The international journal of medical robotics + computer assisted surgery : MRCAS
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Navigation systems are now frequently being used for guiding surgical procedures. Existing neuronavigation systems suffer from the lack of updated images when tissue changes during surgery as well as from user-friendly displays of all essential images for accurate and safe surgery guidance. ⋯ We claim that new features, as demonstrated in the present paper, using intraoperative 3D ultrasound in combination with advanced registration and display algorithms will represent important contributions towards more accurate, safer and more optimized future patient treatment.
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The insertion of distal locking screws is a difficult task in intra-medullary (IM) nailing operations of long bones and contributes a significant proportion to the overall operating time. The current technique to insert these screws uses numerous fluoroscopic images and depends on the skills and expertise of the surgeon. The Computer Assisted Orthopaedic Surgical System (CAOSS) was developed to assist orthopaedic surgeons in these operations. ⋯ This study shows that CAOSS in IM nailing is robust and reliable. Positional accuracy was shown to be within 0.3 mm and angular accuracy within 0.2 degrees with femoral IM nail. CAOSS was also shown to be very reliable and accurate at different angles of distal screws in fluoroscopic image space.
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Within the framework of the collaborative research centre "Information Technology in Medicine--Computer and Sensor-Aided Surgery" (SFB414) new methods for intraoperative computer assistance of surgical procedures are being developed. The developed tools will be controlled by an intraoperative host which provides interfaces to the electronic health record (EHR) and intraoperative computer assisted instruments. ⋯ Intraoperative systems currently under development are intraoperative augmented reality (AR) using a projector and via a microscope, a planning system for definition of complex trajectories and a surgical robot system. The developed systems are under clinical evaluation and showing promising results in their application.
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Medical robotics and computer assisted surgery are feasible and promising applications of robotic technology, whose main goals are surgical augmentation, information enhancement and improved surgical action. Neurosurgery probably presents the most major challenges, and can considerably benefit from the introduction of computers and robots to guide surgical procedures. This paper presents an innovative master-slave haptic robotic system for minimally invasive neurosurgery, which can help surgeons overcome human shortcomings and perform more accurate, repeatable, and reliable stereotactic neurosurgery. ⋯ The tool insertion into the brain is guided by the surgeon through the haptic master which also provides force feedback to the operator. Not only can the haptic master reproduce the contact force between the surgical tool and the treated tissue, but it can also produce virtual forces aimed at assisting surgeons during the operations. Experiments have been conducted to prove the soundness and accuracy of the overall system mechanical design and to assess the effectiveness of the control schemes synthesized for the master and the slave.
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Review Historical Article
Robotics in neurosurgery: state of the art and future technological challenges.
The use of robotic technologies to assist surgeons was conceptually described almost thirty years ago but has only recently become feasible. In Neurosurgery, medical robots have been applied to neurosurgery for over 19 years. Nevertheless this field remains unknown to most neurosurgeons. ⋯ The paper begins with an overview of the development of the medical robotics, followed by the current clinical applications in neurosurgery and an analysis of current limitations. We discuss robotic applications based in our own experience in the field. Next, we discuss the technological challenges and research areas to overcome those limitations, including some of our current research approaches for future progress in the field.