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Papers by Rafael Grossmann

Emerging science journal, Apr 1, 2024

Despite the location (Earth or Space), surgical simulation is a vital part of improving technical... more Despite the location (Earth or Space), surgical simulation is a vital part of improving technical skills and ensuring patients' safety in the real procedure. The purpose of this study is to describe the Space System for Minimally Invasive Surgery (SY-MIS©) project, which started in 2016 under the supervision of the Center for Space Systems (C-SET). The process connects the best features of the following machines: Biomedik Surgeon, Space Biosurgeon, SP-LAP 1, and SP-LAP 2, which were defined using the VDI 2221 guidelines. This research uses methods based on 3 standards: i) Biomedical design: ISO 9001-13485 / FDA 21 CFR 820.30 / ASTM F1744-96(2016); ii) Aerospace human factors: HF-STD-001; iii) Mechatronics design: VDI 2206. The results depict the conceptual biomedical design of a novel training system named Surgical Engineering and Mechatronic System (SETY©), which integrates the use of 2 laparoscopic tools and 2 anthropomorphic mini-robotic arms (6 DOF). It has been validated by the Evaluation of Technical Criteria, getting a total score of 90% related to clinical assessment, machine adaptability, and robustness. The novelty of the research lies in the introduction of a new procedure that covers the simultaneous use of laparoscopic and robotic systems, named Hybrid Cyber-Physical Surgery (HYS©). In conclusion, the development of SY-MIS© promotes the use of advanced technologies to improve surgical procedures and humanmachine medical cooperation for the next frontier of habitability on other planets.

Actas Urologicas Espanolas, Oct 1, 2021

INTRODUCTION AND OBJECTIVE Artificial intelligence (AI) is in full development and its implementa... more INTRODUCTION AND OBJECTIVE Artificial intelligence (AI) is in full development and its implementation in medicine has led to an improvement in clinical and surgical practice. One of its multiple applications is surgical training, with the creation of programs that allow avoiding complications and risks for the patient. The aim of this article is to analyze the advantages of AI applied to surgical training in urology. MATERIAL AND METHODS A literary research is carried out to identify articles published in English regarding AI applied to medicine, especially in surgery and the acquisition of surgical skills. RESULTS Surgical training has evolved over time thanks to AI. A model for surgical learning where skills are acquired in a progressive way while avoiding complications to the patient, has been created. The use of simulators allows a progressive learning, providing trainees with procedures that increase in number and complexity. On the other hand, AI is used in imaging tests for surgical or treatment planning. CONCLUSION Currently, the use of AI in daily clinical practice has led to progress in medicine, specifically in surgical training.

Actas Urológicas Españolas (English Edition), 2021

Journal of Digital Imaging, 2022

Augmented and virtual reality devices are being actively investigated and implemented for a wide ... more Augmented and virtual reality devices are being actively investigated and implemented for a wide range of medical uses. However, significant gaps in the evaluation of these medical devices and applications hinder their regulatory evaluation. Addressing these gaps is critical to demonstrating the devices’ safety and effectiveness. We outline the key technical and clinical evaluation challenges discussed during the US Food and Drug Administration’s public workshop, “Medical Extended Reality: Toward Best Evaluation Practices for Virtual and Augmented Reality in Medicine” and future directions for evaluation method development. Evaluation challenges were categorized into several key technical and clinical areas. Finally, we highlight current efforts in the standards communities and illustrate connections between the evaluation challenges and the intended uses of the medical extended reality (MXR) devices. Participants concluded that additional research is needed to assess the safety and...

BioMed Research International

Three-dimensional printing (3DP) has recently gained importance in the medical industry, especial... more Three-dimensional printing (3DP) has recently gained importance in the medical industry, especially in surgical specialties. It uses different techniques and materials based on patients’ needs, which allows bioprofessionals to design and develop unique pieces using medical imaging provided by computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, the Department of Biology and Medicine and the Department of Physics and Engineering, at the Bioastronautics and Space Mechatronics Research Group, have managed and supervised an international cooperation study, in order to present a general review of the innovative surgical applications, focused on anatomical systems, such as the nervous and craniofacial system, cardiovascular system, digestive system, genitourinary system, and musculoskeletal system. Finally, the integration with augmented, mixed, virtual reality is analyzed to show the advantages of personalized treatments, taking into account the improvements for preo...

Current Opinion in Urology, 2020

PURPOSE OF REVIEW Artificial intelligence appears as a potential revolution in the general proces... more PURPOSE OF REVIEW Artificial intelligence appears as a potential revolution in the general process of medical training, disease diagnosis and treatment. A novel disruptive technology of the 21st century will be 'learner' robots from artificial intelligence systems able to use all the combination of the available knowledge in medical repositories to give the best standard of care. RECENT FINDINGS The autonomy level of robots depends on three factors: the complexity of the task; the environment in which the robot operates, and the required level of human-robot interaction. Autonomous robots in healthcare may be classified in delivery, nurse, and surgical robots. The increasing capability of robots to perform independent actions and complex tasks raises responsibility and accountability issues in a wide variety of application domains. Ethical analyses of these issues are underway and are mostly oriented toward the development of ethical policies requiring a law frame on robotic autonomous behaviors. SUMMARY Autonomous robots have the potential to improve current medical practice offering a more secure, reliable, and reproducible medicine. Many advancements are required for these new technologies to be fully integrated. Furthermore, the ethical implications of these technologies are yet to be evaluated.

Bulletin of the American College of Surgeons, 2011

mHealth, 2015

The new term improved reality (i-Reality) is suggested to include virtual reality (VR) and augmen... more The new term improved reality (i-Reality) is suggested to include virtual reality (VR) and augmented reality (AR). It refers to a real world that includes improved, enhanced and digitally created features that would offer an advantage on a particular occasion (i.e., a medical act). I-Reality may help us bridge the gap between the high demand for medical providers and the low supply of them by improving the interaction between providers and patients.

Telehealth and Medicine Today® ISSN 2471-6960 https://doi.org/10.30953/tmt.v6.248 Predictions for... more Telehealth and Medicine Today® ISSN 2471-6960 https://doi.org/10.30953/tmt.v6.248 Predictions for Telehealth in 2021: We Cannot Wait for It! Lyle Berkowitz, MD, FACP, FHIMSS;1 Shayan Vyas, MD, MBA, FAAP;2 Igor O. Korolev, DO, PhD;3 Paul De Raeve, RN, MSc, MStat, PhD;4 Prabhakaran Dorairaj, MD, DM (Cardiology), MSc, FRCP, FNASC;5 Prof. Sergio Pillon;6 Matthew Sakumoto, MD;7 Ingrid Vasiliu-Feltes, MD;8 Liz Ashall-Payne,9 Mitch B. Parker, MBA, CISSP;10 Brendan Smith;11,12 Allison Viola, MBA;13 Rafael J. Grossmann, MD, FACS;14 Srikanth Velamakanni;15 Chris Roberts;16 Amar Gupta, MBA, PhD; John D. Halamka, MD17

Bulletin of the American College of Surgeons