Development of a Laparoscope Prototype Based on the Continuous Redundant Cable Robot Tested in a Simulated Abdominal Pelvic Cavity

Camila Valentina Osorio Pena,Laura Catalina Lopez Riano,Julian David Medina Alfonso,Hernando Leon-Rodriguez 제어로봇시스템학회 2022 제어로봇시스템학회 국제학술대회 논문집 Vol.2022 No.11

The applications of continuous-redundant robots in the medical field, thanks to their hyper-flexibility and their ability to slide through complex curvilinear lines, make them ideal for surgical procedures. This paper describes the design, construction and control of a continuous redundant robot, driven by tension cables, based on the robotic model. Tests were carried out in a simulated physical environment of the Abdominopelvic cavity. Regarding the control of the system, inverse kinematics were used, which allowed to relate the different variables of the same, using the MatLAB and Arduino programs; its manipulation was carried out by means of a joystick and a PID control. Evaluation, performance of the system, position of the end effector, the length of the tension cables in each movement, as well as their respective curvature and angles were recorded through calculations.

Age-specific predictors of cervical dysplasia recurrence after primary conization: analysis of 3,212 women

Giorgio Bogani,Ciro Pinelli,Valentina Chiappa,Fabio Martinelli,Salvatore Lopez,Antonino Ditto,Francesco Raspagliesi 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.5

Objective: This study aimed to identify predictors of recurrence/persistence of cervicalintraepithelial neoplasia grade 2+ (CIN2+) lesion (r-CIN2+) after primary conization. Methods: Retrospective analysis involving all consecutive women having conization for CIN2+between 1998 and 2018. The risk of r-CIN2+ was assessed using Kaplan-Meier and Cox models. Results: Data of 3,212 women were retrospectively identified. After a mean follow-up of 47(±22.2) months, 112 (3.5%) patients developed r-CIN2+. Mean time interval between priorconization and diagnosis of r-CIN2+ was 26.2 (±13.2) months. Via multivariate analysis,presence of high-risk human papillomavirus (HPV) types at the time of CIN2+ diagnosis,hazard ratio (HR)=3.40 (95% confidence interval [CI]=1.66–6.95) for HPV16/18 and HR=2.59(95% CI=1.21–5.55) for HPV types other than 16/18, positive margins at primary conization,HR=4.11 (95% CI=2.04–8.26) and HPV persistence after conization, HR=16.69 (95%CI=8.20–33.9), correlated with r-CIN2+, independently. Considering age-specific HPV typesdistribution, we observed that HPV16/18 infection correlated to an increased risk of r-CIN2+only in young women (aged ≤25 years; p=0.031, log-rank test); while in the older population(>25 years) HPV type(s) involved had not impact on r-CIN2+ risk (p>0.200, log-rank test). Conclusion: HPV persistence is the main factor predicting r-CIN2+. Infection from HPV16/18has a detrimental effect in young women, thus highlighting the need of implementingvaccination against HPV in this population. Further prospective studies are warranted fortailoring clinical decision-making for post-conization follow-up on the basis of risk factors.

Impact of BRCA1/2 gene mutations on survival of patients with pancreatic cancer: A case-series analysis

Ernesto Barzola Navarro,Emilio Vicente Lopez,Yolanda Quijano,Riccardo Caruso,Valentina Ferri,Hipolito Durand,Isabel Fabra Cabrera,Eduardo Diaz Reques,Benedetto Ielpo,Anastasiia Yuriyivna Glagoliev,Car 한국간담췌외과학회 2019 Annals of hepato-biliary-pancreatic surgery Vol.23 No.2

BRCA gene mutations are found in up to 10% of pancreatic adenocarcinoma cases. We present a description of 4 cases along with a review of the current literature regarding pathogenesis, target treatment, response and survival rates in these types of malignancies. We describe four cases of pancreatic adenocarcinoma, in three of which the BRCA2 mutation was identified, in one - BRCA1 gene alteration. Two patients underwent surgery following the neoadjuvant treatment with Folfirinox and radiotherapy; in the first case, a distal pancreatectomy with splenectomy was performed and in the second one - the Whipple’s procedure. In both cases, a complete pathological response was reported. Other 2 patients were treated with Folfirinox after BRCA mutation identification and acceptable life expectancy was obtained. The association of pathologic complete response (PCR) with lower rates of local recurrence and better survival in patients with various types of adenocarcinomas is well known. Identification of such patients carrying BRCA mutations could provide an application of better personalized treatment. In some patients with pancreatic cancer, especially when there is clinical or demographic reason to suspect a genetic predisposition, a confirmation of the presence of BRCA mutations could provide an opportunity to use target treatment with beneficial outcomes regarding survival.

Oncologic effectiveness of nerve-sparing radical hysterectomy in cervical cancer

Antonino Ditto,Giorgio Bogani,Umberto Leone Roberti Maggiore,Fabio Martinelli,Valentina Chiappa,Carlos Lopez,Stefania Perotto,Domenica Lorusso,Francesco Raspagliesi 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.3

Objective: Nerve-sparing radical hysterectomy (NSRH) was introduced with the aim to reduce pelvic dysfunctions related to conventional radical hysterectomy (RH). Here, we sought to assess the effectiveness and safety of NSRH in a relatively large number of the patients of cervical cancer (CC) patients undergoing either primary surgery or neoadjuvant chemotherapy (NACT) followed by surgery. Methods: Outcomes of consecutive patients undergoing NSRH and of a historical cohort of patients undergoing conventional RH were retrospectively reviewed. Results: This study included 325 (49.8%) and 327 (50.2%) undergoing NSRH and RH, respectively. Via a multivariable model, nodal status was the only factor predicting for DFS (hazard ratio [HR]=2.09; 95% confidence interval [CI]=1.17–3.73; p=0.01). A trend towards high risk of recurrence was observed for patients affected by locally advanced cervical cancer (LACC) undergoing NACT followed by surgery (HR=2.57; 95% CI=0.95–6.96; p=0.06). Type of surgical procedures (NSRH vs. RH) did not influence risk of recurrence (p=0.47). Similarly, we observed that the execution of NSRH rather than RH had not a detrimental effect on OS (HR=1.19; 95% CI=0.16–9.01; p=0.87). Via multivariable model, no factor directly correlated with OS. No difference in early complication rates was observed between the study groups. Conversely, a significant higher number of late complications was reported in RH versus NSRH groups (p=0.02). Conclusion: Our data suggested that NSRH upholds effectiveness of conventional RH, without increasing recurrence and complication rates but improving pelvic dysfunction rates.

Adipose tissue-derived mesenchymal stromal cells for treating chronic kidney disease: A pilot study assessing safety and clinical feasibility

( Sandra Villanueva ),( Fernando Gonzalez ),( Eduardo Lorca ),( Andres Tapia ),( Valentina Lopez G ),( Rocio Strodthoff ),( Francisca Fajre ),( Juan E. Carreno ),( Ricardo Valjalo ),( Cesar Vergara ) 대한신장학회 2019 Kidney Research and Clinical Practice Vol.38 No.2

Background: Chronic kidney disease (CKD) is a growing public health concern, and available treatments are insufficient in limiting disease progression. New strategies, including regenerative cell-based therapies, have emerged as therapeutic alternatives. Results from several groups, including our own, have reported evidence of a supportive role for mesenchymal stromal cells (MSCs) in functional recovery and prevention of tissue damage in murine models of CKD. Prompted by these data, an open pilot study was conducted to assess the safety and efficacy of a single injection of autologous adipose tissue-derived MSCs (AT-MSCs) for treatment of CKD. Methods: AT-MSCs were infused intravenously into six CKD patients at a dose of 1 million cells/kg. Patients were stabilized and followed for one year prior to MSC infusion and one year following infusion. Results: No patients presented with adverse effects. Statistically significant improvement in urinary protein excretion was observed in AT-MSCs transplanted patients, from a median of 0.75 g/day (range, 0.15-9.57) at baseline to 0.54 g/day (range, 0.01-2.66) at month 12 (P = 0.046). The glomerular filtration rate was not significantly decreased post-infusion of AT-MSCs. Conclusion: Findings from this pilot study demonstrate that intravenous infusion of autologous expanded AT-MSCs into CKD patients was not associated with adverse effects and could benefit patients already undergoing standard medical treatment.