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弥合差距:机器人在脑动脉瘤神经介入治疗中的应用——系统评价。

Bridging the gap: robotic applications in cerebral aneurysms neurointerventions - a systematic review.

机构信息

Department of Biophysics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Jordana 18, Zabrze, 40-043, Poland.

2Department of Biophysics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Jordana 18, Zabrze, 40-043, Poland.

出版信息

Neurosurg Rev. 2024 Apr 11;47(1):150. doi: 10.1007/s10143-024-02400-5.

Abstract

Cerebral aneurysm is a life-threatening condition, which requires high precision during the neurosurgical procedures. Increasing progress of evaluating modern devices in medicine have led to common usage of robotic systems in many fields, including cranial aneurysm operations. However, currently no systematic review describes up-to date knowledge of this topic. Following PRISMA guidelines, we have independently screened and extracted works from seven databases. Only studies fulfilling inclusion criteria were presented in this study. Device used, operation time, complications, aneurysm type and patient demographics were extracted from each work. We identified a total of 995 articles from databases. We have found six original works and one supplementary article eligible for this synthesis. Majority of works (4/6) have implemented CorPath GRX in cerebral aneurysm procedures. The procedures involved diverse aneurysm locations, utilizing flow diverters, stents, or coiling. One study described implementation of robot-assist on 117 patients and compared results to randomized clinical trials. One work with a small patient cohort described use of the magnetically-controlled microguidewire in the coiling procedures, without any complications. Additionally, one case-series study described use of a robotic arm for managing intraoperative aneurysm rupture. Currently, robotical devices for cerebral aneurysm treatment mainly lack jailing and haptic feedback feature. Further development of these devices will certainly be beneficial for operators and patients, allowing for more precise and remote surgeries.

摘要

颅内动脉瘤是一种危及生命的疾病,在神经外科手术中需要高度精确。评估现代医学设备的不断进步导致机器人系统在许多领域得到了广泛应用,包括颅内动脉瘤手术。然而,目前尚无系统评价描述这一主题的最新知识。我们遵循 PRISMA 指南,从七个数据库中独立筛选和提取了文献。只有符合纳入标准的研究才在本研究中呈现。从每项研究中提取了使用的器械、手术时间、并发症、动脉瘤类型和患者人口统计学特征。我们从数据库中总共确定了 995 篇文章。我们发现了六篇原始作品和一篇补充文章符合本综述的要求。大多数研究(4/6)都在颅内动脉瘤手术中实施了 CorPath GRX。这些手术涉及不同位置的动脉瘤,使用了血流导向装置、支架或线圈。一项研究描述了在 117 名患者中实施机器人辅助的结果,并与随机临床试验进行了比较。一项小样本患者队列研究描述了在弹簧圈手术中使用磁控微导丝,没有任何并发症。此外,一项病例系列研究描述了使用机器人臂来处理术中动脉瘤破裂。目前,用于颅内动脉瘤治疗的机器人设备主要缺乏监禁和触觉反馈功能。这些设备的进一步发展肯定对操作人员和患者都有益,可以实现更精确和远程的手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7548/11006626/66453ea95a0b/10143_2024_2400_Fig1_HTML.jpg

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