Monahan Emily, Shimada Kenji
Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.
Int J Med Robot. 2006 Sep;2(3):271-8. doi: 10.1002/rcs.100.
While arthroscopic surgery has many advantages over traditional surgery, this minimally invasive technique is not often applied to the hip joint. Two main reasons for this are the complexity of navigating within the joint and the difficulty of correctly placing portal incisions without damaging critical neurovascular structures. This paper proposes a computer-aided navigation system to address the challenges of arthroscopic hip surgery.
Unlike conventional arthroscopic methods, our system uses a hyper-redundant encoder linkage to track surgical instruments, thus eliminating the occlusion and distortion problems associated with standard optical and electromagnetic tracking systems. The encoder linkage position information is used to generate a computer display of patient anatomy.
The tracking error from the encoder linkage was evaluated to be within an acceptable range for this tracking prototype, and the new computer-aided approach to arthroscopic hip surgery was applied to a prototype system for concept verification.
This navigation system for arthroscopic hip surgery can be used as a tool to address the challenges of joint navigation and portal placement in arthroscopic hip surgery by visually supplementing the limiting view from the arthroscope. The introduction of a tracking linkage shows significant potential as an alternative to other tracking systems. Positive feedback about the completed demo system was obtained from surgeons who perform arthroscopic procedures.
虽然关节镜手术相对于传统手术有许多优势，但这种微创技术并不常应用于髋关节。造成这种情况的两个主要原因是在关节内导航的复杂性以及在不损伤关键神经血管结构的情况下正确放置入口切口的难度。本文提出一种计算机辅助导航系统，以应对关节镜髋关节手术的挑战。
与传统的关节镜方法不同，我们的系统使用超冗余编码器连杆来跟踪手术器械，从而消除了与标准光学和电磁跟踪系统相关的遮挡和失真问题。编码器连杆位置信息用于生成患者解剖结构的计算机显示。
对于该跟踪原型，评估得出编码器连杆的跟踪误差在可接受范围内，并且将这种关节镜髋关节手术的新型计算机辅助方法应用于一个原型系统进行概念验证。
这种关节镜髋关节手术导航系统可作为一种工具，通过视觉上补充关节镜有限的视野，来应对关节镜髋关节手术中关节导航和入口放置的挑战。引入跟踪连杆显示出作为其他跟踪系统替代方案的巨大潜力。从进行关节镜手术的外科医生那里获得了关于完整演示系统的积极反馈。
