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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item Impact of Refractive Errors on Da Vinci SI Robotic System(SOC LAPAROENDOSCOPIC SURGEONS, 2020-01-01) Tuna, Mustafa Bilal; Kilavuzoglu, Ayse Ebru; Mourmouris, Panogiotis; Argun, Omer Burak; Doganca, Tunkut; Obek, Can; Ozisik, Ozan; Kural, Ali RizaObjective: To investigate the impact of refractive errors on binocular visual acuity while using the Da Vinci SI robotic system console. Methods: Eighty volunteers were examined on the Da Vinci SI robotic system console by using a near vision chart. Refractive errors, anisometropia status, and Fly Stereo Acuity Test scores were recorded. Spherical equivalent (SE) were calculated for all volunteers' right and left eyes. Visual acuity was assessed by the logarithm of the minimal angle of resolution (LogMAR) method. Binocular uncorrected and best corrected (with proper contact lens or glasses) LogMAR values of the subjects were recorded. The difference between these values (DiffLogMAR) are affected by different refractive errors. Results: In the myopia and/or astigmatism group, uncorrected SE was found to have significant impact on the DiffLogMAR (P < 0.001) and myopia greater than 1.75 diopter had significantly higher DiffLogMAR values (p < 0.05). Subjects with presbyopia had significantly higher DiffLogMAR values (p < 0.01), and we observed positive correlation between presbyopia and DiffLogMAR values (p = 0.33, p < 0.01). The cut off value of presbyopia that correlated the most with DiffLogMAR differences was found to be 1.25 diopter (P< 0.001). In 13 hypermetropic volunteers, we found significant correlation between hypermetropia value and DiffLogMAR (p > 0.7, p < 0.01). The statistical analysis between Fly test and SE revealed a significant impact of presbyopia and hypermetropia to the stereotactic view of the subject (p = -0.734, p < 0.05). Conclusion: Surgeons suffering from myopia greater than 1.75 diopter, presbyopia greater than 1.25 diopter (D), and hypermetropia regardless of grade must always perform robotic surgeries with the proper correction.Item Minimizing Ports During Robotic Partial Nephrectomy(SOC LAPAROENDOSCOPIC SURGEONS, 2016-01-01) Argun, Omer Burak; Mourmouris, Panagiotis; Tufek, Ilter; Obek, Can; Tuna, Mustafa Bilal; Keskin, Selcuk; Kural, Ali RizaBackground and Objective: Robotic upper urinary tract surgery is in most of the cases performed utilizing a standard 5 port configuration. Fewer ports can potentially produce a less invasive operation. Taking in consideration the above we report a novel technique for robot assisted laparoscopic partial nephrectomy utilizing fewer ports and we test its feasibility and safety profile. Methods: Data on 11 robot-assisted laparoscopic partial nephrectomies performed by using our technique from February 2015 through June 2015 were retrospectively analyzed. The robotic platform used was DaVinci Xi (Intuitive Surgical, Inc., Sunnyvale, California, USA) with a 3-arm setup. The AirSeal system (SurgiQuest, Milford, Connecticut, USA) was used as a port allowing simultaneous introduction of 2 instruments for the bedside surgeon, obviating the need for an additional (fourth) robotic arm. A long suction-and-irrigation device and atraumatic grasping forceps were used. Both instruments were introduced through the trocar of the AirSeal system, making simultaneous introduction and use possible. We preferred the long suction-and-irrigation device, because it minimizes collision of the instruments. Results: Mean age and BMI of the patients were 55 +/- 14.6 y and 29.18 +/- 6.85, respectively. Seven tumors were on the right side and 4 were on the left. The mean size of the tumors was 32.45 mm (+/- 11.31). Surgical time was 132.2 minutes (+/- 37.17), with an estimated blood loss and ischemia time of 103.63 mL (+/- 65.92) and 16.72 minutes (+/- 9.52), respectively. One patient had postoperative bleeding that was resolved without transfusion. The median hospitalization period was 3.9 d (+/- 0.53). Loss of intra-abdominal pressure was not observed, and pressure was stable at 10 mm Hg. Conclusion: The AirSeal System and its valveless trocar eliminated the need for an additional port placement in our series. The technique is feasible, safe, and reproducible