In prostate brachytherapy, oblique-tip needles are frequently used to deliver radioactive seeds to the target area. These needles often experience deflection during insertion, leading to deviations from the planned trajectory and compromising treatment accuracy.
Method
This study did not involve human participants or animals, and therefore, ethics review and approval were not required. The proposed method combines preoperative needle trajectory planning with real-time intraoperative corrections, using an adaptive PID controller enhanced by reinforcement learning to adjust corrective forces during needle insertion.
Results
Experimental results demonstrated that the proposed method reduced the average seed implantation error to 1.92 mm, with a standard error of 0.56 mm. These findings indicate that the method minimises needle deflection and improves precision in seed implantation.
Conclusion
The proposed modular robotic system and puncture control method enhance the precision of seed implantation and show promise for improving treatment outcomes in prostate cancer therapy.
{"title":"Research on Prostate Brachytherapy Robot Design and Puncture Control Strategy","authors":"Xuesong Dai, Yongde Zhang, Yue Sun","doi":"10.1002/rcs.70059","DOIUrl":"https://doi.org/10.1002/rcs.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In prostate brachytherapy, oblique-tip needles are frequently used to deliver radioactive seeds to the target area. These needles often experience deflection during insertion, leading to deviations from the planned trajectory and compromising treatment accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This study did not involve human participants or animals, and therefore, ethics review and approval were not required. The proposed method combines preoperative needle trajectory planning with real-time intraoperative corrections, using an adaptive PID controller enhanced by reinforcement learning to adjust corrective forces during needle insertion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Experimental results demonstrated that the proposed method reduced the average seed implantation error to 1.92 mm, with a standard error of 0.56 mm. These findings indicate that the method minimises needle deflection and improves precision in seed implantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The proposed modular robotic system and puncture control method enhance the precision of seed implantation and show promise for improving treatment outcomes in prostate cancer therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Traditional robot-assisted hysterectomy port placement causes visible scarring. We developed a novel diamond-shaped lower abdominal port placement technique using the Hugo RAS System, designed to minimise scarring while maintaining surgical efficacy through the system's modular design.
Methods
We analysed records of 72 robot-assisted hysterectomies performed between November 2023 and August 2024, including six cases using diamond port placement. We evaluated demographics, operative metrics, complications, and pain scores.
Results
Median operative time was 70 min, with minimal blood loss and no complications. Postoperative pain scores at 24 h (median 2.5) were significantly lower than preoperative expectations (median 7.0, p = 0.00409).
Conclusions
The lower abdominal diamond port placement technique for Hugo RAS System hysterectomy appears safe and effective, potentially improving cosmetic outcomes while maintaining surgical efficiency.
{"title":"First Case Series of Robotic-Assisted Hysterectomy Below the Bikini Line: ‘Diamond’ Port Placement Using the Hugo RAS System","authors":"Ikuko Sakamoto, Yoshihiko Ito, Kosuke Matsuda, Takahiro Nozaki, Keiko Kagami","doi":"10.1002/rcs.70061","DOIUrl":"https://doi.org/10.1002/rcs.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Traditional robot-assisted hysterectomy port placement causes visible scarring. We developed a novel diamond-shaped lower abdominal port placement technique using the Hugo RAS System, designed to minimise scarring while maintaining surgical efficacy through the system's modular design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed records of 72 robot-assisted hysterectomies performed between November 2023 and August 2024, including six cases using diamond port placement. We evaluated demographics, operative metrics, complications, and pain scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median operative time was 70 min, with minimal blood loss and no complications. Postoperative pain scores at 24 h (median 2.5) were significantly lower than preoperative expectations (median 7.0, <i>p</i> = 0.00409).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The lower abdominal diamond port placement technique for Hugo RAS System hysterectomy appears safe and effective, potentially improving cosmetic outcomes while maintaining surgical efficiency.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Compared with traditional open surgery, robotic-assisted minimally invasive surgery lacks force sensing ability.
Methods
A sensorless transparency optimised force safety mechanism is put forward to improve the external force safety of the surgical robot in this paper. An improved fixed-time indirect adaptive fuzzy controller is proposed to approximate the unknown uncertainties in the dynamics of the patient-side manipulator. An online force simulation controller is designed based on the hierarchical force.
Results
Simulations and experiments demonstrate that the designed fixed-time indirect adaptive fuzzy controller exhibits excellent performance in trajectory tracking, fixed-time convergence, fuzzy approximation, and smooth control input. In addition, the online force simulation controller effectively decreases the force in the potentially unsafe area, thereby inhibiting the unsafe force.
Conclusions
This mechanism offers potential applications to improve the safety of external forces for the sensorless surgical robots.
{"title":"Sensorless Transparency Optimised Force Safety Guarantee Mechanism for Robot-Assisted Minimally Invasive Surgery","authors":"Fang Huang, Hongqiang Sang, Fen Liu, Rui Han","doi":"10.1002/rcs.70060","DOIUrl":"https://doi.org/10.1002/rcs.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Compared with traditional open surgery, robotic-assisted minimally invasive surgery lacks force sensing ability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A sensorless transparency optimised force safety mechanism is put forward to improve the external force safety of the surgical robot in this paper. An improved fixed-time indirect adaptive fuzzy controller is proposed to approximate the unknown uncertainties in the dynamics of the patient-side manipulator. An online force simulation controller is designed based on the hierarchical force.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Simulations and experiments demonstrate that the designed fixed-time indirect adaptive fuzzy controller exhibits excellent performance in trajectory tracking, fixed-time convergence, fuzzy approximation, and smooth control input. In addition, the online force simulation controller effectively decreases the force in the potentially unsafe area, thereby inhibiting the unsafe force.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This mechanism offers potential applications to improve the safety of external forces for the sensorless surgical robots.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robotic systems are increasingly utilised to improve clinical outcomes in prostate interventions.
Methods
We enroled 20 patients to verify the clinical feasibility of transrectal ultrasound (TRUS)-guided robot-assisted prostate biopsy (PBx). For each patient, controlled trials of systematic 12-core PBx were initially conducted manually using a biopsy gun, followed by a 3-core cognitive fusion targeted biopsy performed by the hand-held robot.
Results
The targeting errors for robot-assisted biopsy and freehand biopsy were 3.71 ± 1.41 mm and 3.94 ± 1.49 mm, respectively. Their cancer core rates were 19.1% and 12.6%, and the average duration of each biopsy was 6.94 min and 1.62 min, respectively.
Conclusions
The robot's sampling success rate was lower than that of freehand with a biopsy gun in the clinical trial. However, robot-assisted PBx has shown improved cancer core rate, slightly enhanced surgical accuracy, and the capability to reach clinically significant tumours' 5 mm error range, all demonstrating its clinical value.
{"title":"Safety and Efficacy Clinical Trial of Robot-Assisted Prostate Biopsy Using a Hand-Held Robotic System","authors":"Wenhe Jiang, Yongzhuo Gao, Mingwei Wen, Qiangqiang Huang, Hui Dong, Huageng Liang, Dongmei Wu, Wei Dong","doi":"10.1002/rcs.70062","DOIUrl":"https://doi.org/10.1002/rcs.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic systems are increasingly utilised to improve clinical outcomes in prostate interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enroled 20 patients to verify the clinical feasibility of transrectal ultrasound (TRUS)-guided robot-assisted prostate biopsy (PBx). For each patient, controlled trials of systematic 12-core PBx were initially conducted manually using a biopsy gun, followed by a 3-core cognitive fusion targeted biopsy performed by the hand-held robot.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The targeting errors for robot-assisted biopsy and freehand biopsy were 3.71 ± 1.41 mm and 3.94 ± 1.49 mm, respectively. Their cancer core rates were 19.1% and 12.6%, and the average duration of each biopsy was 6.94 min and 1.62 min, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The robot's sampling success rate was lower than that of freehand with a biopsy gun in the clinical trial. However, robot-assisted PBx has shown improved cancer core rate, slightly enhanced surgical accuracy, and the capability to reach clinically significant tumours' 5 mm error range, all demonstrating its clinical value.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143581824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Haiyan Du, Zhongwen Wang, Yongde Zhang, Xun Huang, Xilei Wang
Background
At present, breast cancer has become the cancer with the highest incidence rate in the world. Breast intervention robot is an important biopsy or targeted therapy method for breast diseases.
Method
According to the robot's work requirements, the structure, actuation method, auxiliary device, and puncture planning method for the breast intervention robot are summarised. Based on the research status of intervention breast robots, the limitations of current research are discussed and the future development trends are proposed.
Results
The structure, actuation method, auxiliary device, and puncture planning method of breast robots have been widely studied. They significantly impact robotic intervention accuracy, stability, efficiency, and patient satisfaction.
Conclusions
The development of breast intervention robots faces many challenges. With the continuous progress of science and technology, these challenges are expected to be addressed through multidisciplinary research. Breast intervention robots have adequate potential for treating and diagnosing breast diseases.
{"title":"System and Technology of Breast Intervention Robot: A Review","authors":"Haiyan Du, Zhongwen Wang, Yongde Zhang, Xun Huang, Xilei Wang","doi":"10.1002/rcs.70055","DOIUrl":"https://doi.org/10.1002/rcs.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>At present, breast cancer has become the cancer with the highest incidence rate in the world. Breast intervention robot is an important biopsy or targeted therapy method for breast diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>According to the robot's work requirements, the structure, actuation method, auxiliary device, and puncture planning method for the breast intervention robot are summarised. Based on the research status of intervention breast robots, the limitations of current research are discussed and the future development trends are proposed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The structure, actuation method, auxiliary device, and puncture planning method of breast robots have been widely studied. They significantly impact robotic intervention accuracy, stability, efficiency, and patient satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The development of breast intervention robots faces many challenges. With the continuous progress of science and technology, these challenges are expected to be addressed through multidisciplinary research. Breast intervention robots have adequate potential for treating and diagnosing breast diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The advantages of robotic-assisted pancreatoduodenectomy (RPD) in comparison with open pancreatoduodenectomy (OPD) have not been well-established. We aimed to compare their short-term outcomes by inverse probability of treatment weighting (IPTW) analysis.
Methods
Patients who underwent RPD/OPD at our hospital were recruited. Stabilised IPTW were performed to adjust observed covariates. Short-term outcomes were compared.
Results
After IPTW, the effective sample comprised 807 patients (199 RPD, 608 OPD) with balanced clinicopathological characteristics. RPD had a longer operation time, fewer intraoperative blood loss (IBL), and lower blood transfusion rate than OPD. RPD was associated with a lower incidence of clinically relevant postoperative pancreatic fistula and reoperation but did not reach statistical significance. In pancreatic adenocarcinoma, RPD had a significantly higher number of lymph nodes examined. There were no significant differences in postoperative morbidities and length-of-stay.
Conclusions
RPD was associated with fewer IBL and transfusion rates than OPD. RPD can be considered feasible and safe.
{"title":"Comparison of Short-Term Outcomes Between Robotic-Assisted and Open Pancreatoduodenectomy: A Retrospective Cohort Study With Inverse Probability of Treatment Weighting (IPTW) Analysis","authors":"Xi-Tai Huang, Jin-Zhao Xie, Jian-Peng Cai, Qiong-Cong Xu, Wei Chen, Chen-Song Huang, Bin Li, Jia-Ming Lai, Li-Jian Liang, Xiao-Yu Yin","doi":"10.1002/rcs.70057","DOIUrl":"https://doi.org/10.1002/rcs.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The advantages of robotic-assisted pancreatoduodenectomy (RPD) in comparison with open pancreatoduodenectomy (OPD) have not been well-established. We aimed to compare their short-term outcomes by inverse probability of treatment weighting (IPTW) analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent RPD/OPD at our hospital were recruited. Stabilised IPTW were performed to adjust observed covariates. Short-term outcomes were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After IPTW, the effective sample comprised 807 patients (199 RPD, 608 OPD) with balanced clinicopathological characteristics. RPD had a longer operation time, fewer intraoperative blood loss (IBL), and lower blood transfusion rate than OPD. RPD was associated with a lower incidence of clinically relevant postoperative pancreatic fistula and reoperation but did not reach statistical significance. In pancreatic adenocarcinoma, RPD had a significantly higher number of lymph nodes examined. There were no significant differences in postoperative morbidities and length-of-stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RPD was associated with fewer IBL and transfusion rates than OPD. RPD can be considered feasible and safe.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
RuiXiao Li, JianXin Ni, Xuelian Li, Bin Wu, Bo Li, RuiPing Su, Song Xue, YongPan An, GuoJun Wu
Background
To explore the preliminary safety and efficacy of domestic single-port robot-assisted pyeloplasty in ureteropelvic junction obstruction.
Methods
Data from patients undergoing single-port robotic-assisted pyeloplasty (November 2023—May 2024) using the ‘SHURUI’ SP system through a single-site approach were reviewed. Details included patient demographics, intraoperative and postoperative data, and surgical outcomes.
Results
The study included 20 patients, ages 13–39, with a male-to-female ratio of 4:1. Clinical presentations:abdominal pain (7cases), infection (2cases), and asymptomatic (11cases). All surgeries were successful, with an average operation time of 147(IQR, 125–175) minutes, blood loss of 35(IQR, 30–60) mL, and a hospital stay of 5(IQR, 3–6)days. The ureteral stent was removed 6–8 weeks post-surgery, with a subsequent CT scan at 4 months showing 100% success based on pain and obstruction resolution.
Conclusion
The ‘SHURUI’ single-port robotic-assisted pyeloplasty is a safe and feasible treatment for UPJO in both adults and paediatric patients.
{"title":"Functional Outcomes After ‘SHURUI’ Single-Port Robot-Assisted Pyeloplasty for Uretero Pelvic Junction Obstruction: Single-Centre Experience","authors":"RuiXiao Li, JianXin Ni, Xuelian Li, Bin Wu, Bo Li, RuiPing Su, Song Xue, YongPan An, GuoJun Wu","doi":"10.1002/rcs.70056","DOIUrl":"https://doi.org/10.1002/rcs.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To explore the preliminary safety and efficacy of domestic single-port robot-assisted pyeloplasty in ureteropelvic junction obstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from patients undergoing single-port robotic-assisted pyeloplasty (November 2023—May 2024) using the ‘SHURUI’ SP system through a single-site approach were reviewed. Details included patient demographics, intraoperative and postoperative data, and surgical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 20 patients, ages 13–39, with a male-to-female ratio of 4:1. Clinical presentations:abdominal pain (7cases), infection (2cases), and asymptomatic (11cases). All surgeries were successful, with an average operation time of 147(IQR, 125–175) minutes, blood loss of 35(IQR, 30–60) mL, and a hospital stay of 5(IQR, 3–6)days. The ureteral stent was removed 6–8 weeks post-surgery, with a subsequent CT scan at 4 months showing 100% success based on pain and obstruction resolution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The ‘SHURUI’ single-port robotic-assisted pyeloplasty is a safe and feasible treatment for UPJO in both adults and paediatric patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The present study aimed to examine the impact of prior experience of computed tomography-based navigated THA (CTN-THA) on the accuracy of cup placement in robotic arm-assisted total hip arthroplasty via direct anterior approach using the Mako system (Mako-THA).
Methods
We evaluated the first 60 hips that underwent Mako-THA performed by surgeons with and without CTN-THA experience and compared the absolute error of pre-operative and post-operative cup placement using a three-dimensional template between the two groups.
Results
The CTN-user group demonstrated significantly better results in radiographic inclination, y-(sagittal) axis placement, and z-(vertical) axis placement than the non-CTN-user group (CTN-user group: 1.0° ± 0.9°, 1.5 ± 1.4 mm, and 1.4 ± 1.1 mm, respectively; non-CTN-user group: 2.2° ± 1.8°, 2.3 ± 1.2 mm, and 2.4 ± 1.4 mm, respectively). There was no significant difference in radiographic anteversion (CTN-user group: 1.4° ± 1.4° vs. non-CTN-user group: 1.9° ± 1.8°).
Conclusions
Surgeons with prior CTN-THA experience achieved higher accuracy in cup placement than surgeons without CTN-THA experience.
{"title":"Impact of Prior Computed Tomography-Based Navigation Experience on Cup-Placement Accuracy in Early Cases of Robotic Arm-Assisted Total Hip Arthroplasty via Direct Anterior Approach: A Retrospective Cohort Study","authors":"Tomoya Okazaki, Takashi Imagama, Hiroshi Tanaka, Eiichi Shiigi, Yuta Matsuki, Takehiro Kaneoka, Takehiro Kawakami, Kazuhiro Yamazaki, Kei Sasaki, Takashi Sakai","doi":"10.1002/rcs.70058","DOIUrl":"https://doi.org/10.1002/rcs.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The present study aimed to examine the impact of prior experience of computed tomography-based navigated THA (CTN-THA) on the accuracy of cup placement in robotic arm-assisted total hip arthroplasty via direct anterior approach using the Mako system (Mako-THA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated the first 60 hips that underwent Mako-THA performed by surgeons with and without CTN-THA experience and compared the absolute error of pre-operative and post-operative cup placement using a three-dimensional template between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The CTN-user group demonstrated significantly better results in radiographic inclination, <i>y</i>-(sagittal) axis placement, and <i>z</i>-(vertical) axis placement than the non-CTN-user group (CTN-user group: 1.0° ± 0.9°, 1.5 ± 1.4 mm, and 1.4 ± 1.1 mm, respectively; non-CTN-user group: 2.2° ± 1.8°, 2.3 ± 1.2 mm, and 2.4 ± 1.4 mm, respectively). There was no significant difference in radiographic anteversion (CTN-user group: 1.4° ± 1.4° vs. non-CTN-user group: 1.9° ± 1.8°).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Surgeons with prior CTN-THA experience achieved higher accuracy in cup placement than surgeons without CTN-THA experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shilun Du, Yingda Hu, Murong Li, Mengruo Shen, Zhen Wang, Yong Lei
Background
Energy-based cutting tools combine cutting and haemostasis, making them widely utilised. Accurately predicting tissue deformation during energy-based cutting can provide precise navigation information to enhance surgical outcomes, while existing surgical cutting models focussing on blades-based tools are unable to accurately predict energy cutting deformation.
Methods
This paper aims to propose a novel energy cutting model under different cutting trajectories. First, a stratified discontinuity mechanism-based modelling method of energy cutting is proposed. Second, a parameterised impact zone model is developed for describing complex surgical manipulations using intraoperative trajectories. Third, an incremental cutting computation algorithm and a novel void enrichment function are proposed to enhance the computational efficiency.
Results
The mean absolute deformation errors of numerical and experimental results under various of cutting trajectories are less than 1 mm. The computation efficiency and convergence are also validated.
Conclusions
The desired cutting deformation accuracy is achieved robustly while maintaining computation efficiency.
{"title":"Modelling and Simulation of Energy Cutting Tool for Soft Tissue Using a Novel extended Finite Element Method","authors":"Shilun Du, Yingda Hu, Murong Li, Mengruo Shen, Zhen Wang, Yong Lei","doi":"10.1002/rcs.70052","DOIUrl":"https://doi.org/10.1002/rcs.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Energy-based cutting tools combine cutting and haemostasis, making them widely utilised. Accurately predicting tissue deformation during energy-based cutting can provide precise navigation information to enhance surgical outcomes, while existing surgical cutting models focussing on blades-based tools are unable to accurately predict energy cutting deformation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This paper aims to propose a novel energy cutting model under different cutting trajectories. First, a stratified discontinuity mechanism-based modelling method of energy cutting is proposed. Second, a parameterised impact zone model is developed for describing complex surgical manipulations using intraoperative trajectories. Third, an incremental cutting computation algorithm and a novel void enrichment function are proposed to enhance the computational efficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean absolute deformation errors of numerical and experimental results under various of cutting trajectories are less than 1 mm. The computation efficiency and convergence are also validated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The desired cutting deformation accuracy is achieved robustly while maintaining computation efficiency.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amit Kumar, Dwarakanath T. A., Gaurav Bhutani, Dwarakanath Srinivas
Background
Accurate perception of pedicle geometry during pedicle-screw placement surgery is critically important because the margin-for-error is small.
Method
An assessment algorithm is developed to provide machine-independent MultiPlanar Reconstruction (MiMPR) of the pedicle. The reconstruction is independent of the CT-machine frame and enhances patient data portability. Additionally, the algorithm obtains the pedicle-screw axis with optimum direction, length, and margin using MPRs. A method for the autonomous identification of four body features to form a CT-independent vertebral frame, {V}, in the image space is formulated.
Result
Applied to 200 high-resolution CT images, the approach achieved a 100% success rate in defining the pedicle-medial axis and maximum screw diameter considering the safety margin of 2 mm.
Conclusions
The method eliminates subjective assessment. It provides objective assessment in determining the pedicle-medial axis with optimal direction and margin without human annotation. Additionally, it significantly enhances screw placement accuracy in robot-assisted spinal fusion surgeries, regardless of vertebra orientation.
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