收稿日期: 2022-06-15
录用日期: 2022-08-17
网络出版日期: 2022-09-28
基金资助
上海市科学技术委员会优秀技术带头人(20XD1433400);上海市科学技术委员会科技支撑项目(20S31902200);上海交通大学医学院技术转移推广项目(ZT202109);上海交通大学医学院附属第九人民医院“交叉”研究基金项目(JYJC201802);上海交通大学医学院附属第九人民医院多学科团队临床研究项目(201906);上海交通大学医学院附属第九人民医院临床研究项目(JYLJ201920)
Experimental study on the accuracy evaluation of robot-assisted osteotomy of genioplasty
Received date: 2022-06-15
Accepted date: 2022-08-17
Online published: 2022-09-28
Supported by
Excellent Technical Leader of Science and Technology Commission of Shanghai Municipality(20XD1433400);Science and Technology Support Project of Science and Technology Commission of Shanghai Municipality(20S31902200);Technology Transfer Project of Shanghai Jiao Tong University School of Medicine(ZT202109);Cross-research Fund Project of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine(JYJC201802);Multidisciplinary Team Clinical Research Project of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine(201906);Clinical Research Project of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine(JYLJ201920)
目的·初步评价自主研发的颅颌面外科手术机器人(cranial-maxilofacial robot,CMF ROBOT)系统对头颅模型行颏成形术截骨操作的执行精度。方法·纳入2019年8月—2020年10月于上海交通大学医学院附属第九人民医院就诊的9例颏部畸形患者为研究对象。术前,采集患者的全头颅螺旋CT图像,通过三维打印制作头颅模型,并行虚拟手术规划。术中,实验组采用CMF ROBOT系统对9例头颅模型进行自动截骨;对照组采用三维打印手术导板辅助,由高年资外科医师对相同的9例头颅模型进行手动截骨。术后行螺旋CT扫描,对2组截骨平面的距离误差和方向误差进行三维测量,并对该2项误差的组间差异进行统计分析。结果·2组均顺利完成了颏成形术的截骨操作。实验组整体截骨的距离误差为(1.40±0.27)mm、方向误差为7.03°±3.02°,对照组整体截骨的距离误差为(1.23±0.27)mm、方向误差为6.08°±2.24°;且该2项误差的组间差异均无统计学意义(P=0.256,P=0.462)。结论·CMF ROBOT系统可根据术前规划完成颏成形术的自动截骨操作,其在截骨面的距离误差、方向误差均可达到以三维打印手术导板辅助的手动截骨操作的精度水平。
回文宇 , 吴锦阳 , 黄建华 , 栾楠 , 张志愿 , 张诗雷 . 机器人辅助颏成形术行截骨操作的精度评价实验研究[J]. 上海交通大学学报(医学版), 2022 , 42(9) : 1347 -1352 . DOI: 10.3969/j.issn.1674-8115.2022.09.023
Objective ·To preliminarily evaluate the execution accuracy of the self-developed cranial-maxilofacial robot (CMF ROBOT) system for genioplasty osteotomy of skull models. Methods ·Nine patients with chin deformity who were admitted to Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from August 2019 to October 2020 were included in the study. Before the operation, the spiral CT images of the whole head of the patients were collected, the skull models were made by 3D printing, and the virtual surgical planning was carried out. During the operation, the experimental group used CMF ROBOT system to perform automatic osteotomy on 9 skull models; the control group was manually osteotomized by senior surgeons assisted by 3D printing surgical guide plate. After the operation, spiral CT scanning was performed to measure the distance error and the direction error of the osteotomy plane of the two groups in three dimensions, and the differences of the two errors between the two groups were statistically analyzed. Results ·The osteotomy of genioplasty was successfully completed in the two groups. The distance error of the overall osteotomy in the experimental group was (1.40±0.27) mm and the direction error was 7.03°±3.02°, while the distance error of the overall osteotomy in the control group was (1.23±0.27) mm, and the direction error was 6.08°±2.24°. There was no significant difference between the two errors mentioned above (P=0.256, P=0.462). Conclusion ·The CMF ROBOT system can complete the automatic osteotomy of genioplasty according to the preoperative planning, and the distance error and direction error of the osteotomy surface can reach the precision level of manual osteotomy assisted by 3D printing surgical guide plate.
Key words: medical robot; computer-assisted surgery; control mode; genioplasty
1 | LI Y Q, YANG X, LI D. The application of three-dimensional surface imaging system in plastic and reconstructive surgery[J]. Ann Plast Surg, 2016, 77(Suppl 1): S76-S83. |
2 | WONG A, GOONEWARDENE M S, ALLAN B P, et al. Accuracy of maxillary repositioning surgery using CAD/CAM customized surgical guides and fixation plates[J]. Int J Oral Maxillofac Surg, 2021, 50(4): 494-500. |
3 | YU H B, SHEN S G, WANG X D, et al. The indication and application of computer-assisted navigation in oral and maxillofacial surgery-Shanghai's experience based on 104 cases[J]. J Craniomaxillofac Surg, 2013, 41(8): 770-774. |
4 | WU J Y, HUI W Y, CHEN S H, et al. Error analysis of robot-assisted orthognathic surgery[J]. J Craniofac Surg, 2020, 31(8): 2324-2328. |
5 | LIN H H, LONIC D, LO L J. 3D printing in orthognathic surgery: a literature review[J]. J Formos Med Assoc, 2018, 117(7): 547-558. |
6 | CHEN J, ZHANG R, LIANG Y, et al. Deviation analyses of computer-assisted, template-guided mandibular reconstruction with combined osteotomy and reconstruction pre-shaped plate position technology: a comparative study[J]. Front Oncol, 2021, 11: 719466. |
7 | SIRES J D, CRAIK J D, WILSON C J. Accuracy of bone resection in MAKO total knee robotic-assisted surgery[J]. J Knee Surg, 2021, 34(7): 745-748. |
8 | DE SMET M D, NAUS G J L, FARIDPOOYA K, et al. Robotic-assisted surgery in ophthalmology[J]. Curr Opin Ophthalmol, 2018, 29(3): 248-253. |
9 | LIEBERMAN I H, KISINDE S, HESSELBACHER S. Robotic-assisted pedicle screw placement during spine surgery[J]. JBJS Essent Surg Tech, 2020, 10(2): e0020. |
10 | MIKHAIL D, SARCONA J, MEKHAIL M, et al. Urologic robotic surgery[J]. Surg Clin North Am, 2020, 100(2): 361-378. |
11 | PARK S Y, KIM H K, JANG D S, et al. Initial experiences with robotic single-site thoracic surgery for mediastinal masses[J]. Ann Thorac Surg, 2019, 107(1): 242-247. |
12 | MOZER P S. Accuracy and deviation analysis of static and robotic guided implant surgery: a case study[J]. Int J Oral Maxillofac Implants, 2020, 35(5): e86-e90. |
13 | CHAO A H, WEIMER K, RACZKOWSKY J, et al. Pre-programmed robotic osteotomies for Fibula free flap mandible reconstruction: a preclinical investigation[J]. Microsurgery, 2016, 36(3): 246-249. |
14 | ZHU J H, DENG J, LIU X J, et al. Prospects of robot-assisted mandibular reconstruction with filbula flap: comparison with a computer-assisted navigation system and freehand technique[J]. J Reconstr Microsurg, 2016, 32(9): 661-669. |
15 | BELL S W, ANTHONY I, JONES B, et al. Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty: data from a prospective, randomized controlled study[J]. J Bone Joint Surg Am, 2016, 98(8): 627-635. |
16 | SUN M, LIN L, CHEN X, et al. Robot-assisted mandibular angle osteotomy using electromagnetic navigation[J]. Ann Transl Med, 2021, 9(7): 567. |
17 | SUN M Z, CHAI Y H, CHAI G, et al. Fully automatic robot-assisted surgery for mandibular angle split osteotomy[J]. J Craniofac Surg, 2020, 31(2): 336-339. |
18 | LIN L, SHI Y Y, TAN A, et al. Mandibular angle split osteotomy based on a novel augmented reality navigation using specialized robot-assisted arms: a feasibility study[J]. J Craniomaxillofac Surg, 2016, 44(2): 215-223. |
/
〈 |
|
〉 |