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机器人辅助设备在计算机断层扫描引导下经皮诊断和治疗程序中的性能

Performance of a Robotic Assistance Device in Computed Tomography-Guided Percutaneous Diagnostic and Therapeutic Procedures.

作者信息

Smakic Arman, Rathmann Nils, Kostrzewa Michael, Schönberg Stefan O, Weiß Christel, Diehl Steffen J

机构信息

Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Department of Biomathematics and Medical Statistics, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.

出版信息

Cardiovasc Intervent Radiol. 2018 Apr;41(4):639-644. doi: 10.1007/s00270-017-1841-8. Epub 2017 Nov 20.

Abstract

PURPOSE

To evaluate a commercially available robotic assistance device for computed tomography-guided diagnostic and therapeutic interventions, compared to regular, manually performed CT scan-guided interventions in terms of precision, exposure to radiation to the patient and intervention time.

MATERIALS AND METHODS

Over a period of 6 months, 55 consecutive patients were recruited and treated using robotic assistance and compared to a control group of 101 patients previously treated with a regular CT scan-guided, manual approach. Evaluated parameters were precision (deviation from planned target and number of needle replacements), radiation exposure to the patient and intervention time. Evaluations were performed with regard to complexity (in-plane vs out-of-plane interventions) and type of anesthesia (general vs local).

RESULTS

Parameters related to precision were in general significantly better in the robotic assistance group (p < 0.01) with a mean deviation of 1.2 mm (± 1.6 mm) compared to 2.6 mm (± 1.1 mm) in the comparison group. Compared to manual procedure, the mean intervention time was reduced by 15 min (± 5.4 min) on average for an out-of-plane needle placement in the robotic group. There was no increase of exposure to radiation to the patient while radiation exposure for the physician was reduced to zero when the navigation system was used.

CONCLUSION

Compared to manual placement, the use of a robotic assistance device in out-of-plane CT-guided interventions under general anesthesia allows for probe placement with high precision. Intervention time is reduced with no increase of exposure to radiation to the patient.

摘要

目的

评估一种用于计算机断层扫描引导下诊断和治疗干预的商用机器人辅助设备,将其与常规手动进行的CT扫描引导干预在精度、患者辐射暴露和干预时间方面进行比较。

材料与方法

在6个月的时间里,连续招募了55例患者,使用机器人辅助进行治疗,并与之前采用常规CT扫描引导手动方法治疗的101例患者组成的对照组进行比较。评估的参数包括精度(与计划目标的偏差和针更换次数)、患者的辐射暴露和干预时间。根据复杂性(平面内与平面外干预)和麻醉类型(全身麻醉与局部麻醉)进行评估。

结果

机器人辅助组与精度相关的参数总体上显著更好(p < 0.01),平均偏差为1.2毫米(±1.6毫米),而对照组为2.6毫米(±1.1毫米)。与手动操作相比,机器人组平面外针放置的平均干预时间平均减少了15分钟(±5.4分钟)。患者的辐射暴露没有增加,而当使用导航系统时,医生的辐射暴露降至零。

结论

与手动放置相比,在全身麻醉下的平面外CT引导干预中使用机器人辅助设备可实现高精度的探头放置。干预时间减少,且患者的辐射暴露没有增加。

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