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Medicina (Kaunas, Lithuania) Mar 2023: Endodontic surgery has evolved over the last two decades. The use of state-of-the-art guided endodontic surgical procedures produces a predictable outcome in the... (Review)
Review
: Endodontic surgery has evolved over the last two decades. The use of state-of-the-art guided endodontic surgical procedures produces a predictable outcome in the healing of lesions of endodontic origin. The main objective of this review paper is to define and characterize guided surgical endodontics as well as its benefits and drawbacks by reviewing the most recent relevant scientific literature. : A literature search was conducted using multiple databases comprising of MEDLINE (via PubMed), EMBASE, and Web of Science. The terms used for the search were 'guided endodontics', 'surgical endodontics', and 'endodontic microsurgery'. : In total, 1152 articles were obtained from the analysis of the databases. Unrelated articles from the available full text of 388 articles were excluded. A total of 45 studies were finally included in the review. : Surgical-guided endodontics is a relatively new area of study that is still maturing. It has many applications such as root canal access and localization, microsurgical endodontics, endodontic retreatment, and glass fiber post removal. Additionally, it does not matter how experienced the operator is; the procedure can be completed for the patient in less time and provides greater accuracy and safety than conventional endodontics.
Topics: Humans; Root Canal Therapy; Endodontics; Microsurgery
PubMed: 37109636
DOI: 10.3390/medicina59040678 -
Sensors (Basel, Switzerland) Oct 2023Microsurgical techniques have been widely utilized in various surgical specialties, such as ophthalmology, neurosurgery, and otolaryngology, which require intricate and... (Review)
Review
Microsurgical techniques have been widely utilized in various surgical specialties, such as ophthalmology, neurosurgery, and otolaryngology, which require intricate and precise surgical tool manipulation on a small scale. In microsurgery, operations on delicate vessels or tissues require high standards in surgeons' skills. This exceptionally high requirement in skills leads to a steep learning curve and lengthy training before the surgeons can perform microsurgical procedures with quality outcomes. The microsurgery robot (MSR), which can improve surgeons' operation skills through various functions, has received extensive research attention in the past three decades. There have been many review papers summarizing the research on MSR for specific surgical specialties. However, an in-depth review of the relevant technologies used in MSR systems is limited in the literature. This review details the technical challenges in microsurgery, and systematically summarizes the key technologies in MSR with a developmental perspective from the basic structural mechanism design, to the perception and human-machine interaction methods, and further to the ability in achieving a certain level of autonomy. By presenting and comparing the methods and technologies in this cutting-edge research, this paper aims to provide readers with a comprehensive understanding of the current state of MSR research and identify potential directions for future development in MSR.
Topics: Humans; Robotics; Microsurgery; Neurosurgical Procedures; Neurosurgery; Clinical Competence
PubMed: 37896597
DOI: 10.3390/s23208503 -
International Journal of Computer... Nov 2017Origami-based biomedical device design is an emerging technology due to its ability to be deployed from a minimal foldable pattern to a larger volume. This paper aims to... (Review)
Review
PURPOSE
Origami-based biomedical device design is an emerging technology due to its ability to be deployed from a minimal foldable pattern to a larger volume. This paper aims to review state-of-the-art origami structures applied in the medical device field.
METHODS
Publications and reports of origami structure related to medical device design from the past 10 years are reviewed and categorized according to engineering specifications, including the application field, fabrication material, size/volume, deployment method, manufacturability, and advantages.
RESULTS
This paper presents an overview of the biomedical applications of devices based on origami structures, including disposable sterilization covers, cardiac catheterization, stent grafts, encapsulation and microsurgery, gastrointestinal microsurgery, laparoscopic surgical grippers, microgrippers, microfluidic devices, and drug delivery. Challenges in terms of materials and fabrication, assembly, modeling and computation design, and clinical adoptability are discussed at the end of this paper to provide guidance for future origami-based design in the medical device field.
CONCLUSION
Concepts from origami can be used to design and develop novel medical devices. Origami-based medical device design is currently progressing, with researchers improving design methods, materials, fabrication techniques, and folding efficiency.
Topics: Biocompatible Materials; Cardiac Catheterization; Equipment Design; Humans; Laparoscopy; Microsurgery; Surgical Equipment
PubMed: 28260164
DOI: 10.1007/s11548-017-1545-1 -
Current Opinion in Biotechnology Feb 2014Small multicellular genetic organisms form a central part of modern biological research. Using these small organisms provides significant advantages in genetic... (Review)
Review
Small multicellular genetic organisms form a central part of modern biological research. Using these small organisms provides significant advantages in genetic tractability, manipulation, lifespan and cost. Although the small size is generally advantageous, it can make procedures such as surgeries both time consuming and labor intensive. Over the past few years there have been dramatic improvements in microfluidic technologies that enable significant improvements in microsurgery and interrogation of small multicellular model organisms.
Topics: Humans; Laser Therapy; Microfluidics; Microsurgery
PubMed: 24484877
DOI: 10.1016/j.copbio.2013.08.007 -
Graefe's Archive For Clinical and... Dec 2022Ophthalmic surgery involves the manipulation of micron-level sized structures such as the internal limiting membrane where tactile sensation is practically absent. All... (Review)
Review
PURPOSE
Ophthalmic surgery involves the manipulation of micron-level sized structures such as the internal limiting membrane where tactile sensation is practically absent. All humans have physiologic tremors that are of low amplitude and not discernible to the naked eye; they do not adversely affect the majority of the population's daily functioning. However, during microsurgery, such tremors can be problematic. In this review, we focus on the impact of physiological tremors on ophthalmic microsurgery and offer a comparative discussion on the impact of such tremors on other surgical specialties.
METHODS
A single investigator used the MEDLINE database (via PubMed) to search for and identify articles for inclusion in this systematic review. Ten key factors were identified as potentially having an impact on tremor amplitude: beta-blockers, muscle fatigue, robotic systems, handheld tools/micromanipulators, armrests/wrist supports, caffeine, diet, sleep deprivation, consuming alcohol, and workouts (exercise). These key terms were then searched using the advanced Boolean search tool and operators (i.e., AND, OR) available on PubMed: (*keyword*) AND (surgeon tremor OR microsurgery tremor OR hand steadiness OR simulator score).
RESULTS
Ten studies attempted to quantify the baseline severity of operator physiologic tremor. Approximately 89% of studies accessing the impact of tremors on performance in regards to surgical metrics reported an improvement in performance compared to 57% of studies concluding that tremor elimination was of benefit when considering procedural outcomes.
CONCLUSIONS
Robotic technology, new instruments, exoskeletons, technique modifications, and lifestyle factors have all demonstrated the potential to assist in overcoming tremors in ophthalmology.
Topics: Humans; Tremor; Ophthalmology; Microsurgery; Robotics; Caffeine
PubMed: 35788893
DOI: 10.1007/s00417-022-05718-2 -
Swiss Dental Journal 2017
Topics: Bone Screws; Dental Pins; Device Removal; Equipment Design; Equipment Failure; Foreign Bodies; Humans; Microsurgery; Reoperation; Root Canal Preparation; Root Canal Therapy; Tooth Root
PubMed: 28480949
DOI: No ID Found -
Surgical Innovation Oct 2023Surgical robots have innovated the microsurgical field by providing advantages that improve surgical performance. These robots have been adopted by certain specialties... (Review)
Review
BACKGROUND
Surgical robots have innovated the microsurgical field by providing advantages that improve surgical performance. These robots have been adopted by certain specialties more than others. This study discusses the potential advantages of robotics in plastic and reconstructive surgery.
METHOD
This study is a literature review of articles investigating "robotic microsurgery in plastic and reconstructive surgery" using the PubMed database and the Cochrane Library.
RESULT
A total of nineteen relevant articles were found and 5 articles performed a direct comparison between the robotic and manual approaches. Longer operating times were reported in the robotic groups featuring higher learning curves. Reported advantages to robotic use included higher accuracy, precision and flexibility, elimination of tremor and improvement of ergonomic factors.
CONCLUSION
While the results provide an outlook into the outcome of robotic platforms in this field, current research is limited and further studies are required to provide a fundamental analysis.
Topics: Robotics; Microsurgery; Surgery, Plastic; Plastic Surgery Procedures; Robotic Surgical Procedures
PubMed: 37490999
DOI: 10.1177/15533506231191211 -
Asia-Pacific Journal of Ophthalmology... 2017Our purpose is to present a broad review about the principles, early history, evolution, applications, and complications of femtosecond lasers used in refractive and... (Review)
Review
Our purpose is to present a broad review about the principles, early history, evolution, applications, and complications of femtosecond lasers used in refractive and nonrefractive corneal surgical procedures. Femtosecond laser technology added not only safety, precision, and reproducibility to established corneal surgical procedures such as laser in situ keratomileusis (LASIK) and astigmatic keratotomy, but it also introduced new promising concepts such as the intrastromal lenticule procedures with refractive lenticule extraction (ReLEx). Over time, the refinements in laser optics and the overall design of femtosecond laser platforms led to it becoming an essential tool for corneal surgeons. In conclusion, femtosecond laser is a heavily utilized tool in refractive and nonrefractive corneal surgical procedures, and further technological advances are likely to expand its applications.
Topics: Corneal Diseases; Corneal Surgery, Laser; Humans; Lasers, Excimer; Microsurgery; Refractive Surgical Procedures; Surgical Flaps
PubMed: 28780779
DOI: 10.22608/APO.2017163 -
Fertility and Sterility Apr 2016
Review
Topics: Animals; Fallopian Tube Diseases; Female; Humans; Infertility, Female; Microsurgery; Plastic Surgery Procedures; Reproductive Techniques, Assisted
PubMed: 26773194
DOI: 10.1016/j.fertnstert.2015.12.040 -
Indian Journal of Ophthalmology 2008Sutureless vitrectomy has rapidly been accepted as an essential part of a vitreoretinal surgical setup. The size and structure of the wound along with near intact... (Review)
Review
Sutureless vitrectomy has rapidly been accepted as an essential part of a vitreoretinal surgical setup. The size and structure of the wound along with near intact conjunctival covering makes the incision self-sealing and safe. This allows the vitrectomy instruments to be used without creating an initial limited peritomy to expose bare sclera, and obviates the need for sutures at the end of the procedure. Wound construction is the essential step in ensuring postoperative wound stability. Both one-step and two-step wound constructions have been described. Key points include an oblique, tunneled approach to ensure a valve-like effect as well as misalignment of conjunctival and scleral wounds by displacing conjunctiva during construction. Advantages include decreased operative times in certain cases and decreased postoperative inflammation, early postoperative rehabilitation, improved patient comfort, and minimal conjunctival damage. Complications are based around wound competence, hypotony, and its relationship to endophthalmitis rates. Early reports highlighted an increase in endophthalmitis though further studies are required to accurately assess the incidence. Endophthalmitis has not been reported in cases that underwent fluid/air exchange. This review focuses on techniques, benefits, complications, personal experiences, and the safety profiles of sutureless vitrectomy systems. A literature review was undertaken using 'Medline' and 'Pubmed'. Search terms included sutureless vitrectomy, 20 gauge, 23 gauge, 25 gauge, and transconjunctival and small gauge vitrectomy.
Topics: History, 20th Century; History, 21st Century; Humans; Microsurgery; Minimally Invasive Surgical Procedures; Suture Techniques; Vitrectomy; Wound Healing
PubMed: 18974514
DOI: 10.4103/0301-4738.43364