Document Detail

Haptic robot-assisted surgery improves accuracy of wide resection of bone tumors: a pilot study.
MedLine Citation:
PMID:  22911372     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Accurate reproduction of the preoperative plan at the time of surgery is critical for wide resection of primary bone tumors. Robotic technology can potentially help the surgeon reproduce a given preoperative plan, but yielding control of cutting instruments to a robot introduces potentially serious complications. We developed a novel passive ("haptics") robot-assisted resection technique for primary bone sarcomas that takes advantage of robotic accuracy while still leaving control of the cutting instrument in the hands of the surgeon.
QUESTIONS/PURPOSES: We asked whether this technique would enable a preoperative resection plan to be reproduced more accurately than a standard manual technique.
METHODS: A joint-sparing hemimetaphyseal resection was precisely outlined on the three-dimensionally reconstructed image of a representative Sawbones femur. The indicated resection was performed on 12 Sawbones specimens using the standard manual technique on six specimens and the haptic robotic technique on six specimens. Postresection images were quantitatively analyzed to determine the accuracy of the resections compared to the preoperative plan, which included measuring the maximum linear deviation of the cuts from the preoperative plan and the angular deviation of the resection planes from the target planes.
RESULTS: Compared with the manual technique, the robotic technique resulted in a mean improvement of 7.8 mm of maximum linear deviation from the preoperative plan and 7.9° improvement in pitch and 4.6° improvement in roll for the angular deviation from the target planes.
CONCLUSIONS: The haptic robot-assisted technique improved the accuracy of simulated wide resections of bone tumors compared with manual techniques.
CLINICAL RELEVANCE: Haptic robot-assisted technology has the potential to enhance primary bone tumor resection. Further bench and clinical studies, including comparisons with recently introduced computer navigation technology, are warranted.
Fazel Khan; Andrew Pearle; Christopher Lightcap; Patrick J Boland; John H Healey
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  471     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-05     Completed Date:  2013-04-03     Revised Date:  2014-03-09    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  851-9     Citation Subset:  AIM; IM    
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MeSH Terms
Computer Graphics
Computer Simulation
Femoral Neoplasms / pathology,  surgery*
Magnetic Resonance Imaging
Models, Anatomic
Motor Skills
Neoplasm, Residual
Osteotomy / adverse effects,  instrumentation,  methods*
Pilot Projects
Robotics* / instrumentation
Sarcoma / pathology,  surgery*
Surgery, Computer-Assisted* / adverse effects,  instrumentation
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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