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Three-dimensional analysis of microneurosurgical approach for robotic surgery

机器人手术显微神经外科手术方法的三维分析

基本信息

批准号：
15591515
负责人：
TANAKA Yuichiro
金额：
$ 1.22万
依托单位：
Shinshu University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2006
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15591515/
关键词：
robotic surgery computer brain tumor surgical simulation 脳動脈瘤流体力学シミュレーション MRI

项目摘要

Establishment of robotic surgery is needed to perform further accurate microneurosurgery for lesions in the central nervous system. The lesions of the central nervous system is cooped in the hard skull and the anatomical structures around the lesions are very complex. Therefore, more accurate microneurosurgical technique is required than surgeries in the other locations. The robotic surgery is not yet practical because of the anatomical complexity of the central nervous system. In order to advance the robotic system for neurosurgery, we found it necessary to analyze the surgical approaches to various intracranial lesions, for example, cerebral aneurysm, arteriovenous malformation, pituitary adenoma, craniopharyngioma, meningioma, acoustic neurinoma, etc. The aim of the present study is to obtain data regarding the surgical approaches to undergo microsurgical robotic operation under high magnification.Retrospective analysis was performed to know factors for influencing functional outcom … More e and best treatment strategy in craniopharyngiomas. 56 patients were treated between 1978 and 2005. They were initially treated with surgery and surgical cure was obtained in 29 patients (Group A). Subtotal tumor resection with prophylactic radiation was performed in 8 patients (Group D). Tumor recurrence was noted in 19 patients and stereotactic radiation or 2nd operation was performed in 11 patients (Group B). 2nd operation and fractionated radiation were undertaken in 8 patients (Group C). Endocrine, vision and recognition were scored from 2 to 0, respectively ; 2 indicates normal, 1 partially disturbed, 0 fully disturbed. The mean score before treatment was 4.7 and the final was 3.9. Factors leading to poor outcome included extrasellar origin, solid tumor, bad score before treatment, 2nd surgery for recurrence. The change of scores after the treatment was-0.1 in group A, -0.7 in Group B, -0.9 in Group C and 0.3 in Group D. Maximum tumor removal should be attempted with functional preservation. Subtotal removal with prophylactic radiation is recommended if the patient had normal hypothalamic function.The aim of vestibular schwannoma surgery for neurosurgeons in the era of gamma knife is total tumor removal without any neurological deterioration. We describe anatomical landmarks such as emissary vein, subarcuate artery, endolymphatic sac, vestibular aqueduct, common crus, jugular bulb, and cochlear aqueduct and the related surgical techniques. The suboccipital approach is one of the most fundamental surgical approaches in neurosurgery and should be always revised based on the recent neuroimaging studies and anatomical knowledge Less

需要建立机器人手术来对中枢神经系统病变进行进一步精确的显微神经外科手术。中枢神经系统的病变局限于坚硬的颅骨内，病变周围的解剖结构非常复杂。因此，需要比其他部位手术更精确的显微神经外科技术。由于中枢神经系统的解剖学复杂性，机器人手术尚未实用。为了推进神经外科机器人系统的发展，我们发现有必要分析各种颅内病变的手术入路，例如脑动脉瘤、动静脉畸形、垂体腺瘤、颅咽管瘤、脑膜瘤、听神经鞘瘤、本研究的目的是获得在高倍镜下进行显微外科机器人手术的手术入路数据，并进行回顾性分析了解影响功能结果的因素 ...更多信息颅咽管瘤的最佳治疗策略1978年至2005年间共治疗了56例患者。他们最初接受手术治疗，29例患者（A组）获得手术治愈。8例患者（D组）接受肿瘤次全切除和预防性放疗。B组19例肿瘤复发，11例接受立体定向放射治疗或二次手术。C组8例，行二次手术加分次放疗。内分泌、视力和识别分别从2到0评分; 2表示正常，1表示部分干扰，0表示完全干扰。治疗前平均评分为4.7，最终评分为3.9。导致预后不良的因素包括鞍外起源、实体瘤、治疗前评分差、复发二次手术。治疗后A组、B组、C组和D组的评分变化分别为-0.1、-0.7、-0.9和0.3。应尽量切除肿瘤并保留功能。如果患者的下丘脑功能正常，则建议在预防性放射的情况下进行次全切除。在伽玛刀时代，神经外科医生的前庭神经鞘瘤手术的目标是完全切除肿瘤，而不会导致任何神经功能恶化。我们描述了解剖标志，如导静脉，弓状下动脉，内淋巴囊，前庭水管，总动脉，颈静脉球，耳蜗水管和相关的手术技术。枕下入路是神经外科最基本的手术入路之一，应根据最新的神经影像学研究和解剖学知识进行修订。