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Robot-Assisted Free Flap Reconstruction for Oropharyngeal Cancer: A Systematic Review
Panagiotis Vrakas,Deepak Kalaskar,Raghav C Dwivedi 대한이비인후과학회 2024 대한이비인후과학회지 두경부외과학 Vol.67 No.2
Management of oropharyngeal cancer is undergoing a shift due to different profiles of pa-tients, who tend to be younger and show better prognosis. Transoral robotic surgery is beingestablished as the first-line approach as the procedure has shown minimal invasiveness andgood oncological and functional outcomes, while avoiding extensive open surgery approachesand intensive chemoradiotherapy treatments. Naturally, the next step in the management oforopharyngeal cancer would be using the same technology for reconstruction to preserve thefunction and anatomy of the oropharynx. Free flaps, especially the radial forearm free flapand the anterolateral thigh flap, proved to be ideal for oropharyngeal reconstruction, and ro-botic assistance in these cases is yet to be explored. A limited number of studies have reportedrobot-assisted oropharyngeal reconstruction, so this review summarizes the currently avail-able data and explores the feasibility, safety, and functional outcomes of this novel technique.
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Ravi Prajapati,Suryank Dwivedi,Deepak Kumar,Ashish Kumar Srivastava,Amit Rai Dixit 한국정밀공학회 2024 International Journal of Precision Engineering and Vol.11 No.1
The demand for novel laminated sheets encouraged using newer technologies to produce tailored materials for multipurpose applications. An inventive solid-state joining method: friction stir additive manufacturing, which offers several advantages over traditional lamination processes. In this study, the Al2O3 powder is used as reinforcement during AA6063/Al2O3/AA6063 composites fabrication. The fabricated specimen was characterized by bonding features such as thickness reduction, metallography, mechanical properties, and tribological performances and compared with sheet lamination and base metal. The optical microscope and scanning electron microscopic images showed that the Al2O3 powder is distributed within the composites. The structural analysis at the interface of the fabricated composite was conducted through X-ray diffraction, confirming the compounds like Mg2SiO4, Mg2Al4, and Al2O3 in the crystallographic planes. The microstructural and morphological results of the laminated composite showed the refined and equiaxed grains and also depicted the dispersion of the Al2O3 powder near the stir zone. The microhardness properties were enhanced and obtained as 91.2 HV and 77.5 HV with and without reinforcement, respectively. Further, the ultimate tensile strength with and without reinforcement is improved by 36.9% and 24.7% compared to the base metal. Furthermore, the tribological analysis was performed at variable process parameters. Taguchi's L9 orthogonal array and variance analysis (ANOVA) were done to analyze the effect of individual parameters and their significance. The obtained results showed that load and frequency are significant parameters during the tribology test. The laminated composite's specific wear rate, wear depth, and COF values are less than the sheet lamination and align with ANOVA test results. Furthermore, the wear mechanism was observed, and it was found that sheet lamination has high wear at increased load when compared to laminated composite parts. Therefore, the obtained results dictate that the addition of Al2O3 powder can significantly enhance the bonding strength, mechanical and tribological properties of the fabricated composites.
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