EndoCAS Center, Department of Oncology, Transplantation and New Technologies in Medicine, University of Pisa, Pisa, Italy.
Int J Med Robot. 2012 Sep;8(3):300-10. doi: 10.1002/rcs.1417. Epub 2012 Feb 27.
Endovascular procedures are nowadays limited by difficulties arising from the use of 2D images and are associated with dangerous X-ray exposure and the injection of nephrotoxic contrast medium.
An electromagnetic navigator is proposed to guide endovascular procedures with reduced radiation dose and contrast medium injection. Five DOF electromagnetic sensors are calibrated and used to track in real time the positions and orientation of endovascular catheters and guidewires, while intraoperative 3D rotational angiography is used to acquire 3D models of patient anatomy. A preliminary prototype is developed to prove the feasibility of the system using an anthropomorphic phantom.
The spatial accuracy of the system was evaluated during 70 targeting trials obtaining an overall accuracy of 1.2 ± 0.3 mm; system usability was positively evaluated by three surgeons.
The strategy proposed to sensorize endovascular instruments paves the way for the development of surgical strategies with reduced radiation dose and contrast medium injection. Further in vitro, animal and clinical experiments are necessary for complete surgical validation.
目前，血管内手术受到 2D 图像应用带来的困难限制，并与危险的 X 射线辐射和肾毒性造影剂的注射相关联。
提出了一种电磁导航器，以减少辐射剂量和造影剂注射来引导血管内手术。校准了五个自由度的电磁传感器，用于实时跟踪血管内导管和导丝的位置和方向，同时术中 3D 旋转血管造影用于获取患者解剖结构的 3D 模型。开发了一个初步的原型，使用人体模型来证明系统的可行性。
在 70 次靶向试验中评估了系统的空间精度，总体精度为 1.2±0.3mm；三位外科医生对系统的可用性进行了积极评价。
为了实现减少辐射剂量和造影剂注射的手术策略，提出了对血管内器械进行传感器化的策略。还需要进行更多的体外、动物和临床实验来进行完整的手术验证。
