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预测目标血管位置以改进机器人辅助冠状动脉搭桥手术的规划。

Predicting target vessel location for improved planning of robot-assisted CABG procedures.

作者信息

Cho Daniel S, Linte Cristian A, Chen Elvis, Wedlake Chris, Moore John, Barron John, Patel Rajni, Peters Terry M

机构信息

Imaging Research Laboratories, Robarts Research Institute.

出版信息

Med Image Comput Comput Assist Interv. 2010;13(Pt 3):205-12. doi: 10.1007/978-3-642-15711-0_26.

Abstract

Prior to performing a robot-assisted coronary artery bypass grafting procedure, a pre-operative computed tomography scan is used to assess patient candidacy and to identify the location of the target vessel. The surgeon then determines the optimal port locations to ensure proper reach to the target with the robotic instruments, while assuming that the heart does not undergo any significant changes between the pre- and intra-operative stages. However, the peri-operative workflow itself leads to changes in heart position and consequently the intra-operative target vessel location. As such, the pre-operative plan must be adequately updated to adjust the target vessel location to better suit the intraoperative condition. Here we propose a technique to predict the position of the peri-operative target vessel location with approximately 3.5 mm RMS accuracy. We believe this technique will potentially reduce the rate of conversion of robot-assisted procedures to traditional open-chest surgery due to poor planning.

摘要

在进行机器人辅助冠状动脉搭桥手术之前,会使用术前计算机断层扫描来评估患者是否适合手术,并确定目标血管的位置。然后,外科医生确定最佳端口位置,以确保使用机器人器械能够正确抵达目标位置,同时假定心脏在术前和术中阶段不会发生任何显著变化。然而,围手术期的工作流程本身会导致心脏位置发生变化,进而导致术中目标血管位置改变。因此,必须充分更新术前计划,以调整目标血管位置,使其更适合术中情况。在此,我们提出一种技术,能够以约3.5毫米的均方根误差精度预测围手术期目标血管的位置。我们相信,这项技术可能会降低因规划不佳而导致机器人辅助手术转为传统开胸手术的比率。

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