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[天玑机器人与Artis Zeego双机器人导航下微创治疗骨盆骨折的初步应用研究]

[Preliminary application study of dual-robotic navigated minimally invasive treatment by TiRobot and Artis Zeego on pelvic fractures].

作者信息

Liu Kexin, You Mengzhen, Huang Moran, Chen Cheng, Rui Biyu, Gao Hong, Chen Yunfeng, Li Xiaolin, Zhang Wei, Sun Yuqiang, Wang Lei

机构信息

Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, P. R. China.

Department of Orthopedics, the First Affiliated Hospital of University of Science and Technology of China, Hefei Anhui, 230001, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022 Aug 15;36(8):929-933. doi: 10.7507/1002-1892.202203026.

Abstract

OBJECTIVE

To summarize the surgical learning curve and preliminary operative experience of dual-robotic navigated minimally invasive treatment on pelvic fractures by TiRobot and Artis Zeego.

METHODS

Between July 2019 and February 2021, 90 patients with pelvic fractures were treated with dual-robotic navigated minimally invasive surgery by TiRobot and Artis Zeego. There were 64 males and 26 females, with an average age of 46.5 years (range, 13-78 years). Body mass index was 14.67-32.66 kg/m (mean, 23.61 kg/m ). Causes of injuries included traffic accident in 43 cases, falling from height in 37 cases, low-energy injuries such as flat falls in 10 cases. The interval between injury and surgery was 1-36 days (mean, 7.3 days). According to the location of the implanted screws, the patients were divided into sacroiliac screw group ( =33), acetabular screw group (acetabulum anterior/posterior column, =24), composite screws group (sacroiliac and acetabulum anterior/posterior column, =33). According to the screw implantation time and accuracy, the surgical learning curve was plotted, and the differences in the relevant indicators between learning stage and skilled stage were compared.

RESULTS

All 90 patients successfully completed the operation, the intraoperative bleeding volume was 5-200 mL (median, 20 mL). There was no vascular or nerve injury. All incisions healed by first intention. The screw implantation time ranged from 7.5 to 33.0 minutes (mean, 18.92 minutes), and the screw implantation accuracy ranged from 1.1 to 1.8 mm (mean, 1.56 mm). According to the learning curve, the practice stage of 3 groups was reached after 7, 10, and 11 cases, respectively. With the accumulation of surgical experience, the screw implantation time had a significant downward trend. Compared with the learning stage, the screw implantation time on skilled stage in 3 groups significantly shortened ( <0.05), but the difference in the screw implantation accuracy was not significant ( >0.05).

CONCLUSION

TiRobot and Artis Zeego assisted pelvic fracture surgery is safe and efficient, which helps the surgeon to quickly master the pelvic channel screw surgery, and the operation time is significantly shortened on the premise of ensuring the implantation accuracy.

摘要

目的

总结运用天玑机器人(TiRobot)和术中影像引导系统(Artis Zeego)双机器人导航下微创治疗骨盆骨折的手术学习曲线及初步手术经验。

方法

2019年7月至2021年2月,90例骨盆骨折患者接受了天玑机器人和术中影像引导系统双机器人导航下的微创手术治疗。其中男性64例,女性26例,平均年龄46.5岁(范围13 - 78岁)。体重指数为14.67 - 32.66 kg/m²(平均23.61 kg/m²)。受伤原因包括交通事故43例,高处坠落37例,平地跌倒等低能量损伤10例。受伤至手术间隔时间为1 - 36天(平均7.3天)。根据植入螺钉的部位,将患者分为骶髂螺钉组(n = 33)、髋臼螺钉组(髋臼前后柱,n = 24)、复合螺钉组(骶髂及髋臼前后柱,n = 33)。根据螺钉植入时间及准确性绘制手术学习曲线,并比较学习阶段和熟练阶段相关指标的差异。

结果

90例患者均成功完成手术,术中出血量为5 - 200 mL(中位数20 mL)。无血管或神经损伤。所有切口均一期愈合。螺钉植入时间为7.5 - 33.0分钟(平均18.92分钟),螺钉植入准确性为1.1 - 1.8 mm(平均1.56 mm)。根据学习曲线,3组分别在7例、10例、11例后达到练习阶段。随着手术经验的积累,螺钉植入时间呈明显下降趋势。与学习阶段相比,3组熟练阶段的螺钉植入时间均显著缩短(P < 0.05),但螺钉植入准确性差异无统计学意义(P > 0.05)。

结论

天玑机器人和术中影像引导系统辅助骨盆骨折手术安全、高效,有助于术者快速掌握骨盆通道螺钉手术,且在保证植入准确性的前提下,手术时间显著缩短。

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[The safety of TiRobot-guided percutaneous transpedicular screw implantation].[天玑机器人引导下经皮椎弓根螺钉植入术的安全性]
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Jul 15;35(7):813-817. doi: 10.7507/1002-1892.202103072.
3
Computer-Assisted Orthopedic and Trauma Surgery.计算机辅助骨科和创伤外科。
Dtsch Arztebl Int. 2020 Nov 20;117(47):793-800. doi: 10.3238/arztebl.2020.0793.
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Intraoperative Imaging in Pelvic Surgery.盆腔手术中的术中成像
Z Orthop Unfall. 2019 Aug;157(4):367-377. doi: 10.1055/a-0732-5986. Epub 2018 Nov 12.

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