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Item An Assessment Tool to Provide Targeted Feedback to Robotic Surgical Trainees: Development and Validation of the End-to-End Assessment of Suturing Expertise (EASE)(American Urological Association, 2022-11) Haque, Taseen F.; Hui, Alvin; You, Jonathan; Ma, Runzhuo; Nguyen, Jessica H.; Lei, Xiaomeng; Cen, Steven; Aron, Monish; Collins, Justin W.; Djaladat, Hooman; Ghazi, Ahmed; Yates, Kenneth A.; Abreu, Andre L.; Daneshmand, Siamak; Desai, Mihir M.; Goh, Alvin C.; Hu, Jim C.; Lebastchi, Amir H.; Lendvay, Thomas S.; Porter, James; Schuckman, Anne K.; Sotelo, Rene; Sundaram, Chandru P.; Gill, Inderbir S.; Hung, Andrew J.; Urology, School of MedicinePurpose: To create a suturing skills assessment tool that comprehensively defines criteria around relevant sub-skills of suturing and to confirm its validity. Materials and Methods: 5 expert surgeons and an educational psychologist participated in a cognitive task analysis (CTA) to deconstruct robotic suturing into an exhaustive list of technical skill domains and sub-skill descriptions. Using the Delphi methodology, each CTA element was systematically reviewed by a multi-institutional panel of 16 surgical educators and implemented in the final product when content validity index (CVI) reached ≥0.80. In the subsequent validation phase, 3 blinded reviewers independently scored 8 training videos and 39 vesicourethral anastomoses (VUA) using EASE; 10 VUA were also scored using Robotic Anastomosis Competency Evaluation (RACE), a previously validated, but simplified suturing assessment tool. Inter-rater reliability was measured with intra-class correlation (ICC) for normally distributed values and prevalence-adjusted bias-adjusted Kappa (PABAK) for skewed distributions. Expert (≥100 prior robotic cases) and trainee (<100 cases) EASE scores from the non-training cases were compared using a generalized linear mixed model. Results: After two rounds of Delphi process, panelists agreed on 7 domains, 18 sub-skills, and 57 detailed sub-skill descriptions with CVI ≥ 0.80. Inter-rater reliability was moderately high (ICC median: 0.69, range: 0.51-0.97; PABAK: 0.77, 0.62-0.97). Multiple EASE sub-skill scores were able to distinguish surgeon experience. The Spearman’s rho correlation between overall EASE and RACE scores was 0.635 (p=0.003). Conclusions: Through a rigorous CTA and Delphi process, we have developed EASE, whose suturing sub-skills can distinguish surgeon experience while maintaining rater reliability.Item Comparison of Perioperative Outcomes Between Holmium Laser Enucleation of the Prostate and Robot-Assisted Simple Prostatectomy(Liebert, 2017-09) Zhang, Mimi W.; El Tayeb, Marawan M.; Borofsky, Michael S.; Dauw, Casey A.; Wagner, Kristofer R.; Lowry, Patrick S.; Bird, Erin T.; Hudson, Tillman C.; Lingeman, James E.; Urology, School of MedicineObjectives: To compare perioperative outcomes for patients undergoing holmium laser enucleation of the prostate (HoLEP) and robotic-assisted simple prostatectomy (RSP) for benign prostatic hypertrophy (BPH).Methods: Patient demographics and perioperative outcomes were compared between 600 patients undergoing HoLEP and 32 patients undergoing RSP at two separate academic institutions between 2008 and 2015.Results: Patients undergoing HoLEP and RSP had comparable ages (71 vs 71, p = 0.96) and baseline American Urological Association Symptom Scores (20 vs 24, p = 0.21). There was no difference in mean specimen weight (96 g vs 110 g, p = 0.15). Mean operative time was reduced in the HoLEP cohort (103 minutes vs 274 minutes, p < 0.001). Patients undergoing HoLEP had lesser decreases in hemoglobin, decreased transfusions rates, shorter hospital stays, and decreased mean duration of catheterization. There was no difference in the rate of complications Clavien grade 3 or greater (p = 0.33).Conclusions: HoLEP and RSP are both efficacious treatments for large gland BPH. In expert hands, HoLEP appears to have a favorable perioperative profile. Further studies are necessary to compare long-term efficacy, cost, and learning curve influences, especially as minimally invasive approaches become more widespread.Item LabVIEW™ Database Interfacing For Robotic Control(2006-07-26T14:13:05Z) Gebregziabher, Netsanet; Perry, Douglas G.The Zymark™ System is a lab automation workstation that uses the Caliper Life Sciences (Hopkinton, MA) Zymate XP robot. At Indiana University-Purdue University Indianapolis, a Zymate is used in a course, INFO I510 Data Acquisition and Laboratory Automation, to demonstrate the fundamentals of laboratory robotics. This robot has been re-engineered to function with National Instruments™ graphical software program LabVIEW™. LabVIEW is an excellent tool for robotic control. Based on changing conditions, it is able to dynamically use data from any source to modify the operating parameters of a robot. For dynamically changing information, storage of that information must be readily accessible. For example, there is a need to continuously store and update the calibration data of the robot, populate the setting of each axis and positioning inside the workplace, and also store robot positioning information. This can be achieved by using a database which allows for robotic control data to be easily searched and accessed. To address this need, an interface was developed which would allow full, dynamic communication between any LabVIEW program (called “virtual instruments,” or VIs) and the database. This has been accomplished by developing a set of subVIs that can be dropped into the calling robotic control VIs. With these subVIs, a user has the ability to create table and column information, delete a table, retrieve table information by clicking a particular table name on the user interface, or query using any SQL-specific combination of columns or tables within the database. For robot functionality, subVIs were created to store and retrieve data such as calibration data points and regression calculations.Item A Meta-analysis of the Uncanny Valley's Independent and Dependent Variables(ACM, 2022-03) Diel, Alexander; Weigelt, Sarah; MacDorman, Karl F.; Human-Centered Computing, School of Informatics and ComputingThe uncanny valley (UV) effect is a negative affective reaction to human-looking artificial entities. It hinders comfortable, trust-based interactions with android robots and virtual characters. Despite extensive research, a consensus has not formed on its theoretical basis or methodologies. We conducted a meta-analysis to assess operationalizations of human likeness (independent variable) and the UV effect (dependent variable). Of 468 studies, 72 met the inclusion criteria. These studies employed 10 different stimulus creation techniques, 39 affect measures, and 14 indirect measures. Based on 247 effect sizes, a three-level meta-analysis model revealed the UV effect had a large effect size, Hedges’ g = 1.01 [0.80, 1.22]. A mixed-effects meta-regression model with creation technique as the moderator variable revealed face distortion produced the largest effect size, g = 1.46 [0.69, 2.24], followed by distinct entities, g = 1.20 [1.02, 1.38], realism render, g = 0.99 [0.62, 1.36], and morphing, g = 0.94 [0.64, 1.24]. Affective indices producing the largest effects were threatening, likable, aesthetics, familiarity, and eeriness, and indirect measures were dislike frequency, categorization reaction time, like frequency, avoidance, and viewing duration. This meta-analysis—the first on the UV effect—provides a methodological foundation and design principles for future research.