Evidence map›Paper›PMID 34919177›Full record

ArticleSurgical endoscopy2022

PLAFOKON: a new concept for a patient-individual and intervention-specific flexible surgical platform.

Lukas Bernhard, Roman Krumpholz, Yannick Krieger, Tobias Czempiel, Alexander Meining, Nassir Navab, Tim Lüth, Dirk Wilhelm

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Lukas BernhardResearch Group for Minimally Invasive Interdisciplinary Therapeutic Intervention (MITI), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. lukas.bernhard@tum.de.ORCID http://orcid.org/0000-0002-9729-8928
Roman KrumpholzResearch Group for Minimally Invasive Interdisciplinary Therapeutic Intervention (MITI), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Yannick KriegerInstitute of Micro Technology and Medical Device Technology, Department of Mechanical Engineering, Technical University of Munich, Munich, Germany.
Tobias CzempielChair for Computer Aided Medical Procedures & Augmented Reality, Technical University of Munich, Munich, Germany.
Alexander MeiningDepartment of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany.
Nassir NavabChair for Computer Aided Medical Procedures & Augmented Reality, Technical University of Munich, Munich, Germany.
Tim LüthInstitute of Micro Technology and Medical Device Technology, Department of Mechanical Engineering, Technical University of Munich, Munich, Germany.
Dirk WilhelmResearch Group for Minimally Invasive Interdisciplinary Therapeutic Intervention (MITI), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Technical University of Munich · DETUM Klinikum · DEUniversitätsklinikum Würzburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundResearch in the field of surgery is mainly driven by aiming for trauma reduction as well as for personalized treatment concepts. Beyond laparoscopy, other proposed approaches for further reduction of the therapeutic trauma have failed to achieve clinical translation, with few notable exceptions. We believe that this is mainly due to a lack of flexibility and high associated costs. We aimed at addressing these issues by developing a novel minimally invasive operating platform and a preoperative design workflow for patient-individual adaptation and cost-effective rapid manufacturing of surgical manipulators. In this article, we report on the first in-vitro cholecystectomy performed with our operating platform.

methodsThe single-port overtube (SPOT) is a snake-like surgical manipulator for minimally invasive interventions. The system layout is highly flexible and can be adapted in design and dimensions for different kinds of surgery, based on patient- and disease-specific parameters. For collecting and analyzing this data, we developed a graphical user interface, which assists clinicians during the preoperative planning phase. Other major components of our operating platform include an instrument management system and a non-sterile user interface. For the trial surgery, we used a validated phantom which was further equipped with a porcine liver including the gallbladder.

resultsFollowing our envisioned preoperative design workflow, a suitable geometry of the surgical manipulator was determined for our trial surgery and rapidly manufactured by means of 3D printing. With this setup, we successfully performed a first in-vitro cholecystectomy, which was completed in 78 min.

conclusionsBy conducting the trial surgery, we demonstrated the effectiveness of our PLAFOKON operating platform. While some aspects - especially regarding usability and ergonomics - can be further optimized, the overall performance of the system is highly promising, with sufficient flexibility and strength for conducting the necessary tissue manipulations.

Indexed as

LaparoscopyAnimalsCholecystectomyEquipment DesignErgonomicsHumansPrinting, Three-DimensionalSurgical InstrumentsSwine3D printingIndividualized surgeryOperating platformPreoperative planningSurgical manipulator

Identifiers

PMID34919177
PMCPMC9160157
OpenAlexW4200524026

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.