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The purpose of this paper is to propose a robotic system for percutaneous surgery. The key component in the system, a robotic arm that can manipulate a puncture needle is presented. The mechanical design, the motion control and the force control method of the robotic arm are discussed in the paper.

The arm with an arc mechanism placed on a 3D Cartesian stage is developed as a puncture needle manipulator to locate the position of the needle tip, tune the needle’s posture and actuate the puncture motion under the visual guidance of two orthogonal X-ray images of a patient by a surgeon. A focusing method by using two laser spots is proposed to automatically move the needle tip to a surgery entry point on the skin. A dynamics model is developed to control the position of the needle mechanism and an explicit force control strategy is utilized to perform the needle insertion.

With the surgical system, a surgeon can easily perform puncture operation by taking two orthogonal real-time X-ray images as a visual feedback and accurately navigating the needle insertion. The laser-guided focusing method is efficient in placement of the needle tip. The explicit force control strategy is proved to be effective for holding constant and stable puncture force in experiments.

The robotic arm has an advantage in easy redirection of the needle because the rotation and the translation are decoupled in the mechanism. By adopting simple laser pens and a well-developed kinematics model, the system can handle the entry point, locating task automatically. The focusing method and the force control method proposed in the paper are useful for the present system and could be intuitive for similar surgical robots.

One of the biggest challenges in the health sector is that of costs compared to economic resources and the quality of services. Hospitals register a progressive increase in expenditure due to the aging of the population. In fact, hip and knee arthroplasty surgery are mainly due to primary osteoarthritis that affects the elderly population. This study was carried out with the aim of analysing the introduction of the fast track surgery protocol, through the lean Six Sigma, on patients undergoing knee and hip prosthetic replacement surgery. The goal was to improve the arthroplasty surgery process by reducing the average length of stay (LOA) and hospital costs

Lean Six Sigma was applied to evaluate the arthroplasty surgery process through the DMAIC cycle (define, measure, analyse, improve and control) and the lean tools (value stream map), adopted to analyse the new protocol and improve process performance. The dataset consisted of two samples of patients: 54 patients before the introduction of the protocol and 111 patients after the improvement. Clinical and demographic variables were collected for each patient (gender, age, allergies, diabetes, cardiovascular diseases and American Society of Anaesthesiologists (ASA) score).

The results showed a 12.70% statistically significant decrease in LOS from an overall average of 8.72 to 7.61 days. Women patients without allergies, with a low ASA score not suffering from diabetes and cardiovascular disease showed a significant a reduction in hospital days with the implementation of the FTS protocol. Only the age variable was not statistically significant.

The introduction of the FTS in the orthopaedic field, analysed through the LSS, demonstrated to reduce LOS and, consequently, costs. For each individual patient, there was an economic saving of € 445.85. Since our study takes into consideration a dataset of 111 patients post-FTS, the overall economic saving brought by this study amounts to €49,489.35.

The purpose of this paper is to illuminate the ethical concerns associated with the use of artificial intelligence (AI) in the medical sector and to provide solutions that allow deriving maximum benefits from this technology without compromising ethical principles.

This paper provides a comprehensive overview of AI in medicine, exploring its technical capabilities, practical applications, and ethical implications. Based on our expertise, we offer insights from both technical and practical perspectives.

The study identifies several advantages of AI in medicine, including its ability to improve diagnostic accuracy, enhance surgical outcomes, and optimize healthcare delivery. However, there are pending ethical issues such as algorithmic bias, lack of transparency, data privacy issues, and the potential for AI to deskill healthcare professionals and erode humanistic values in patient care. Therefore, it is important to address these issues as promptly as possible to make sure that we benefit from the AI’s implementation without causing any serious drawbacks.

This paper gains its value from the combined practical experience of Professor Elhassan gained through his practice at top hospitals worldwide, and the theoretical expertise of Dr. Arabi acquired from international institutes. The shared experiences of the authors provide valuable insights that are beneficial for raising awareness and guiding action in addressing the ethical concerns associated with the integration of artificial intelligence in medicine.

The purpose of this study is to describe the design and validation of a three-dimensional (3D)-printed phantom of a uterus to support the development of uterine balloon tamponade devices conceived to stop post-partum haemorrhages (PPHs).

The phantom 3D model is generated by analysing the main requirements for validating uterine balloon tamponade devices. A modular approach is implemented to guarantee that the phantom allows testing these devices under multiple working conditions. Once finalised the design, the phantom effectiveness is validated experimentally.

The modular phantom allows performing the required measurements for testing the performance of devices designed to stop PPH.

PPH is the leading obstetric cause of maternal death worldwide, mainly in low- and middle-income countries. The proposed phantom could speed up and optimise the design and validation of devices for PPH treatment, reducing the maternal mortality ratio.

To the best of the authors’ knowledge, the 3D-printed phantom represents the first example of a modular, flexible and transparent uterus model. It can be used to validate and perform usability tests of medical devices.

Is humanity heading to immortal living? If so, what areas of society are playing an active role in achieving this? In order to understand this, the study explores the relationship between immortality and the wellness and medical tourism industry to seek potential relationships between them and ultimately, asks difficult questions about the growth of these tourism sectors and the potential need for greater regulation of them.

Taking a pragmatic philosophical approach and through the examination of refined information from secondary sources and published material and reports, the study presents original theoretical knowledge and a model exploring tourism and human immortality.

This paper argues that continued growth in the wellness and medical markets today could lead to a world where transhumanists and cyborgs are present in our world, even taking over from Homo sapiens. The study presents a model highlighting the potential role of wellness and medical tourism markets, illustrating the potential for future consumer services that could further fuel the search for immortality. Thus, how such markets and consumer desires are (in)directly supporting humanities desire for (non-human) immortal existence.

Today, individuals are driven by wellness practices and medical and cosmetic desires and are willing to travel the globe in search of companies who are either capable of carrying out the desired procedures or seeking prices more affordable to them. This research offers novel insights into these complex relationships and maps the affiliation between wellness and medical practices and the concept of immortality.

This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in Colombia. Also, to increase the amount of diagnosis training of vascular surgery (VS) in civilians.

The operation method includes five stages: strategy development and adjustment; translation of the strategy into a real-world setting; operation logistics planning; strategy analysis and adoption. The operation plan worked efficiently in this study’s sample. It demonstrated high sensibility, efficiency and safety in a real-world setting.

The authors developed and implemented a flow model operating plan for screening vascular pathologies in low-income patients pro bono without proper access to vascular health care. A total of 140 patients from rural areas in Colombia were recruited to a controlled screening session where they underwent serial noninvasive ultrasound assessments conducted by health professionals of different training stages in VS.

The plan was designed to be implemented in remote, conflict areas with limited access to VS care. Vascular injuries are critically important and common among civilians and military forces in regions with active armed conflicts. As this strategy can be modified and adapted to different medical specialties and geographic areas, the authors recommend checking the related legislation and legal aspects of the intended areas where we will implement this tool.

Different sub-specialties can implement the described method to be translated into significant areas of medicine, as the authors can adjust the deployment and execution for the assessment in peripheral areas, conflict zones and other public health crises that require a faster response. This is necessary, as the amount of training to which VS trainees are exposed is low. A simulated exercise offers a novel opportunity to enhance their current diagnostic skills using ultrasound in a controlled environment.

Evaluating and assessing patients with limited access to vascular medicine and other specialties can decrease the burden of vascular disease and related complications and increase the number of treatments available for remote communities.

It is essential to assess the most significant number of patients and treat them according to their triage designation. This management is similar to assessment in remote areas without access to a proper VS consult. The authors were able to determine, classify and redirect to therapeutic interventions the patients with positive findings in remote areas with a fast deployment methodology in VS.

Access to health care is limited due to multiple barriers and the assessment and response, especially in peripheral areas that require a highly skilled team of medical professionals and related equipment. The authors tested a novel mobile assessment tool for remote and conflict areas in a rural zone of Colombia.

Quantifying the performance level of surgeons with digital virtual reality (VR) simulators can help ensure that quality requirements in healthcare are met. In order to better understand integration amongst quality principles, practices and technologies in the adoption and diffusion of VR simulators, the authors applied a technological innovation system (TIS) framework. The purpose of this study is to understand how the adoption and diffusion of VR surgical simulators in a Swedish healthcare context is influenced by various system factors.

In this study, single-case holistic design based on innovation system theory was used to analyse the adoption of digital quality technologies related to surgical performance in Swedish hospitals. The case employs a mixed methods approach triangulating data longitudinally from published documents and expert interviews.

Adoption of digital technologies regarding surgical performance is restricted by system factors relating to inconsistent normative and regulatory requirements for quantified performance criteria to judge surgical expertise. Addressing these systems' weaknesses with evidence-based training programmes can have a significant impact on the further development of the innovation system and can ultimately affect healthcare reliability and quality.

This paper explores quality management (QM) challenges in the context of digital transformation in healthcare. The paper attempts to fill the gap for TIS studies in a healthcare context and highlight the role of innovation function strength along the value chain and in relation to technology cycles to increase the understanding of adoption of digital technologies relating to surgical performance.

The pandemic has reinforced the need for revamping the healthcare service delivery systems around the world to meet the increased challenges of modern-day illnesses. The use of medical cyber–physical system (MCPS) in the healthcare is one of the means of transforming the landscape of the traditional healthcare service delivery system. The purpose of this study is to critically examine the impact of MCPS on the quality of healthcare service delivery.

This paper uses an evidence-based approach, the authors have conducted a systematic literature review to study the impact of MCPS on healthcare service delivery. Fifty-four articles were thematically examined to study the impact of MCPS on eight characteristics of the healthcare service delivery proposed by the world health organisation.

The study proposes support that MCPS will positively impact (1) comprehensiveness, (2) accessibility, (3) coverage, (4) continuity, (5) quality, (6) person-centredness, (7) coordination, (8) accountability and (9) efficiency dimension of the healthcare service delivery. The study further draws nine propositions to support the impact of MCPS on the healthcare service delivery.

This study can be used by stakeholders as a guide point while using MCPS in healthcare service delivery systems. Besides, healthcare managers can use this study to understand the performance of their healthcare system. This study can further be used for designing effective strategies for deploying MCPS to be effective and efficient in each of the dimensions of healthcare service delivery.

The previous studies have focussed on technology aspects of MCPS and none of them critically analysed the impact on healthcare service delivery. This is the first literature review carried out to understand the impact of MCPS on the nine dimensions of healthcare service delivery proposed by WHO. This study provides improved thematic awareness of the resulting body of knowledge, allowing the field of MCPS and healthcare service delivery to progress in a more informed and multidisciplinary manner.

The purpose of this paper is to establish a chair-side design and production method for a tooth-supported fixed implant guide and to evaluate its accuracy.

Three-dimensional (3D) data of the alveolar ridge, adjacent teeth and antagonistic teeth were acquired from models of the edentulous area of 30 patients. The implant guides were then constructed using self-developed computer-aided design software and chair-side fused deposition modelling 3D-printing and positioned on a dental model. A model scanner was used to acquire 3D data of the positioned implant guides, and the overall error was then evaluated.

The overall error was 0.599 ± 0.146 mm (n = 30). One-way ANOVA revealed no statistical differences among the 30 implant guides. The gap between the occlusal surface of the teeth covering and the tissue surface of the implant guide was measured. The maximum gap after positioning of the implant guide was 0.341 mm (mean, 0.179 ± 0.019 mm). The implanted axes of the printed implant guide and designed guide were compared in terms of overall, lateral and angular error, which were 0.104 ± 0.004 mm, 0.097 ± 0.003 mm, and 2.053° ± 0.017°, respectively.

The results of this study demonstrated that the accuracy of a new chair-side tooth-supported fixed implant guide can satisfy clinical requirements.

This study aims to examine some of the benefits and drawbacks of communication visibility. Specifically, building on communication visibility theory, the authors study how and why message transparency and network translucence may increase knowledge reuse and perceived overload through behavioral responses of vicarious learning and technology-assisted supplemental work.

Drawing on survey data obtained from 1,127 employees of a global company operating in the industrial machinery sector, the authors used structural equation modeling to test the hypothesized model.

The results demonstrate that the two aspects of communication visibility yield somewhat differential benefits and drawbacks in terms of knowledge reuse and communication overload, through vicarious learning and supplemental work practices.

The results demonstrate the relationship between different aspects of communication visibility and knowledge reuse, specifically through vicarious learning. Furthermore, the findings highlight a potential drawback of visibility – communication overload – specifically through technology-assisted supplemental work. Overall, network translucence seems more beneficial compared to message transparency in terms of knowledge reuse and communication overload.

The study connects with recent work on communication visibility by distinguishing differential direct and indirect effects of message transparency and network translucence. It also extends this work by testing relationships between communication visibility and a potential drawback of visibility – communication overload – specifically through technology-assisted supplemental work.