Pub Date : 2016-01-01DOI: 10.1080/24699322.2016.1210679
Leyi Xu, Ken Cai, Rongqian Yang, Qinyong Lin, Hongwei Yue, Feng Liu
ABSTRACT Radiofrequency ablation (RFA) is a crucial alternative treatment for liver cancer with the advantages of minimal invasion and a fast prognosis. However, two problems limit its further application: the orientation of the puncture point and the ablation of large tumors. The optical surgery navigation system in the RFA presents a promising approach for solving the localization problem in the puncturing process, which greatly increases puncture accuracy and has overcome the disadvantages of traditional RFA surgery. In addition, the use of multiple electrodes in the RFA (multi-probe RFA) is proposed and is applied clinically to deal with large tumors. In this study, we present a multi-probe RFA model using the finite element method (FEM) combined with a self-developed optical surgical navigation system. A real 3D liver model was adopted as an effective reference. Based on this model, two-probe RFA simulations were performed under different active modes. An analysis was conducted from the perspective of the temperature and electric potential fields and cell necrosis. The simulation results showed that different active modes had separate advantages and were suitable for different situations. Understanding their advantages can not only help doctors make surgical plans that fit the patients’ conditions, but also the understanding can offer a virtual surgery platform for further development in the preoperative planning of RFA incorporated with the surgery navigation system.
{"title":"Simulation of multi-probe radiofrequency ablation guided by optical surgery navigation system under different active modes","authors":"Leyi Xu, Ken Cai, Rongqian Yang, Qinyong Lin, Hongwei Yue, Feng Liu","doi":"10.1080/24699322.2016.1210679","DOIUrl":"https://doi.org/10.1080/24699322.2016.1210679","url":null,"abstract":"ABSTRACT Radiofrequency ablation (RFA) is a crucial alternative treatment for liver cancer with the advantages of minimal invasion and a fast prognosis. However, two problems limit its further application: the orientation of the puncture point and the ablation of large tumors. The optical surgery navigation system in the RFA presents a promising approach for solving the localization problem in the puncturing process, which greatly increases puncture accuracy and has overcome the disadvantages of traditional RFA surgery. In addition, the use of multiple electrodes in the RFA (multi-probe RFA) is proposed and is applied clinically to deal with large tumors. In this study, we present a multi-probe RFA model using the finite element method (FEM) combined with a self-developed optical surgical navigation system. A real 3D liver model was adopted as an effective reference. Based on this model, two-probe RFA simulations were performed under different active modes. An analysis was conducted from the perspective of the temperature and electric potential fields and cell necrosis. The simulation results showed that different active modes had separate advantages and were suitable for different situations. Understanding their advantages can not only help doctors make surgical plans that fit the patients’ conditions, but also the understanding can offer a virtual surgery platform for further development in the preoperative planning of RFA incorporated with the surgery navigation system.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"21 1","pages":"107 - 116"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1210679","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60126139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.1080/24699322.2016.1240235
Guangye Wang, Wen-jun Huang, Q. Song, Y. Qin, Jinfeng Liang
Abstract Acetabular fractures have always been very challenging for orthopedic surgeons; therefore, appropriate preoperative evaluation and planning are particularly important. This study aimed to explore the application methods and clinical value of preoperative computer simulation (PCS) in treating pelvic and acetabular fractures. Spiral computed tomography (CT) was performed on 13 patients with pelvic and acetabular fractures, and Digital Imaging and Communications in Medicine (DICOM) data were then input into Mimics software to reconstruct three-dimensional (3D) models of actual pelvic and acetabular fractures for preoperative simulative reduction and fixation, and to simulate each surgical procedure. The times needed for virtual surgical modeling and reduction and fixation were also recorded. The average fracture-modeling time was 45 min (30–70 min), and the average time for bone reduction and fixation was 28 min (16–45 min). Among the surgical approaches planned for these 13 patients, 12 were finally adopted; 12 cases used the simulated surgical fixation, and only 1 case used a partial planned fixation method. PCS can provide accurate surgical plans and data support for actual surgeries.
髋臼骨折一直是困扰骨科医生的难题;因此，适当的术前评估和规划尤为重要。本研究旨在探讨术前计算机模拟(PCS)在骨盆髋臼骨折治疗中的应用方法及临床价值。对13例骨盆、髋臼骨折患者行螺旋CT扫描，并将DICOM数据输入Mimics软件，重建实际骨盆、髋臼骨折的三维模型，进行术前模拟复位和固定，并模拟各手术过程。同时记录虚拟手术建模、复位和固定所需时间。骨折建模平均时间为45 min (30 ~ 70 min)，骨复位固定平均时间为28 min (16 ~ 45 min)。在这13例患者计划的手术入路中，最终采用了12例;12例采用模拟手术固定，仅有1例采用部分计划固定。PCS可以为实际手术提供准确的手术方案和数据支持。
{"title":"Computer-assisted virtual preoperative planning in orthopedic surgery for acetabular fractures based on actual computed tomography data","authors":"Guangye Wang, Wen-jun Huang, Q. Song, Y. Qin, Jinfeng Liang","doi":"10.1080/24699322.2016.1240235","DOIUrl":"https://doi.org/10.1080/24699322.2016.1240235","url":null,"abstract":"Abstract Acetabular fractures have always been very challenging for orthopedic surgeons; therefore, appropriate preoperative evaluation and planning are particularly important. This study aimed to explore the application methods and clinical value of preoperative computer simulation (PCS) in treating pelvic and acetabular fractures. Spiral computed tomography (CT) was performed on 13 patients with pelvic and acetabular fractures, and Digital Imaging and Communications in Medicine (DICOM) data were then input into Mimics software to reconstruct three-dimensional (3D) models of actual pelvic and acetabular fractures for preoperative simulative reduction and fixation, and to simulate each surgical procedure. The times needed for virtual surgical modeling and reduction and fixation were also recorded. The average fracture-modeling time was 45 min (30–70 min), and the average time for bone reduction and fixation was 28 min (16–45 min). Among the surgical approaches planned for these 13 patients, 12 were finally adopted; 12 cases used the simulated surgical fixation, and only 1 case used a partial planned fixation method. PCS can provide accurate surgical plans and data support for actual surgeries.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"21 1","pages":"160 - 165"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1240235","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60126292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.1080/24699322.2016.1178330
P. Cerveri, G. Baroni, N. Confalonieri, A. Manzotti
Abstract Diagnostic and therapeutic purposes are issuing pressing demands to improve the evaluation of the dysplasia condition of the femoral trochlea. The traditional clinical assessment of the dysplasia, based on Dejour classification, recognized 4 increasing (A, B, C, D) levels of severity. It has been extensively questioned in the literature that this classification methodology can be defective suggesting that quantitative measures can ensure more reliable criteria for the dysplasia severity assessment. This study reports on a novel technique to model the trochlear surface (TS), digitally reconstructed by 3D volumetric imaging, using three hyperbolic paraboloids (HP), one to describe the global trochlear aspect, two to represent the local aspects of the medial and lateral compartments, respectively. Results on a cohort of 43 patients, affected by aspecific anterior knee pain, demonstrate the consistency of the estimated model parameters with the morphologic aspect of the TS. The obtained small fitting error (on average lower than 0.80 mm) demonstrated that the ventral aspect of the trochlear morphology can be modeled with high accuracy by HPs. We also showed that HP modeling provides a continuous representation of morphologic variations in shape parameter space while we found that similar morphologic anomalies of the trochlear aspect are actually attributed to different severity grades in the Dejour classification. This finding is in agreement with recent works in the literature reporting that morphometric parameters can only optimistically be used to discriminate between the Grade A and the remaining three grades. In conclusion, we can assert that the proposed methodology is a further step toward modeling of anatomical surfaces that can be used to quantify deviations to normality on a patient-specific basis.
{"title":"Patient-specific modeling of the trochlear morphologic anomalies by means of hyperbolic paraboloids","authors":"P. Cerveri, G. Baroni, N. Confalonieri, A. Manzotti","doi":"10.1080/24699322.2016.1178330","DOIUrl":"https://doi.org/10.1080/24699322.2016.1178330","url":null,"abstract":"Abstract Diagnostic and therapeutic purposes are issuing pressing demands to improve the evaluation of the dysplasia condition of the femoral trochlea. The traditional clinical assessment of the dysplasia, based on Dejour classification, recognized 4 increasing (A, B, C, D) levels of severity. It has been extensively questioned in the literature that this classification methodology can be defective suggesting that quantitative measures can ensure more reliable criteria for the dysplasia severity assessment. This study reports on a novel technique to model the trochlear surface (TS), digitally reconstructed by 3D volumetric imaging, using three hyperbolic paraboloids (HP), one to describe the global trochlear aspect, two to represent the local aspects of the medial and lateral compartments, respectively. Results on a cohort of 43 patients, affected by aspecific anterior knee pain, demonstrate the consistency of the estimated model parameters with the morphologic aspect of the TS. The obtained small fitting error (on average lower than 0.80 mm) demonstrated that the ventral aspect of the trochlear morphology can be modeled with high accuracy by HPs. We also showed that HP modeling provides a continuous representation of morphologic variations in shape parameter space while we found that similar morphologic anomalies of the trochlear aspect are actually attributed to different severity grades in the Dejour classification. This finding is in agreement with recent works in the literature reporting that morphometric parameters can only optimistically be used to discriminate between the Grade A and the remaining three grades. In conclusion, we can assert that the proposed methodology is a further step toward modeling of anatomical surfaces that can be used to quantify deviations to normality on a patient-specific basis.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"21 1","pages":"29 - 38"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1178330","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60125679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.1080/24699322.2016.1185466
D. Putzer, S. Klug, J. Moctezuma, E. Mayr, M. Nogler
Abstract Determining how deep instruments can be inserted into the femoral canal without touching adjacent structures is a fundamental necessity for navigating instruments in primary and revision total hip arthroplasty. The aim of the study was to determine the reachable depth of a straight instrument inserted into the femur canal during primary and revision total hip arthroplasty. Based on the three-dimensional data of twenty-six femurs, obtained from a CT scan, the insertion depth of a virtual, straight instrument was accessed by a simulation. The effect of the diameter of the virtual instrument and the extension of the osteotomy were evaluated. Without extending the osteotomy, 100% of the femoral canal was reachable to a depth of 5.1–6.3 cm for instruments with a diameter of 10 mm. The depth was measured from the lower edge of the osteotomy. A maximum lateral extension of the osteotomy by 1 cm enlarges the access to a depth of 8.8 cm. The results provide a theoretical basis for the limitations of guiding instruments used for the preparation of the femoral canal. Bone preserving methods need the development of angulated instruments to reach deep areas in the femoral canal.
{"title":"How deep can straight instruments be inserted into the femoral canal: a simulation study based on cadaveric femora*","authors":"D. Putzer, S. Klug, J. Moctezuma, E. Mayr, M. Nogler","doi":"10.1080/24699322.2016.1185466","DOIUrl":"https://doi.org/10.1080/24699322.2016.1185466","url":null,"abstract":"Abstract Determining how deep instruments can be inserted into the femoral canal without touching adjacent structures is a fundamental necessity for navigating instruments in primary and revision total hip arthroplasty. The aim of the study was to determine the reachable depth of a straight instrument inserted into the femur canal during primary and revision total hip arthroplasty. Based on the three-dimensional data of twenty-six femurs, obtained from a CT scan, the insertion depth of a virtual, straight instrument was accessed by a simulation. The effect of the diameter of the virtual instrument and the extension of the osteotomy were evaluated. Without extending the osteotomy, 100% of the femoral canal was reachable to a depth of 5.1–6.3 cm for instruments with a diameter of 10 mm. The depth was measured from the lower edge of the osteotomy. A maximum lateral extension of the osteotomy by 1 cm enlarges the access to a depth of 8.8 cm. The results provide a theoretical basis for the limitations of guiding instruments used for the preparation of the femoral canal. Bone preserving methods need the development of angulated instruments to reach deep areas in the femoral canal.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"21 1","pages":"56 - 62"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1185466","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60125801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.1080/24699322.2016.1189966
Sonny Chan, Peter Li, Garrett D. Locketz, K. Salisbury, N. Blevins
Abstract Medical imaging techniques provide a wealth of information for surgical preparation, but it is still often the case that surgeons are examining three-dimensional pre-operative image data as a series of two-dimensional images. With recent advances in visual computing and interactive technologies, there is much opportunity to provide surgeons an ability to actively manipulate and interpret digital image data in a surgically meaningful way. This article describes the design and initial evaluation of a virtual surgical environment that supports patient-specific simulation of temporal bone surgery using pre-operative medical image data. Computational methods are presented that enable six degree-of-freedom haptic feedback during manipulation, and that simulate virtual dissection according to the mechanical principles of orthogonal cutting and abrasive wear. A highly efficient direct volume renderer simultaneously provides high-fidelity visual feedback during surgical manipulation of the virtual anatomy. The resulting virtual surgical environment was assessed by evaluating its ability to replicate findings in the operating room, using pre-operative imaging of the same patient. Correspondences between surgical exposure, anatomical features, and the locations of pathology were readily observed when comparing intra-operative video with the simulation, indicating the predictive ability of the virtual surgical environment.
{"title":"High-fidelity haptic and visual rendering for patient-specific simulation of temporal bone surgery","authors":"Sonny Chan, Peter Li, Garrett D. Locketz, K. Salisbury, N. Blevins","doi":"10.1080/24699322.2016.1189966","DOIUrl":"https://doi.org/10.1080/24699322.2016.1189966","url":null,"abstract":"Abstract Medical imaging techniques provide a wealth of information for surgical preparation, but it is still often the case that surgeons are examining three-dimensional pre-operative image data as a series of two-dimensional images. With recent advances in visual computing and interactive technologies, there is much opportunity to provide surgeons an ability to actively manipulate and interpret digital image data in a surgically meaningful way. This article describes the design and initial evaluation of a virtual surgical environment that supports patient-specific simulation of temporal bone surgery using pre-operative medical image data. Computational methods are presented that enable six degree-of-freedom haptic feedback during manipulation, and that simulate virtual dissection according to the mechanical principles of orthogonal cutting and abrasive wear. A highly efficient direct volume renderer simultaneously provides high-fidelity visual feedback during surgical manipulation of the virtual anatomy. The resulting virtual surgical environment was assessed by evaluating its ability to replicate findings in the operating room, using pre-operative imaging of the same patient. Correspondences between surgical exposure, anatomical features, and the locations of pathology were readily observed when comparing intra-operative video with the simulation, indicating the predictive ability of the virtual surgical environment.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"21 1","pages":"101 - 85"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1189966","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60125949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.1080/24699322.2016.1209243
Y. Zhang, Shu Z Wen, Hui Q. Zhang, Ya G Li, Jian M. Zhao, Yong Yang
ABSTRACT Objective: Since the 1970s, research and applications on flap and muscle flap had solved many problems in microsurgical reconstruction. However, the traditional flap design is completely dependent on two-dimensional (2D) images. The purpose of this study was to discuss the methods in the visualization of saphenous artery flap by digitalized technique and its applications by digitalized technique. Methods: Two adult fresh cadaver specimens, one male and one female, were subject to radiographic computerized tomography (CT) scanning before and after perfused with lead oxide–gelatine mixture, whose collimation are 0.625 mm (120 kV, 110 mA, 512 × 512 matrix). Through Amira 5.4.1 software, the 2D images in DICOM format were transformed into the 3D models of the entire region. The structures of saphenous artery were observed and the digitized visible models of saphenous artery flap were established through three-dimensional (3D) computerized reconstructions methods from these data using Amira 5.4.1 software. Next six cases of soft-tissue defects of the tibia region, involving the exposure bones underwent contrast-enhanced CT angiography of lower limbs utilizing a 64-row multi-slice spiral CT after median cubital vein injection with Ultravist (3.5 ml/s). 2D images from these data in DICOM format were transformed into computer. The structures of saphenous artery flap were observed and measured using Amira 5.4.1 software. Then, all cases were treated by saphenous artery flap. Results: The 3D reconstructed visible models established from these datasets perfectly displayed the saphenous artery flap anatomy. In six cases, the main trunk and branched of the blood vessels in the designed flap were consistent with the surgical findings. The starting point of the saphenous artery to the average distance of the knee clearance were 119.2 ± 9.6 mm, the average diameter of the saphenous artery from the starting point were 1.5 ± 0.3 mm. The range of flap was 8.0 × 5.0 cm to 20.0 × 8.0 cm. All flaps survived well. After 8–24 months’ follow-up the knee flexion was 120–140°, the straight 0–10°. There was no case appeared incision infection. Conclusions: The preoperative use of 3D digitalized virtual planning for the saphenous artery flap improves the surgical accuracy, decreases the operation time and increases the survival rate of the flap.
{"title":"Three-dimensional digitalized virtual planning for saphenous artery flap: a pilot study","authors":"Y. Zhang, Shu Z Wen, Hui Q. Zhang, Ya G Li, Jian M. Zhao, Yong Yang","doi":"10.1080/24699322.2016.1209243","DOIUrl":"https://doi.org/10.1080/24699322.2016.1209243","url":null,"abstract":"ABSTRACT Objective: Since the 1970s, research and applications on flap and muscle flap had solved many problems in microsurgical reconstruction. However, the traditional flap design is completely dependent on two-dimensional (2D) images. The purpose of this study was to discuss the methods in the visualization of saphenous artery flap by digitalized technique and its applications by digitalized technique. Methods: Two adult fresh cadaver specimens, one male and one female, were subject to radiographic computerized tomography (CT) scanning before and after perfused with lead oxide–gelatine mixture, whose collimation are 0.625 mm (120 kV, 110 mA, 512 × 512 matrix). Through Amira 5.4.1 software, the 2D images in DICOM format were transformed into the 3D models of the entire region. The structures of saphenous artery were observed and the digitized visible models of saphenous artery flap were established through three-dimensional (3D) computerized reconstructions methods from these data using Amira 5.4.1 software. Next six cases of soft-tissue defects of the tibia region, involving the exposure bones underwent contrast-enhanced CT angiography of lower limbs utilizing a 64-row multi-slice spiral CT after median cubital vein injection with Ultravist (3.5 ml/s). 2D images from these data in DICOM format were transformed into computer. The structures of saphenous artery flap were observed and measured using Amira 5.4.1 software. Then, all cases were treated by saphenous artery flap. Results: The 3D reconstructed visible models established from these datasets perfectly displayed the saphenous artery flap anatomy. In six cases, the main trunk and branched of the blood vessels in the designed flap were consistent with the surgical findings. The starting point of the saphenous artery to the average distance of the knee clearance were 119.2 ± 9.6 mm, the average diameter of the saphenous artery from the starting point were 1.5 ± 0.3 mm. The range of flap was 8.0 × 5.0 cm to 20.0 × 8.0 cm. All flaps survived well. After 8–24 months’ follow-up the knee flexion was 120–140°, the straight 0–10°. There was no case appeared incision infection. Conclusions: The preoperative use of 3D digitalized virtual planning for the saphenous artery flap improves the surgical accuracy, decreases the operation time and increases the survival rate of the flap.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"21 1","pages":"102 - 106"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1209243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60126128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.1080/24699322.2016.1217352
T. Altokhais, Hala Mandora, Ayed Al-Qahtani, A. Al-Bassam
Abstract Background: Achalasia is rare in children. Surgical options include open, laparoscopic and robotic approaches. However, Heller’s myotomy remains the treatment of choice. This report describes our experience with robot-assisted Heller’s myotomy in children and presents a review of the literature. Methods: Included in this study are children who underwent robot-assisted Heller’s myotomy for esophageal achalasia via the Da Vinci surgical system between 2004 and 2015 at King Saud University Medical City, Riyadh, Saudi Arabia. The medical records of these patients were reviewed for demographic data, presenting symptoms, diagnostic modalities, operative procedures, complications, outcomes and follow-ups. Results: Six patients were identified. The age of the patients at surgery ranged between 2 and 12 years (mean 7.1 years). The most common presenting symptoms were dysphagia, vomiting and nocturnal cough. Contrast swallow and upper gastrointestinal endoscopy established a diagnosis of esophageal achalasia in all of the patients. Four patients underwent esophageal dilatation 2–5 times before the definitive procedure. All patients underwent successful robot-assisted Heller’s myotomy with concomitant partial posterior fundoplication. The postoperative course was uneventful. Five patients had a complete resolution of the symptoms and one patient improved. The follow-up assessments have been consistent and have ranged from 0.5 to 11 years (mean 4.4 years). Conclusion: Robotic-assisted Heller’s myotomy for esophageal achalasia in children is safe and effective and is a suitable alternative to open and laparoscopic approaches.
{"title":"Robot-assisted Heller’s myotomy for achalasia in children","authors":"T. Altokhais, Hala Mandora, Ayed Al-Qahtani, A. Al-Bassam","doi":"10.1080/24699322.2016.1217352","DOIUrl":"https://doi.org/10.1080/24699322.2016.1217352","url":null,"abstract":"Abstract Background: Achalasia is rare in children. Surgical options include open, laparoscopic and robotic approaches. However, Heller’s myotomy remains the treatment of choice. This report describes our experience with robot-assisted Heller’s myotomy in children and presents a review of the literature. Methods: Included in this study are children who underwent robot-assisted Heller’s myotomy for esophageal achalasia via the Da Vinci surgical system between 2004 and 2015 at King Saud University Medical City, Riyadh, Saudi Arabia. The medical records of these patients were reviewed for demographic data, presenting symptoms, diagnostic modalities, operative procedures, complications, outcomes and follow-ups. Results: Six patients were identified. The age of the patients at surgery ranged between 2 and 12 years (mean 7.1 years). The most common presenting symptoms were dysphagia, vomiting and nocturnal cough. Contrast swallow and upper gastrointestinal endoscopy established a diagnosis of esophageal achalasia in all of the patients. Four patients underwent esophageal dilatation 2–5 times before the definitive procedure. All patients underwent successful robot-assisted Heller’s myotomy with concomitant partial posterior fundoplication. The postoperative course was uneventful. Five patients had a complete resolution of the symptoms and one patient improved. The follow-up assessments have been consistent and have ranged from 0.5 to 11 years (mean 4.4 years). Conclusion: Robotic-assisted Heller’s myotomy for esophageal achalasia in children is safe and effective and is a suitable alternative to open and laparoscopic approaches.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"20 1","pages":"127 - 131"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1217352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60126190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.1080/24699322.2016.1236146
Ting Deng, Minghui Jiang, Qing Lei, Lihong Cai, Li Chen
Abstract Study design: Clinical trial for cervical screw insertion by using individualized 3-dimensional (3D) printing screw insertion templates device. Objective: The objective of this study is to evaluate the safety and accuracy of the individualized 3D printing screw insertion template in the cervical spine. Materials and methods: Ten patients who underwent posterior cervical fusion surgery with cervical pedicle screws, laminar screws or lateral mass screws between December 2014 and December 2015 were involved in this study. The patients were examined by CT scan before operation. The individualized 3D printing templates were made with photosensitive resin by a 3D printing system to ensure the screw shafts entered the vertebral body without breaking the pedicle or lamina cortex. The templates were sterilized by a plasma sterilizer and used during the operation. The accuracy and the safety of the templates were evaluated by CT scans at the screw insertion levels after operation. Results: The accuracy of this patient-specific template technique was demonstrated. Only one screw axis greatly deviated from the planned track and breached the cortex of the pedicle because the template was split by rough handling and then we inserted the screws under the fluoroscopy. The remaining screws were inserted in the track as preoperative design and the screw axis deviated by less than 2 mm. Vascular or neurologic complications or injuries did not happen. And no infection, broken nails, fracture of bone structure, or screw pullout occurred. Conclusion: This study verified the safety and the accuracy of the individualized 3D printing screw insertion templates in the cervical spine as a kind of intraoperative screw navigation. This individualized 3D printing screw insertion template was user-friendly, moderate cost, and enabled a radiation-free cervical screw insertion.
{"title":"The accuracy and the safety of individualized 3D printing screws insertion templates for cervical screw insertion","authors":"Ting Deng, Minghui Jiang, Qing Lei, Lihong Cai, Li Chen","doi":"10.1080/24699322.2016.1236146","DOIUrl":"https://doi.org/10.1080/24699322.2016.1236146","url":null,"abstract":"Abstract Study design: Clinical trial for cervical screw insertion by using individualized 3-dimensional (3D) printing screw insertion templates device. Objective: The objective of this study is to evaluate the safety and accuracy of the individualized 3D printing screw insertion template in the cervical spine. Materials and methods: Ten patients who underwent posterior cervical fusion surgery with cervical pedicle screws, laminar screws or lateral mass screws between December 2014 and December 2015 were involved in this study. The patients were examined by CT scan before operation. The individualized 3D printing templates were made with photosensitive resin by a 3D printing system to ensure the screw shafts entered the vertebral body without breaking the pedicle or lamina cortex. The templates were sterilized by a plasma sterilizer and used during the operation. The accuracy and the safety of the templates were evaluated by CT scans at the screw insertion levels after operation. Results: The accuracy of this patient-specific template technique was demonstrated. Only one screw axis greatly deviated from the planned track and breached the cortex of the pedicle because the template was split by rough handling and then we inserted the screws under the fluoroscopy. The remaining screws were inserted in the track as preoperative design and the screw axis deviated by less than 2 mm. Vascular or neurologic complications or injuries did not happen. And no infection, broken nails, fracture of bone structure, or screw pullout occurred. Conclusion: This study verified the safety and the accuracy of the individualized 3D printing screw insertion templates in the cervical spine as a kind of intraoperative screw navigation. This individualized 3D printing screw insertion template was user-friendly, moderate cost, and enabled a radiation-free cervical screw insertion.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"21 1","pages":"143 - 149"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1236146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60126281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.1080/24699322.2016.1184312
Ken Cai, Rongqian Yang, Qinyong Lin, Zhigang Wang
Abstract Surgical navigation systems can assist doctors in performing more precise and more efficient surgical procedures to avoid various accidents. The near-infrared optical system (NOS) is an important component of surgical navigation systems. However, several surgical instruments are used during surgery, and effectively tracking all of them is challenging. A stereo matching algorithm using two intersecting lines and surgical instrument codes is proposed in this paper. In our NOS, the markers on the surgical instruments can be captured by two near-infrared cameras. After automatically searching and extracting their subpixel coordinates in the left and right images, the coordinates of the real and pseudo markers are determined by the two intersecting lines. Finally, the pseudo markers are removed to achieve accurate stereo matching by summing the codes for the distances between a specific marker with the other two markers on the surgical instrument. Experimental results show that the markers on the different surgical instruments can be automatically and accurately recognized. The NOS can accurately track multiple surgical instruments.
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Pub Date : 2016-01-01DOI: 10.1080/24699322.2016.1249959
S. Khuangsirikul, Kreangsak Lekkreusuwan, T. Chotanaphuti
Abstract Background: Both minimally invasive surgery (MIS) and computer-assisted surgery (CAS) in total knee arthroplasty have been scientifically linked with surgical benefits. However, the long-term results of these techniques are still controversial. Most surgeons assessed the surgical outcomes with regard to knee alignment and range of motion, but these factors may not reflect subjective variables, namely patient satisfaction. Purpose: To compare satisfaction and functional outcomes between two technical procedures in MIS total knee arthroplasty, namely computer-assisted MIS and conventional MIS procedure, operated on a sample group of patients after 10 years. Methods: Seventy cases of posterior-stabilized total knee prostheses were implanted using a computer-assisted system and were compared to 74 cases of matched total knee prostheses of the same implant using conventional technique. Both groups underwent arthrotomy by 2 cm limited quadriceps exposure minimally invasive surgery (2 cm Quad MIS). At an average of 10 years after surgery, self-administered patient satisfaction and WOMAC scales were administered and analyzed. Results: Demographic data of both groups including sex, age, preoperative WOMAC and post-operative duration were not statistically different. Post-operative WOMAC for the computer-assisted group was 38.94 ± 5.68, while the conventional one stood at 37.89 ± 6.22. The median of self-administered patient satisfaction scales of the computer-assisted group was 100 (min37.5–max100), while the conventional one was 100 (min25–max100). p Value was 0.889. There was one re-operative case in the conventional MIS group due to peri-prosthetic infection which was treated with debridement, polyethylene exchanged and intravenous antibiotics. Conclusions: The 10-year outcomes of computer-assisted MIS total knee arthroplasty are not superior to that of the conventional MIS technique in function and patient satisfaction. 10 years may not be enough to show the difference between these two techniques.
背景:在全膝关节置换术中，微创手术(MIS)和计算机辅助手术(CAS)都与手术益处有科学联系。然而，这些技术的长期结果仍然存在争议。大多数外科医生评估手术结果时都考虑到膝关节对齐和活动范围，但这些因素可能不能反映主观变量，即患者满意度。目的:比较计算机辅助MIS和传统MIS两种MIS全膝关节置换术的满意度和功能结果。方法:采用计算机辅助系统植入70例后稳定型全膝关节假体，并与74例相同假体采用常规技术匹配的全膝关节假体进行比较。两组均行2 cm有限四头肌暴露微创手术(2 cm Quad MIS)关节切开术。术后平均10年，对患者自我满意度和WOMAC量表进行分析。结果:两组性别、年龄、术前WOMAC、术后时间等人口学数据差异无统计学意义。计算机辅助组术后WOMAC为38.94±5.68，常规组为37.89±6.22。计算机辅助组自我给药患者满意度量表中位数为100 (min37.5-max100)，常规组为100 (min25-max100)。p值为0.889。常规MIS组1例因假体周围感染再手术，行清创、聚乙烯置换及静脉注射抗生素治疗。结论:计算机辅助MIS全膝关节置换术的10年结果在功能和患者满意度方面并不优于传统MIS技术。10年可能不足以显示这两种技术之间的差异。
{"title":"10-Year patient satisfaction compared between computer-assisted navigation and conventional techniques in minimally invasive surgery total knee arthroplasty","authors":"S. Khuangsirikul, Kreangsak Lekkreusuwan, T. Chotanaphuti","doi":"10.1080/24699322.2016.1249959","DOIUrl":"https://doi.org/10.1080/24699322.2016.1249959","url":null,"abstract":"Abstract Background: Both minimally invasive surgery (MIS) and computer-assisted surgery (CAS) in total knee arthroplasty have been scientifically linked with surgical benefits. However, the long-term results of these techniques are still controversial. Most surgeons assessed the surgical outcomes with regard to knee alignment and range of motion, but these factors may not reflect subjective variables, namely patient satisfaction. Purpose: To compare satisfaction and functional outcomes between two technical procedures in MIS total knee arthroplasty, namely computer-assisted MIS and conventional MIS procedure, operated on a sample group of patients after 10 years. Methods: Seventy cases of posterior-stabilized total knee prostheses were implanted using a computer-assisted system and were compared to 74 cases of matched total knee prostheses of the same implant using conventional technique. Both groups underwent arthrotomy by 2 cm limited quadriceps exposure minimally invasive surgery (2 cm Quad MIS). At an average of 10 years after surgery, self-administered patient satisfaction and WOMAC scales were administered and analyzed. Results: Demographic data of both groups including sex, age, preoperative WOMAC and post-operative duration were not statistically different. Post-operative WOMAC for the computer-assisted group was 38.94 ± 5.68, while the conventional one stood at 37.89 ± 6.22. The median of self-administered patient satisfaction scales of the computer-assisted group was 100 (min37.5–max100), while the conventional one was 100 (min25–max100). p Value was 0.889. There was one re-operative case in the conventional MIS group due to peri-prosthetic infection which was treated with debridement, polyethylene exchanged and intravenous antibiotics. Conclusions: The 10-year outcomes of computer-assisted MIS total knee arthroplasty are not superior to that of the conventional MIS technique in function and patient satisfaction. 10 years may not be enough to show the difference between these two techniques.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"21 1","pages":"172 - 175"},"PeriodicalIF":2.1,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24699322.2016.1249959","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60126123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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