Yamamoto Kent K, Brumfiel Timothy A, Qi Ronghuai, Chern Joshua J, Desai Jaydev P
Medical Robotics and Automation (RoboMed) Laboratory, Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta , Georgia , USA.
Current Affiliation: Department of Mechanical Engineering and Materials Science, Duke University, Durham , North Carolina , USA.
Oper Neurosurg. 2024 Apr 1;26(4):389-395. doi: 10.1227/ons.0000000000000976. Epub 2023 Nov 3.
To improve the outcomes of minimally invasive, endoscopic, intracranial procedures, steerable robotic tools have been developed but still require thorough evaluation before use in a clinical setting. This paper compares a novel steerable robotic neuroendoscope tool against a standard rigid tool.
Seventeen participants, 8 nonmedical and 9 medical (neurosurgery residents and fellows), were recruited. The evaluation trial consisted of a task that was completed using either a rigid tool or the steerable tool, followed by the completion of a qualitative survey. Target reach time and tool movement volume (TMV) were recorded for each trial and analyzed. The tools were evaluated within a realistic phantom model of the brain.
Preclinical evaluation of both tools showed that average target reach time for the steerable tool among medical personnel (15.0 seconds) was longer than that of the rigid tool (5.9 seconds). However, the average TMV for the steerable tool (0.178 cm 3 ) was much lower than that of the rigid tool (0.501 cm 3 ) for medical personnel, decreasing the TMV by 64.47%.
The steerable tool required more training and practice in comparison with the standard rigid tool, but it decreased the overall endoscope movement volume, which is a source of parenchymal injury associated with endoscopic procedures.
为了改善微创、内镜下颅内手术的效果,已开发出可操纵的机器人工具,但在临床应用前仍需进行全面评估。本文将一种新型可操纵机器人神经内镜工具与标准刚性工具进行了比较。
招募了17名参与者,其中8名非医学人员,9名医学人员(神经外科住院医师和研究员)。评估试验包括使用刚性工具或可操纵工具完成一项任务,随后完成一项定性调查。记录每次试验的目标到达时间和工具移动体积(TMV)并进行分析。这些工具在逼真的脑模型中进行评估。
两种工具的临床前评估表明,医务人员使用可操纵工具的平均目标到达时间(15.0秒)比刚性工具(5.9秒)长。然而,医务人员使用可操纵工具的平均TMV(0.178立方厘米)远低于刚性工具(0.501立方厘米),使TMV降低了64.47%。
与标准刚性工具相比,可操纵工具需要更多的培训和练习,但它减少了内镜的总体移动体积,而这是与内镜手术相关的实质损伤的一个来源。