ML

M.C. Lemmens

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Robotic-assisted surgical methods are advancing rapidly, offering potential advantages such as improved precision, accuracy, and reduced patient recovery times. However, widespread adoption depends not only on technological advancements but also on patient acceptance and willingness to consent. Informed consent plays a crucial role in the successful integration of robotic-assisted surgery into clinical practice, making it essential to understand the factors influencing patient decision-making.

This study investigates the key factors influencing patient willingness to consent to robotic-assisted total hip replacement surgery in the Netherlands, using a direct-effects model and an extended Technology Acceptance Model (eTAM). A questionnaire-based survey was conducted to assess trust, perceived usefulness (PU), perceived complexity (PC) and willingness to consent across five different surgical scenarios with varying levels of robotic involvement and surgeon presence.

Results indicated that trust and PU showed the strongest association with willingness to consent across all scenarios, emphasizing the need for healthcare providers to prioritize transparency, building trust and discussion risks and benefits. Testing the mediating effect of showed that PU did not act as a consistent mediating variable in any of the scenarios. ANOVA results revealed significant differences between surgical scenarios, with robotic-assisted surgery performed by a surgeon receiving the highest ratings in PU, trust, and willingness to consent. Remote surgery was perceived as the most complex surgical scenario. Participant preferred autonomous robotic surgery over conventional (manual) surgery, despite higher trust and willingness scores for the latter.

Participants also had varying views on the role of technicians in robotic surgery. While many saw their presence as essential for system reliability, others associated it with potential system flaws, emphasizing the need for clear communication about their role. Additionally, most participants mentioned the need for full disclosure regarding surgical methods, reinforcing the importance of patient autonomy.

These findings provide valuable insights for healthcare providers and policymakers to improve informed consent procedures and increase the adoption of robotic-assisted surgery. By addressing patient concerns through education, transparency and building trust, healthcare providers can improve patient comfort and willingness to consent to robotic (assisted) surgery. ...
Organ-on-a-chip (OoC) technology has revolutionized the biomedical research field by offering dynamic platforms which accurately mimic physiological environments of human tissue. This technology has become a promising option to study human biology in vitro, including disease modeling, drug screening and personalized medicine. Organoids, 3D cell cultures derived from human stem cells, represent a promising tool to investigate 3D tissue growth in vitro. However, integration of vasculature in these organoids remains a significant challenge. Establishment of vasculature is essential to enable significant organoid growth, allowing nutrient and oxygen supply and waste removal.

This report aims to develop a Pluronic F127 based hydrogel as a transient barrier in an OoC-platform that combines cell cultures of Vasculature-on-a-Chip and cortical brain organoids. This transient barrier separates the two cell cultures until sufficient maturation of the cortical organoid. Due to thermoreversible gelation, the Pluronic F127 hydrogel barrier can be removed from the barrier channel by a decrease in temperature. Pluronic F127 and di-acrylated Pluronic F127 hydrogels were synthesizes and characterized using rheometry, differential scanning calorimetry and degradation testing to determine the optimal Pluronic F127 hydrogel. Simultaneously, optimization of the OoC-platform was done by fabrication of the platform using Polydimethylsiloxane (PDMS).

It was shown that the OoC platform for Vascularized Organoids-on-a-Chip could effectively by fabricated using PDMS molding. This was achieved through both PDMS-PDMS and PDMS-glass bonding. Pluronic F127 hydrogels were shown to be a viable option to function as a transient barrier for Vascularized Organoids-on-a-Chip. Pluronic F127 hydrogels effectively blocked fluid flow through the barrier channel for seven days. To increase this time, di-acrylated Pluronic F127 was synthesizes. A degree of acrylation of 57% was achieved. This was shown to be insufficient to significantly increase the longevity of Pluronic F127 hydrogels.

Further research needs to be done to find the optimal synthesis and photo-polymerization conditions of di-acrylated Pluronic F127 hydrogels. Ideally, di-acrylated Pluronic F127 hydrogels exhibit a low degradation rate while maintaining the thermoreversible properties of Pluronic F127 hydrogels. ...