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- Vrielink, O. M., et al.
(författare)
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Multicentre study evaluating the surgical learning curve for posterior retroperitoneoscopic adrenalectomy
- 2018
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 105:5, s. 544-551
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPosterior retroperitoneoscopic adrenalectomy has gained international popularity in the past decade. Despite major advantages, including shorter duration of operation, minimal blood loss and decreased postoperative pain, many surgeons still prefer laparoscopic transperitoneal adrenalectomy. It is likely that the unfamiliar anatomical environment, smaller working space and long learning curve impede implementation. The present study assessed the number of procedures required to fulfil the surgical learning curve for posterior retroperitoneoscopic adrenalectomy.MethodsThe first consecutive posterior retroperitoneoscopic adrenalectomies performed by four surgical teams from university centres in three different countries were analysed. The primary outcome measure was duration of operation. Secondary outcomes were conversion to an open or laparoscopic transperitoneal approach, complications and recovery time. The learning curve cumulative sum (LC-CUSUM) was used to assess the learning curves for each surgical team.ResultsA total of 181 surgical procedures performed by four surgical teams were analysed. The median age of the patients was 57 (range 15–84) years and 61·3 per cent were female. Median tumour size was 25 (range 4–85) mm. There were no significant differences in patient characteristics and tumour size between the teams. The median duration of operation was 89 (range 29–265) min. There were 35 perioperative and postoperative complications among the 181 patients (18·8 per cent); 17 of 27 postoperative complications were grade 1. A total of nine conversions to open procedures (5·0 per cent) were observed. The LC‐CUSUM analysis showed that competency was achieved after a range of 24–42 procedures.ConclusionIn specialized endocrine surgical centres between 24 and 42 procedures are required to fulfil the entire surgical learning curve for the posterior retroperitoneoscopic adrenalectomy. Large annual case-load required
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- Hanheide, Marc, et al.
(författare)
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Robot task planning and explanation in open and uncertain worlds
- 2015
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Ingår i: Artificial Intelligence. - : Elsevier. - 0004-3702 .- 1872-7921.
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Tidskriftsartikel (refereegranskat)abstract
- A long-standing goal of AI is to enable robots to plan in the face of uncertain and incomplete information, and to handle task failure intelligently. This paper shows how to achieve this. There are two central ideas. The first idea is to organize the robot's knowledge into three layers: instance knowledge at the bottom, commonsense knowledge above that, and diagnostic knowledge on top. Knowledge in a layer above can be used to modify knowledge in the layer(s) below. The second idea is that the robot should represent not just how its actions change the world, but also what it knows or believes. There are two types of knowledge effects the robot's actions can have: epistemic effects (I believe X because I saw it) and assumptions (I'll assume X to be true). By combining the knowledge layers with the models of knowledge effects, we can simultaneously solve several problems in robotics: (i) task planning and execution under uncertainty; (ii) task planning and execution in open worlds; (iii) explaining task failure; (iv) verifying those explanations. The paper describes how the ideas are implemented in a three-layer architecture on a mobile robot platform. The robot implementation was evaluated in five different experiments on object search, mapping, and room categorization.
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