The last decades, when robots have appeared in the operating room, showed the possibility of surgery enhancement by improving precision, repeatability, stability and dexterity. However, taking into consideration still existing limitations of robotics in surgery, and treating the robots as medical devices with the highest degree of safety level requirements, one must take a number of complex actions when preparing the experimental clinical application of a new modern robot Robin Heart. Presented paper describes the current state of procedures carried out in the Robin Heart project of surgery robots prepared for clinical application. Based on experiences with the devices existing on the market and, first of all, thanks to knowledge and expertise gained by our team during last 12 years, intensive work are currently done in order to introduce both mechanical and electronic modifications as well as to improve the safety system. As far as human resources are concerned, a professional team able to carry out the robot-supported surgery is prepared based on the created system of technical and functional trainings on simulation stands, which also includes the developed operation planning procedures. The first telemanipulator designed for clinical practice is the Robin Heart Vision – endoscopic system manipulator.
Introduction: The prolongation of the life of men results in the growing number of people suffering from benign prostatic hyperplasia (BPH). In 2010, BPH concerned more than 200 million men in the whole world, which at that time made up 6% of the population of men at large. Currently, the population of men in the world amounts about three billion six hundred million. The modern surgical treatment of BPH consists of minimally invasive techniques, including laser systems.
Aim: Evaluation of the eff ectiveness of photoselective vaporization of the prostate (PVP) on the basis of subjective parameters assessed by patients using IPSS and QoL questionnaires as well as objective parameters obtained from results of urodynamic tests.
Material and Methods: Between 2012 and 2015, 120 patients with benign prostatic hyperplasia were included in the study and underwent PVP. Finally, 77 patients were included in the study. In all patients, IPSS and QoL sheets were carried out 1, 6 and 12 months, and urodynamic tests 12 months after the surgical treatment.
Results: The statistically signifi cant change in the value of each parameter assessed: decrease in the IPSS, QoL, PVR, Pmax, Pop, the degree of obstruction according to Schäfer and ICS nomogram, and an increase in the values of Qmax and Qave.
Conclusions: Photoselective vaporization of the prostate is an eff ective method of therapy in patients with benign prostatic hyperplasia.
Dr. Artur Binda, a bariatric surgeon from the Orłowski Independent Public Teaching Hospital in Warsaw, discusses bariatric surgery procedures, frequently the only treatment for patients with life-threatening obesity.
The use of hyperbaric oxygen therapy (HBOT) is an accepted method of supporting wound healing in human medicine. Yet, because of the risk of complications associated with HOBT, a safer modification of the therapy, known as L-HOBT (lower pressure and lower oxygen concen- tration), is increasingly used nowadays. Therefore, due to the lack of literature reports regarding the clinical use of L-HBOT in animals, the authors decided to present the results of L-HBOT supportive treatment of postoperative wounds after hemimastectomy compared to classic treat- ment. The study group included 12 bitches divided into two groups: group A (assisted L-HBOT) and group B (classic treatment). In addition to conventional treatment, the supportive therapy included 1.5 hours of hyperbaric chamber therapy for 5 consecutive days, starting 24 hours after surgery (1500hPa pressure and 26% oxygen concentration in the chamber). The patients were followed and evaluated throughout the course of the treatment by two independent doctors. The results of the treatment revealed no negative clinical impact of L-HOBT supportive therapy on the body of the animals. At the same time, postoperative wounds after L-HOBT healed faster and with fewer postoperative complications compared to the control group. This resulted in a shorter treatment period, terminating with an earlier skin suture removal.
The purpose of this study was to investigate the effect of tramadol (TM) (2 mg/kg) administered intramuscularly (IM) followed by a constant rate infusion (CRI) of TM (2 mg/kg/h) in pigs. Sixteen pigs undergoing experimental surgery were premedicated IM with a combination of alfaxalone (5 mg/kg) and midazolam (0.5 mg/kg). Anaesthesia was induced with propofol (2 mg/kg) intravenously (IV) and maintained with isoflurane. Pigs were randomly assigned to one of the two following groups: Group 1 (n=8): received a loading dose of TM (2 mg/kg) followed by a CRI of TM (2 mg/kg/h); Group 2 (n=8): a loading dose of TM (2 mg/kg) followed by a CRI of lactated Ringer’s solution (2 ml/kg/h). Heart rate (HR), respiratory rate (RR), rectal temperature (RT), haemoglobin oxygen saturation (SpO2), fraction of inspired oxygen (FIO2), end-tidal concentration of isoflurane (FEISO), end-tidal carbon dioxide concentration (FECO2), pH, arterial oxygen partial pressure (PaO2), arterial carbon dioxide partial pressure (PaCO2) and bicarbonate concentration (HCO3-) were recorded immediately after loss of righting reflex (T=0 min) and at 15-min intervals over a period of 60 min. Continuous data were analysed using a repeated-measure analysis of variance (ANOVA) and a p-value <0.05 was considered significant. HR, RR and FEISO were significantly lower (p<0.05) in Group 1 at T30 and T45, which corresponded to the time of the most intense surgical stimulation. The results suggest that the TM infusion minimizes the HR and RR response, slightly reducing isoflurane requirements and determining a superior perioperative analgesia.
Coronaviruses present a considerable concern for humans and animals. The current world- wide pandemic of SARS-CoV-2 virus showed many gaps in understanding of coronaviruses spread and transmission. Because of lack of effective vaccine against SARS-CoV-2 the only preventive measures are represented by wearing protective masks and gloves thus limiting potential risk of contact with the airborne virus. Inversely, the limited time of protective function of the masks presents another drawback of their use. Therefore, the application of disinfection agent dispersed on the surface of protective masks may enhance their effectivity and safety of their application. The aim of the study was to examine the virucidal efficacy of low-concentra- ted sodium hypochlorite dispersed using ultrasonic humidifier on the surface of surgery masks. The study was conducted using SARS-CoV-2 surrogate virus, namely porcine epidemic diarrhea virus (PEDV) representing a model with similar biophysical properties and genomic structure to human coronaviruses. Five different concentrations of the disinfectant with different content of sodium hypochlorite were selected for the study. A final concentration of 0.228 g/L sodium hypochlorite effectively inactivated the PED virus and may support the biosafety of masks usage.