The international journal of medical robotics + computer assisted surgery : MRCAS
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Computer assisted systems in orthopaedic trauma depend in most cases on fixed reference markers. This work evaluated a reference-free image-based guidance system. Outcome parameters were the number of trials needed to achieve an optimal wire position, the radiation and procedure time, and the learning curve. ⋯ The guidance system helped to achieve an optimal K-wire position with less radiation and less time. The major advantage is the ability of the guidance system to be integrated into the workflow and the short and flat learning curve.
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Comparative Study
Personalized image-based templates for iliosacral screw insertions: a pilot study.
Stabilization of rare unstable pelvic fractures in the case of sacral fractures and iliosacral joint dislocations can be tricky. 3D reconstruction and reverse engineering templates may be used to increase the accuracy of screw placement. ⋯ Personalized image-based templates for iliosacral screw insertions can increase the sacral lag screw placement accuracy, reduce radiation exposure, and shorten surgery time compared with traditional fluoroscopic methods.
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Robotic-assisted transaxillary thyroidectomy is a minimally invasive approach for the removal of the thyroid through the axilla. This technique eliminates a visible scar and affords excellent optics of the cervical anatomy. We sought to describe the technique and outcome for transaxillary gasless subtotal thyroidectomy in the paediatric population. ⋯ This initial experience demonstrates that this technique can be a feasible, safe and effective method for subtotal thyroidectomy in the paediatric population. The use of robotic technology for endoscopic thyroid surgery could overcome the limitations of conventional endoscopic surgeries in the surgical management of thyroid disease.
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In contemporary surgical clinical practice, spinal instability is often treated with mechanical stabilization techniques in order to protect the spinal cord and nerve roots. These techniques involve placing screws in defined regions of the vertebrae, typically the pedicle, where the strongest bone is found. The challenge for the surgeon is the accurate placement of screws for good mechanical purchase and to avoid damage to surrounding vital anatomical structures. This is especially critical in the cervical region, where the target bone mass is smaller and the spinal cord, nerve roots and vertebral arteries are all at risk. A robotic system enabling the surgeon to precisely place implants into the vertebrae should enhance safety and may potentially improve surgical results. ⋯ These results confirm the utility and applicability of the system. It is currently in redesign to improve accuracy and to render it compatible with on-line planning.
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Case Reports
Robotic totally endoscopic coronary artery bypass grafting for spontaneous coronary artery dissection.
Patients with spontaneous coronary artery dissection may require surgical revascularization. Reports on the surgical management of this pathology are primarily limited to classic coronary artery bypass grafting via sternotomy on cardiopulmonary bypass, although a limited number of reports of alternatives also exist. ⋯ Selected patients with spontaneous coronary artery dissection may benefit from a totally endoscopic approach to surgical coronary revascularization.