, this environment is constantly changing for example by human interaction, external agents or by the robot itself. Thus, the representation needs to be constantly updated and extended to account for these dynamic scene changes. In this work we face the problem of representing the scene where a robot is acting. Moreover, we ought to improve this representation by reusing the information obtained in previous scenes. Our goal is to build a method to represent a scene and to update it while changes are produced. In order to achieve that, different aspects of computer vision such as space representation or feature tracking are discussed

Design of adjustable packaging line

Diplomityön tavoite oli tutkia, mitä toimintoja ja tekniikoita uusi, joustava kartonkipakkauslinja sisältää ja mitkä suuntaukset pakkausteollisuudessa tulevat olemaan tärkeitä tulevaisuudessa. Pakkauslinjan päätoimintoja tarkasteltiin nykyisten jatulevaisuuden tekniikoiden pohjalta. Erityisesti tarkasteltiin laser-sovellusten käytön mahdollisuutta pakkauslinjan eri osatoiminnoissa. Katsaus pakkausteollisuuden tulevaisuuden näkymiin luotiin kirjallisuuden ja aikaisempien tutkimusten pohjalta, minkä perusteella työssä oletetaan, että yksilölliset ja monitoimipakkaukset tulevat lisääntymään tulevaisuudessa. Eri tuotantoerien välillä olevat asetusajat tulee saada minimoitua, mutta millä keinoin joustavuus on saavutettavissa? Yksi ratkaisu pakkausten valmistamisessa on käyttää robottisolua, mikä on mahdollista luultavasti ainakin kuppimuotoisten pakkausten kohdalla. Muutenkin robotiikka on lisääntymässä pakkausteollisuudessa. Digitaalisten painotekniikoiden kehitys on mahdollistanut yksilölliset painatukset. Tulevaisuudessa painatus on mahdollista tehdä pakkauslinjan loppupäässä, jopa vasta täytön ja suljennan jälkeen. Laserleikkaus on jo nyt käytössä, mutta tulevaisuudessa myös saumaus ja perinteinen nuuttaus on mahdollista tehdä lasersovelluksia käyttäen. Kehittynyt, väyläpohjainen ohjausjärjestelmä on tulevaisuudessa välttämätön joustavassa pakkauslinjassa. Internetin välityksellä toimiva etäohjattu virheenkorjausdiagnostiikka tulee myös olemaan itsestäänselvyys tulevaisuudessa. Kustannussäästöjä voidaan saavuttaa käyttämälläpakkauslinjassa modulaarista rakennetta. Standardiosien ja standardiosajärjestelmien käyttäminen pienentää myös käyttö- ja huoltokustannuksia. Tärkeää on kuitenkin muistaa, ettei joustavuutta voida saavuttaa pelkästään yhtä ominaisuutta tai tekniikkaa hyödyntäen vaan monia menetelmiä yhdistäen. Suunniteltavan pakkauslinjan toiminta on myös hyvä varmistaa käyttäen apuna mallinnusta ja simulointia.

Ambient intelligence application based on environmental measurements performed with an assistant mobile robot

This paper proposes the use of an autonomous assistant mobile robot in order to monitor the environmental conditions of a large indoor area and develop an ambient intelligence application. The mobile robot uses single high performance embedded sensors in order to collect and geo-reference environmental information such as ambient temperature, air velocity and orientation and gas concentration. The data collected with the assistant mobile robot is analyzed in order to detect unusual measurements or discrepancies and develop focused corrective ambient actions. This paper shows an example of the measurements performed in a research facility which have enabled the detection and location of an uncomfortable temperature profile inside an office of the research facility. The ambient intelligent application has been developed by performing some localized ambient measurements that have been analyzed in order to propose some ambient actuations to correct the uncomfortable temperature profile.

Mobile robot localization using sonar ranging and wlan intensity maps

 Main goal of this thesis was to implement a localization system which uses sonars and WLAN intensity maps to localize an indoor mobile robot. A probabilistic localization method, Monte Carlo Localization is used in localization. Also the theory behind probabilistic localization is explained. Two main problems in mobile robotics, path tracking and global localization, are solved in this thesis. Implemented system can achieve acceptable performance in path tracking. Global localization using WLAN received signal strength information is shown to provide good results, which can be used to localize the robot accurately, but also some bad results, which are no use when trying to localize the robot to the correct place. Main goal of solving ambiguity in office like environment is achieved in many test cases.