副甲腺放射導引微創手術術中伽瑪探頭偵測的必要性-apan.pptVIP

ROBOT-ASSISTED LAPAROSCOPIC SURGERY WITH ZEUS SYSTEM: PRELIMINARY RESULTS AND TECHNICAL ASPECTS Hurng-Sheng Wu Department of Surgery, Show-Chwan Memorial Hospital, Changhua, Taiwan, R.O.C Difficulties of laparoscopic surgery Unstable camera platform Loss of degrees of freedom Two-dimentional imaging Poor ergonomics for the surgeon Decades of Changes in Surgical Education 1950 Operating room theaters 1960 Experimental surgery and motion picture films 1970 Industry-research laboratories 1980 Endoscopic surgery 1990 Laparoscopy 2000 Robotics Space Medicine ZEUS da Vinci Master-slave manipulator Simplicity Lightness Range of freedom Motion scaling Real-time high-resolution 3D vision Physiological tremor elimination What is about space medicine? ROBOT: computer-enhanced humanistic device Zeus Robotic System AESOP HERMIS SOCRATES Surgeon Console Three Roboyic Arms LIMITATIONS OF ROBOTIC SURGERY Ports and/or robotic arms placement eg: lithotomy position Cosmetic Depth perception No haptic feed back eg: needle and suture breaks Size Set up Endo-ACAB Definition : A less invasive bypass procedure on the beating heart where all steps are performed endoscopically with the exception of a manual anastomosis. Technique of Endo-ACAB Endoscopic IMA Harvest voice-activated robotic-assisted and a 5mm thoracoscope under single lung ventilation and CO2 insufflation Technique of Endo-ACAB Atrumatic Thoracotomy Technique of Endo-ACAB Direct vision anastomosis Robotic-Assisted Laparoscopic Surgery in Difficult Common Bile Duct Stone: Preliminary Results in Show Chwan Memorial Hospital Hurng-Sheng Wu Department of Surgery, Show Chwan Memorial Hospital, Changhua. Taiwan Background Common bile duct stones are a frequent problem (10-15%) in patients with symptomatic cholecystolithiasis Laparoscopic techniques have expanded the options for their treatment Difficulty in laparoscopic surgery Aims Compare the results in patients with CBD stones by Laparoscopic to roboti