title: Kinematic and experimental investigation of manual resection tools for transurethral bladder tumor resection.
abstract: BACKGROUND
  Transurethral Resection of Bladder Tumors (TURBT) is a challenging procedure partly due to resectoscope limitations. To date, manual resection performance has not been fully characterized. This work characterizes manual resection performance in the bladder while analyzing the effect of resection location on accuracy.
  
  
  METHODS
  Kinematic simulations are used to assess kinematic measures of resection dexterity. An experimental protocol for manual resection accuracy assessment is developed. Cross correlations between the theoretical performance measures and the observed experimental accuracy are investigated.
  
  
  RESULTS
  Tangential accuracy correlates relatively strongly with normal singular value and moderately with tangential kinematic conditioning index and tangential minimum singular value. Simulations also clarified difficulties in resecting close to the bladder neck.
  
  
  CONCLUSIONS
  Measures to evaluate accuracy and dexterity of TURBT from a kinematic viewpoint are presented to provide a currently missing quantified dexterity baseline in manual TURBT. Limitations in various bladder regions are illustrated. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, 37240, USA.|Vanderbilt Initiative in Surgical Engineering (ViSE), Nashville, Tennessee, USA.
authors.forename: Nima
authors.initials: N
authors.lastname: Sarli
authors.affiliation: Department of Urologic Surgery, A-1302 Medical Center North, Vanderbilt University Medical Center, Nashville, TN, 37232-2765.
authors.forename: Tracy
authors.initials: T
authors.lastname: Marien
authors.affiliation: Department of Urologic Surgery, A-1302 Medical Center North, Vanderbilt University Medical Center, Nashville, TN, 37232-2765.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Mitchell
authors.affiliation: Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, 37240, USA.|Vanderbilt Initiative in Surgical Engineering (ViSE), Nashville, Tennessee, USA.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Del Giudice
authors.affiliation: School of Nursing, Vanderbilt University, Nashville, TN, USA.|Department of Biostatistics, School of Medicine, Vanderbilt University, Nashville, TN, USA.
authors.forename: Mary S
authors.initials: MS
authors.lastname: Dietrich
authors.affiliation: Department of Urologic Surgery, A-1302 Medical Center North, Vanderbilt University Medical Center, Nashville, TN, 37232-2765.|Vanderbilt Initiative in Surgical Engineering (ViSE), Nashville, Tennessee, USA.
authors.forename: S Duke
authors.initials: SD
authors.lastname: Herrell
authors.affiliation: Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, 37240, USA.|Vanderbilt Initiative in Surgical Engineering (ViSE), Nashville, Tennessee, USA.
authors.forename: Nabil
authors.initials: N
authors.lastname: Simaan
mesh_terms: D001696:Biomechanical Phenomena; D003198:Computer Simulation; D017076:Computer-Aided Design; D003558:Cystoscopy / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D058733:Hand-Assisted Laparoscopy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D000072662:Margins of Excision; D008962:Models, Theoretical; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D065287:Robotic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D012680:Sensitivity and Specificity; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*
keywords: TURBT; bladder cancer; dexterity evaluation; kinematics; resectoscope