Design of a bone-attached parallel robot for percutaneous cochlear implantation.
Design of a bone-attached parallel robot for percutaneous cochlear implantation.
复制标题
用于经皮的耳蜗植入的骨骼和平行机器人的设计。
DOI：
10.1109/tbme.2011.2162512
复制
发表时间：
2011-10
期刊：
影响因子：
--
通讯作者：
Webster RJ 3rd
中科院分区：
文献类型：
--
作者：
Kratchman LB;Blachon GS;Withrow TJ;Balachandran R;Labadie RF;Webster RJ 3rd
接触耳蜗需要在接近骨嵌入的神经、血管和其他结构的地方钻探，违反这些结构可能会导致患者的并发症。最近的研究表明，微立体定向架可以实现图像引导的经皮途径，消除对人类经验和手眼协调的依赖，并减少创伤。然而，构建目前的微立体定向框架会扰乱临床工作流程，需要数天的外科内制造延迟，或者医院内或附近的随叫随到的机器车间。在这篇文章中，我们描述了一种新的微立体定向框架，它通过可重定位避免了这些延迟和基础设施问题。受骨附着式并联机器人在膝关节和脊柱手术中的成功经验的启发，我们提出了一种自动图像引导的微立体定向架。实验表明，在使用来自人类临床数据集的轨迹进行体模测试时，耳蜗处的平均精度为0.20±0.07 mm。我们还描述了一个评估整个图像引导手术流水线的身体实验，在该实验中，我们在耳蜗处获得了0.38毫米的精度。
Access to the cochlea requires drilling in close proximity to bone-embedded nerves, blood vessels, and other structures, the violation of which can result in complications for the patient. It has recently been shown that microstereotactic frames can enable an image-guided percutaneous approach, removing reliance on human experience and hand–eye coordination, and reducing trauma. However, constructing current microstereotactic frames disrupts the clinical workflow, requiring multiday intrasurgical manufacturing delays, or an on-call machine shop in or near the hospital. In this paper, we describe a new kind of microsterotactic frame that obviates these delay and infrastructure issues by being repositionable. Inspired by the prior success of bone-attached parallel robots in knee and spinal procedures, we present an automated image-guided microstereotactic frame. Experiments demonstrate a mean accuracy at the cochlea of 0.20 ± 0.07 mm in phantom testing with trajectories taken from a human clinical dataset. We also describe a cadaver experiment evaluating the entire image-guided surgery pipeline, where we achieved an accuracy of 0.38 mm at the cochlea.