Haptic Robot-assisted Surgery Improves Accuracy of Wide Resection of Bone Tumors: A Pilot Study
Identifieur interne : 000701 ( Pmc/Curation ); précédent : 000700; suivant : 000702Haptic Robot-assisted Surgery Improves Accuracy of Wide Resection of Bone Tumors: A Pilot Study
Auteurs : Fazel Khan [États-Unis] ; Andrew Pearle [États-Unis] ; Christopher Lightcap [États-Unis] ; Patrick J. Boland [États-Unis] ; John H. Healey [États-Unis]Source :
- Clinical Orthopaedics and Related Research [ 0009-921X ] ; 2012.
Abstract
Accurate reproduction of the preoperative plan at the time of surgery is critical for wide resection of primary bone tumors. Robotic technology can potentially help the surgeon reproduce a given preoperative plan, but yielding control of cutting instruments to a robot introduces potentially serious complications. We developed a novel passive (“haptics”) robot-assisted resection technique for primary bone sarcomas that takes advantage of robotic accuracy while still leaving control of the cutting instrument in the hands of the surgeon.
We asked whether this technique would enable a preoperative resection plan to be reproduced more accurately than a standard manual technique.
A joint-sparing hemimetaphyseal resection was precisely outlined on the three-dimensionally reconstructed image of a representative Sawbones femur. The indicated resection was performed on 12 Sawbones specimens using the standard manual technique on six specimens and the haptic robotic technique on six specimens. Postresection images were quantitatively analyzed to determine the accuracy of the resections compared to the preoperative plan, which included measuring the maximum linear deviation of the cuts from the preoperative plan and the angular deviation of the resection planes from the target planes.
Compared with the manual technique, the robotic technique resulted in a mean improvement of 7.8 mm of maximum linear deviation from the preoperative plan and 7.9° improvement in pitch and 4.6° improvement in roll for the angular deviation from the target planes.
The haptic robot-assisted technique improved the accuracy of simulated wide resections of bone tumors compared with manual techniques.
Haptic robot-assisted technology has the potential to enhance primary bone tumor resection. Further bench and clinical studies, including comparisons with recently introduced computer navigation technology, are warranted.
Url:
DOI: 10.1007/s11999-012-2529-7
PubMed: 22911372
PubMed Central: 3563824
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<author><name sortKey="Khan, Fazel" sort="Khan, Fazel" uniqKey="Khan F" first="Fazel" last="Khan">Fazel Khan</name>
<affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Orthopedic Surgery, State University of New York at Stony Brook, Stony Brook, NY USA</nlm:aff>
<country>États-Unis</country>
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<wicri:cityArea>Department of Orthopedic Surgery, State University of New York at Stony Brook, Stony Brook</wicri:cityArea>
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<author><name sortKey="Pearle, Andrew" sort="Pearle, Andrew" uniqKey="Pearle A" first="Andrew" last="Pearle">Andrew Pearle</name>
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<author><name sortKey="Pearle, Andrew" sort="Pearle, Andrew" uniqKey="Pearle A" first="Andrew" last="Pearle">Andrew Pearle</name>
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<country>États-Unis</country>
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<author><name sortKey="Boland, Patrick J" sort="Boland, Patrick J" uniqKey="Boland P" first="Patrick J." last="Boland">Patrick J. Boland</name>
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<country>États-Unis</country>
<placeName><region type="state">État de New York</region>
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<wicri:cityArea>Memorial Sloan-Kettering Cancer Center, New York</wicri:cityArea>
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<author><name sortKey="Healey, John H" sort="Healey, John H" uniqKey="Healey J" first="John H." last="Healey">John H. Healey</name>
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<series><title level="j">Clinical Orthopaedics and Related Research</title>
<idno type="ISSN">0009-921X</idno>
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<imprint><date when="2012">2012</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Accurate reproduction of the preoperative plan at the time of surgery is critical for wide resection of primary bone tumors. Robotic technology can potentially help the surgeon reproduce a given preoperative plan, but yielding control of cutting instruments to a robot introduces potentially serious complications. We developed a novel passive (“haptics”) robot-assisted resection technique for primary bone sarcomas that takes advantage of robotic accuracy while still leaving control of the cutting instrument in the hands of the surgeon.</p>
</sec>
<sec><title>Questions/Purposes</title>
<p>We asked whether this technique would enable a preoperative resection plan to be reproduced more accurately than a standard manual technique.</p>
</sec>
<sec><title>Methods</title>
<p>A joint-sparing hemimetaphyseal resection was precisely outlined on the three-dimensionally reconstructed image of a representative Sawbones femur. The indicated resection was performed on 12 Sawbones specimens using the standard manual technique on six specimens and the haptic robotic technique on six specimens. Postresection images were quantitatively analyzed to determine the accuracy of the resections compared to the preoperative plan, which included measuring the maximum linear deviation of the cuts from the preoperative plan and the angular deviation of the resection planes from the target planes.</p>
</sec>
<sec><title>Results</title>
<p>Compared with the manual technique, the robotic technique resulted in a mean improvement of 7.8 mm of maximum linear deviation from the preoperative plan and 7.9° improvement in pitch and 4.6° improvement in roll for the angular deviation from the target planes.</p>
</sec>
<sec><title>Conclusions</title>
<p>The haptic robot-assisted technique improved the accuracy of simulated wide resections of bone tumors compared with manual techniques.</p>
</sec>
<sec><title>Clinical Relevance</title>
<p>Haptic robot-assisted technology has the potential to enhance primary bone tumor resection. Further bench and clinical studies, including comparisons with recently introduced computer navigation technology, are warranted.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Orthop Relat Res</journal-id>
<journal-id journal-id-type="iso-abbrev">Clin. Orthop. Relat. Res</journal-id>
<journal-title-group><journal-title>Clinical Orthopaedics and Related Research</journal-title>
</journal-title-group>
<issn pub-type="ppub">0009-921X</issn>
<issn pub-type="epub">1528-1132</issn>
<publisher><publisher-name>Springer-Verlag</publisher-name>
<publisher-loc>New York</publisher-loc>
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<article-meta><article-id pub-id-type="pmid">22911372</article-id>
<article-id pub-id-type="pmc">3563824</article-id>
<article-id pub-id-type="publisher-id">2529</article-id>
<article-id pub-id-type="doi">10.1007/s11999-012-2529-7</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Symposium: Highlights from the First Combined 2011 Meeting of the Musculoskeletal Tumor Society and Connective Tissue Oncology Society</subject>
</subj-group>
</article-categories>
<title-group><article-title>Haptic Robot-assisted Surgery Improves Accuracy of Wide Resection of Bone Tumors: A Pilot Study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Khan</surname>
<given-names>Fazel</given-names>
</name>
<degrees>MD</degrees>
<address><email>fazelkhan928@yahoo.com</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pearle</surname>
<given-names>Andrew</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lightcap</surname>
<given-names>Christopher</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Boland</surname>
<given-names>Patrick J.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="Aff4"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Healey</surname>
<given-names>John H.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="Aff4"></xref>
</contrib>
<aff id="Aff1"><label></label>
Department of Orthopedic Surgery, State University of New York at Stony Brook, Stony Brook, NY USA</aff>
<aff id="Aff2"><label></label>
Hospital for Special Surgery, New York, NY USA</aff>
<aff id="Aff3"><label></label>
Mako Surgical Corporation, Ft Lauderdale, FL USA</aff>
<aff id="Aff4"><label></label>
Memorial Sloan-Kettering Cancer Center, New York, NY USA</aff>
</contrib-group>
<pub-date pub-type="epub"><day>22</day>
<month>8</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="ppub"><month>3</month>
<year>2013</year>
</pub-date>
<volume>471</volume>
<issue>3</issue>
<fpage>851</fpage>
<lpage>859</lpage>
<permissions><copyright-statement>© The Association of Bone and Joint Surgeons® 2012</copyright-statement>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p>Accurate reproduction of the preoperative plan at the time of surgery is critical for wide resection of primary bone tumors. Robotic technology can potentially help the surgeon reproduce a given preoperative plan, but yielding control of cutting instruments to a robot introduces potentially serious complications. We developed a novel passive (“haptics”) robot-assisted resection technique for primary bone sarcomas that takes advantage of robotic accuracy while still leaving control of the cutting instrument in the hands of the surgeon.</p>
</sec>
<sec><title>Questions/Purposes</title>
<p>We asked whether this technique would enable a preoperative resection plan to be reproduced more accurately than a standard manual technique.</p>
</sec>
<sec><title>Methods</title>
<p>A joint-sparing hemimetaphyseal resection was precisely outlined on the three-dimensionally reconstructed image of a representative Sawbones femur. The indicated resection was performed on 12 Sawbones specimens using the standard manual technique on six specimens and the haptic robotic technique on six specimens. Postresection images were quantitatively analyzed to determine the accuracy of the resections compared to the preoperative plan, which included measuring the maximum linear deviation of the cuts from the preoperative plan and the angular deviation of the resection planes from the target planes.</p>
</sec>
<sec><title>Results</title>
<p>Compared with the manual technique, the robotic technique resulted in a mean improvement of 7.8 mm of maximum linear deviation from the preoperative plan and 7.9° improvement in pitch and 4.6° improvement in roll for the angular deviation from the target planes.</p>
</sec>
<sec><title>Conclusions</title>
<p>The haptic robot-assisted technique improved the accuracy of simulated wide resections of bone tumors compared with manual techniques.</p>
</sec>
<sec><title>Clinical Relevance</title>
<p>Haptic robot-assisted technology has the potential to enhance primary bone tumor resection. Further bench and clinical studies, including comparisons with recently introduced computer navigation technology, are warranted.</p>
</sec>
</abstract>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Association of Bone and Joint Surgeons® 2013</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
</record>
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