The international journal of medical robotics + computer assisted surgery : MRCAS
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Comparative Study
Navigated vs arthroscopic-guided drilling for reconstruction of acromioclavicular joint injuries: accuracy and feasibility.
Anatomical reconstruction of the coracoclavicular ligaments is a relatively new technique for acromioclavicular (AC) joint injuries. ⋯ The accuracy of anatomical AC joint reconstruction can be improved using 3D C-arm flat detector navigation.
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Microsurgery is a widely performed process in neurosurgery. However, it is difficult for surgeons because manipulating small and long instruments under a microscope often restricts dexterity. Hand tremors are also an issue, as the accuracy required for microsurgery is very high. ⋯ With the robotic platform, the surgeon was able to perform a fine and complex task, which is very difficult with manual operation. The robotic system showed sufficient accuracy and dexterity, but with a longer task completion time. Further improvement of the dexterity and user interface is expected to realize better performance.
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Randomized Controlled Trial
Cardiovascular and respiratory effects of the degree of head-down angle during robot-assisted laparoscopic radical prostatectomy.
Robot-assisted laparoscopic radical prostatectomy (RALP) requires a steep Trendelenburg position and CO2 pneumoperitoneum for several hours to secure the surgical visual field. The present study was performed to investigate the influence of each angle of Trendelenburg position during RALP on cardiovascular and respiratory homeostasis. ⋯ This study demonstrated that the degree of the head-down angle at RALP affected the cardiovascular and respiratory parameters. Pneumoperitoneum with head-down position in RALP influenced the cardiovascular and respiratory system to a greater extent than RRP, and these effects were stronger with deeper head-down angle.
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Malrotation after femoral nailing is a common problem, yet estimation of the correct rotation during nailing remains a technical challenge. In the current study, a novel technique was developed for determining femoral antetorsion, the anterior cortical angle (ACA) method. The ACA is the angle between a line along the anterior aspect of the femoral neck and the posterior condylar line of the distal femur. The principal advantage of this method is that it facilitates intra-operative assessment of femoral antetorsion by utilizing the positional technology integrated in smartphones. This measurement is directly comparable to measurements made using computed tomography (CT) scans. The objective of the current study was to investigate the possibility and to validate the feasibility and accuracy of the new method and compare the results obtained with the traditional methods of antetorsion estimation via CT and surgical navigation technology. ⋯ The ACA method generated acceptable results and could contribute to improving the results of femoral nailing. The use of this device in a real clinical setting is necessary to truly elucidate its utility.
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Commercial image-guided surgery systems rely on the fundamental assumption that preoperative medical images represent the physical state of the patient in the operating room. The guidance display typically consists of a three-dimensional (3D) model derived from medical images and three orthogonal views of the imaging data. A challenging question in image-guided surgery is: what happens when the images used in the guidance display no longer correspond to the current geometric state of the anatomy and guidance information is still desirable? ⋯ These results suggest that our new technique can be used in place of the computationally expensive task of deforming the image volume, without affecting the time or accuracy of the surgical task. Most notably, our work addresses the problem of incorporating deformation correction into the guidance display and offers a first step toward understanding its effect on surgical performance.