A self-developed and constructed robot for minimally invasive cochlear implantation
A self-developed and constructed robot for minimally invasive cochlear implantation
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DOI：
10.3109/00016489.2011.642813
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发表时间：
2012-04-01
影响因子：
1.4
通讯作者：
Weber, Stefan
中科院分区：
文献类型：
--
作者：
Bell, Brett;Stieger, Christof;Weber, Stefan
结论：与基于工业机器人的现有方法相比，专门为立体定向耳蜗植入而构建的机器人提供了相同或更好的准确度水平，以及更好地集成到临床环境中。目的：旨在评价专门为侧颅底手术开发的机器人系统在反映预期临床应用的实验装置中的技术准确性。耳蜗电极植入手术的侵入性可以通过用直径略大于电极本身的小隧道代替传统的乳突切除术来降低。研究方法：在15个全头尸体标本的颞骨上评估了机器人系统和相关图像引导程序的端到端精度。手术的主要组成部分如下：参考螺钉放置、锥形束CT扫描、计算机辅助计划、手术计划的配对点匹配、直接入路隧道的机器人钻孔和术后锥形束CT扫描以评估准确性。结果：目标点（圆窗）的平均精度为0.56 +/- 0.41 mm，角度偏差为0.88 +/- 0.40度。从配准过程到完成钻孔过程的手术时间为25 +/- 11 min。机器人在临床环境中完全可操作。
Conclusion: A robot built specifically for stereotactic cochlear implantation provides equal or better accuracy levels together with a better integration into a clinical environment, when compared with existing approaches based on industrial robots. Objectives: To evaluate the technical accuracy of a robotic system developed specifically for lateral skull base surgery in an experimental set-up reflecting the intended clinical application. The invasiveness of cochlear electrode implantation procedures may be reduced by replacing the traditional mastoidectomy with a small tunnel slightly larger in diameter than the electrode itself. Methods: The end-to-end accuracy of the robot system and associated image-guided procedure was evaluated on 15 temporal bones of whole head cadaver specimens. The main components of the procedure were as follows: reference screw placement, cone beam CT scan, computer-aided planning, pair-point matching of the surgical plan, robotic drilling of the direct access tunnel, and postoperative cone beam CT scan for accuracy assessment. Results: The mean accuracy at the target point (round window) was 0.56 +/- 0.41 mm with an angular misalignment of 0.88 +/- 0.40 degrees. The procedural time for the registration process through the completion of the drilling procedure was 25 +/- 11 min. The robot was fully operational in a clinical environment.