Nima Sarli1,2, Tracy Marien3, Christopher R Mitchell3, Giuseppe Del Giudice1,2, Mary S Dietrich4,5, S Duke Herrell3,2, Nabil Simaan1,2. 1. Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, 37240, USA. 2. Vanderbilt Initiative in Surgical Engineering (ViSE), Nashville, Tennessee, USA. 3. Department of Urologic Surgery, A-1302 Medical Center North, Vanderbilt University Medical Center, Nashville, TN, 37232-2765. 4. School of Nursing, Vanderbilt University, Nashville, TN, USA. 5. Department of Biostatistics, School of Medicine, Vanderbilt University, Nashville, TN, USA.
Abstract
BACKGROUND: Transurethral Resection of Bladder Tumors (TURBT) is a challenging procedure partly due to resectoscope limitations. To date, manual resection performance has not been fully characterized. This work characterizes manual resection performance in the bladder while analyzing the effect of resection location on accuracy. METHODS: Kinematic simulations are used to assess kinematic measures of resection dexterity. An experimental protocol for manual resection accuracy assessment is developed. Cross correlations between the theoretical performance measures and the observed experimental accuracy are investigated. RESULTS: Tangential accuracy correlates relatively strongly with normal singular value and moderately with tangential kinematic conditioning index and tangential minimum singular value. Simulations also clarified difficulties in resecting close to the bladder neck. CONCLUSIONS: Measures to evaluate accuracy and dexterity of TURBT from a kinematic viewpoint are presented to provide a currently missing quantified dexterity baseline in manual TURBT. Limitations in various bladder regions are illustrated.
BACKGROUND: Transurethral Resection of Bladder Tumors (TURBT) is a challenging procedure partly due to resectoscope limitations. To date, manual resection performance has not been fully characterized. This work characterizes manual resection performance in the bladder while analyzing the effect of resection location on accuracy. METHODS: Kinematic simulations are used to assess kinematic measures of resection dexterity. An experimental protocol for manual resection accuracy assessment is developed. Cross correlations between the theoretical performance measures and the observed experimental accuracy are investigated. RESULTS: Tangential accuracy correlates relatively strongly with normal singular value and moderately with tangential kinematic conditioning index and tangential minimum singular value. Simulations also clarified difficulties in resecting close to the bladder neck. CONCLUSIONS: Measures to evaluate accuracy and dexterity of TURBT from a kinematic viewpoint are presented to provide a currently missing quantified dexterity baseline in manual TURBT. Limitations in various bladder regions are illustrated.
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Authors: Maurizio Brausi; Laurence Collette; Karlheinz Kurth; Adrian P van der Meijden; Wim Oosterlinck; J A Witjes; Donald Newling; Christian Bouffioux; Richard J Sylvester Journal: Eur Urol Date: 2002-05 Impact factor: 20.096
Authors: Nima Sarli; Giuseppe Del Giudice; Smita De; Mary S Dietrich; Stanley Duke Herrell; Nabil Simaan Journal: J Endourol Date: 2018-06 Impact factor: 2.942