5 research outputs found
Precision mechanism design for 3-DOF in-plane alignment in µm and sub-mrad level
No full textTo assist in the fast alignment of tiny components, Prodrive Technologies has developed a type of camera system called the Component Alignment Sensor (CAS) that is used on a pick-and-place machine. The system uses an optical target as the reference during its assembly and final testing steps. Two main components of the target are a glass reticle and a stainless steel carrier that are bonded together. These two components need to be precisely aligned w.r.t. each other. Till now, the alignment between the reticle and carrier has been performed manually by relative movement between them created by hand. However, this method has some limitations, including, but not limited to, an increase in the alignment time and sensitivity to external jerks or disturbances. Accordingly, the thesis objective is to create a (detailed) design of an alignment mechanism to perform the 3-DOF in-plane alignment in µm and sub-mrad level. The research starts with the formulation of design requirements, followed by concept design, evaluation and selection, and finally a detailed design of the mechanism. A flexure-based alignment mechanism was proposed and designed that uses fine screws for actuation. Various design principles were applied to construct a stiff and compact mechanism that uses a limited number of adjustment steps for the alignment. The process was supported by calculations and analyses that contributed to decision making. Besides, the assembly and alignment procedures of the alignment mechanism were described. The thesis is concluded with a plan to verify if the matured design meets the set requirements.Mechanical Engineering | Optomechatronic
Mesh migration into stomach following diaphragmatic hernia repair: a rare complication
No full textMesh erosion and migration are considered the gravest of complications of mesh repairs. To the best of our knowledge, mesh erosion and migration into the stomach following a mesh repair of adult diaphragmatic hernia has yet to be reported in the literature. A case of mesh eroding into the stomach, after a prosthetic repair of an adult diaphragmatic hernia, is presented here because of its rarity
Migracja siatki do światła żołądka po zabiegu plastyki przepukliny przeponowej: rzadkie powikłanie
No full textErozję i migrację siatki uważa się za najpoważniejsze powikłanie po operacji plastyki przepukliny. Według naszej wiedzy, do tej pory w literaturze nie opisywano przypadku penetracji i migracji siatki do światła żołądka po zabiegu plastyki przepukliny przeponowej. W niniejszej pracy przedstawiliśmy przypadek penetracji sieci i jej migracji do żołądka po zabiegu plastyki przepukliny przeponowej u osoby dorosłej ze względu na rzadkość tego powikłania
A Systematic Review of Surgical Management Strategies in the Treatment of Peritoneal Carcinomatosis of Neuroendocrine Origin
No full textCytoreductive surgery (CRS) represents the cornerstone of surgical management for peritoneal carcinomatosis (PC) and involves peritonectomy procedures aimed at complete peritoneal tumour resection. Frequently, CRS is combined with hyperthermic intraperitoneal chemotherapy (HIPEC). The combination of CRS + HIPEC is now considered the standard of care in patients with colorectal and ovarian PC. However, the role of this multi-modality treatment approach in patients with PC of neuroendocrine tumour origin (NET-PC) is less well understood. This systematic review provides a summary of available evidence on management strategies for patients with NET-PC. A systematic literature search was performed using Ovid Medline, EMBASE and Cochrane Library databases to identify studies reporting outcomes for patients with NET-PC undergoing surgical treatment. Eligible studies were assessed for methodological quality and design and evaluated for a method of surgical treatment, method of HIPEC delivery, oncological outcomes, and treatment-related morbidity. Eight studies, including a total of 1240 patients with NET-PC, met predefined inclusion criteria and have been included in this review. In three of the included studies, CRS alone was performed for patients with NET-PC, while five studies reported outcomes with combined treatment using CRS plus HIPEC. All studies were performed at tertiary peritoneal malignancy centres. Only one study directly compared outcomes in patients with NET-PC undergoing CRS plus HIPEC compared with CRS in isolation, with no significant difference in overall survival reported. Carefully selected patients with NET-PC may benefit from aggressive surgical treatment in the form of CRS +/− HIPEC. These procedures are best undertaken at centres with expertise in the management of both neuroendocrine tumours and peritoneal malignancy, as both are conditions that require tertiary-level care. The additional benefit of the HIPEC component in this group of patients remains unclear and warrants further investigation in clinical trials. Overall, the quality of data on this subject is restricted by the low number of studies and the variability in treatment methods employed. A multi-national data registry for patients with NET-PC may offer the opportunity to better define treatment algorithms. Translational research efforts in parallel should focus on developing a better biological understanding of NET-PC, with a view to identifying more effective intraperitoneal cytocidal agents
Global treatment of haemorrhoids—A worldwide snapshot audit conducted by the International Society of University Colon and Rectal Surgeons
No full textAim: There is no universally accepted treatment consensus for haemorrhoids, and thus, management has been individualized all over the world. This study was conducted to assess a global view of how surgeons manage haemorrhoids. Methods: The research panel of the International Society of University Colon and Rectal Surgeons (ISUCRS) developed a voluntary, anonymous questionnaire evaluating surgeons' experience, volume and treatment approaches to haemorrhoids. The 44 multiple-choice questionnaire was available for one month via the ISUCRS email database and the social media platforms Viber and WhatsApp. Results: The survey was completed by 1005 surgeons from 103 countries; 931 (92.6%) were in active practice, 819 (81.5%) were between 30 and 60 years of age, and 822 (81.8%) were male. Detailed patient history (92.9%), perineal inspection (91.2%), and digital rectal examination (91.1%) were the most common assessment methods. For internal haemorrhoids, 924 (91.9%) of participants graded them I–IV, with the degree of haemorrhoids being the most important factor considered to determine the treatment approach (76.3%). The most common nonprocedural/conservative treatment consisted of increased daily fibre intake (86.9%), increased water intake (82.7%), and normalization of bowel habits/toilet training (74.4%). Conservative treatment was the first-line treatment for symptomatic first (92.5%), second (72.4%) and third (47.3%) degree haemorrhoids; however, surgery was the first-line treatment for symptomatic fourth degree haemorrhoids (77.6%). Rubber band ligation was the second-line treatment in first (50.7%) and second (47.2%) degree haemorrhoids, whereas surgery was the second-line treatment in third (82.9%) and fourth (16.7%) degree symptomatic haemorrhoids. Rubber band ligation was performed in the office by 645(64.2%) of the participants. The most common surgical procedure performed for haemorrhoids was an excisional haemorrhoidectomy for both internal (87.1%) and external (89.7%) haemorrhoids – with 716 (71.2%) of participants removing 1, 2 or 3 sectors as necessary. Conclusion: Although there is no global haemorrhoidal treatment consensus, there are many practice similarities among the different cultures, resources, volume and experience of surgeons around the world. With additional studies, a consensus statement could potentially be developed
