Bast P, Popovic A, Wu T, Heger S, Engelhardt M, Lauer W, Radermacher K, Schmieder K
Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Germany.
Int J Med Robot. 2006 Jun;2(2):168-78. doi: 10.1002/rcs.85.
In cases of cranial tumour, manual resection of the cancerous tissue can be very stressful and time-consuming, due to the adhesion of the subjacent dura mater. Computer-assisted planning, navigation and robotic craniotomy, with optional skull reconstruction using customized implants, are of increasing clinical interest in craniofacial and neurosurgery.
Using preoperative computed tomography (CT) images, an automatic segmentation of the tumour is performed, followed by resection planning. The skull reconstruction is performed using computer-assisted implant modeling and manufacturing. Risk analysis of the robot-guided intervention led to the development of a new hexapod robot system.
Results from registration and robot accuracy on plastic and Anatomical skull are shown. The concept of a stand-alone safety system is presented to supervise the robot during the intervention. The entire process from preoperative CT scan to intraoperative robot assisted removal of tumourous bone is shown in laboratory and anatomical trials.
The laboratory and anatomy studies conducted so far provided a substantial basis for further improvement of the system's integration in the surgical workflow and the final approval of the system for initial clinical studies.
在颅部肿瘤病例中，由于下方硬脑膜的粘连，手动切除癌组织可能非常费力且耗时。计算机辅助规划、导航和机器人开颅手术，以及使用定制植入物进行可选的颅骨重建，在颅面外科和神经外科中越来越受到临床关注。
利用术前计算机断层扫描（CT）图像对肿瘤进行自动分割，随后进行切除规划。使用计算机辅助植入物建模和制造进行颅骨重建。对机器人引导干预的风险分析促成了一种新型六足机器人系统的开发。
展示了在塑料颅骨和解剖学颅骨上的配准结果及机器人精度。提出了一种独立安全系统的概念，以在干预过程中监督机器人。在实验室和解剖学试验中展示了从术前CT扫描到术中机器人辅助切除肿瘤性骨的整个过程。
迄今为止进行的实验室和解剖学研究为进一步改进系统在手术工作流程中的整合以及该系统用于初步临床研究的最终批准提供了坚实基础。
