A novel surgical navigation concept for Closed Intramedullary Nailing of femur using 4-DOF laser-guiding robot

Nakdhamabhorn, Sakol; Suthakorn, Jackrit

doi:10.1109/robio.2011.6181332

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…To date, a number of studies have been carried out in an attempt to de-risk the surgery and improve IM nailing outcomes [18][19][20][21][22][23][24][25][26]. These studies utilized sophisticated laser tracking and stereoscopic image overlay solutions to (1) determine the location of the proximal and distal holes of the IM nail after its insertion into the cavity [19,22], (2) control the drilling axis after the holes were located [20,23] and (3) control the insertion depth of a surgical tool [24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Diffuse reflectance spectroscopy-enhanced drill for bone boundary detection

Duperron¹,

Grygoryev²,

Nunan³

et al. 2019

Biomed. Opt. Express

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Intramedullary nailing is a routine orthopedic procedure used for treating fractures of femoral or tibial shafts. A critical part of this procedure involves the drilling of pilot holes in both ends of the bone for the placement of the screws that will secure the IM rod to sections of the fractured bone. This step introduces a risk of soft tissue damage because the drill bit, if not stopped in time, can transverse the bone-tissue boundary into the overlying muscle, causing unnecessary injury and prolonging healing time due to periosteum damage. In this respect, detecting the bone-tissue boundary before breakthrough can reduce the risks and complications associated with intramedullary nailing. Hence, in the present study, a two-wavelength diffuse reflectance spectroscopy technique was integrated into a surgical drill to optically detect bone-tissue boundary and automatically trigger the drill to stop. Furthermore, Monte-Carlo simulations were used to estimate the maximum distance from within the bone at which the bone-tissue boundary could be detected using DRS. The simulation results estimated that the detection distance, termed the "look-ahead-distance" was ∼1.5 mm for 1.3 mm source-detector fiber separation. Experimental measurements with 1.3 mm source-detector fiber separation showed that the look-ahead-distance was in the order of 250 µm in experiments with set drill rate and in the range of 1 mm in experiments where the holes were drilled by hand. Despite this difference, the automated DRS enhanced drill successfully detected the approaching bone tissue boundary when tested on samples of bovine femur and muscle tissue.

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Section: Introductionmentioning

confidence: 99%

Diffuse reflectance spectroscopy-enhanced drill for bone boundary detection

Duperron¹,

Grygoryev²,

Nunan³

et al. 2019

Biomed. Opt. Express

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“…The concept of surgical navigation for close intramedullary nailing of femur using an overlay laser guiding was proposed by Nakdhamabhorn and J.T. Liang [19,20].…”

Section: Introductionmentioning

confidence: 99%

System integration of a fluoroscopic image calibration using robot assisted surgical guidance for distal locking process in closed intramedullary nailing of femur

Nakdhamabhorn

Suthakorn

2019

IJECE

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<span>Distal locking procedure is one of the most complex tasks in close intramedullary nailing operation which requires fluoroscopic image to interpret 2-D distal locking position on image related to 3-D distal locking position on the patient site. Hence the surgeon has to perform the distal locking process by using multiple fluoroscopic images which causes a lot of x-ray exposure to the patient and surgeon and is a time consuming task. This paper presents the system integration of a fluoroscopic image calibration using robot assisted surgical guidance. The system integration consists of three parts; distal locking recovery, fluoroscopic calibration and tracking, and robot assisted surgical guidance. The distal locking-hole recovery algorithm is based on characteristic information of the major and minor axes of distal locking hole. The fluoroscopic calibration and tracking is modeled as pin-hole projection model to estimate a projection equation based on optical tracking system. The robot-assisted surgical guidance is developed to overlay a trajectory path using a laser beam for reducing the problem of hand – eye coordination on most surgical navigation system. We integrate each part to complete a surgical navigation system for distal locking process. The experiment of system integration is conducted to validate the accuracy of distal locking axis position and orientation. The results of the system integration shows a mean angular error of 1.10 and mean Euclidean distance in X-Y plane error of 3.65 mm.</span>

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A novel smart navigation system for intramedullary nailing in orthopedic surgery

et al. 2017

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This paper proposes a novel smart surgical navigation system for intramedullary nailing in orthopedic surgery. Using a handle-integrated laser guidance module, the system can target a drill insertion point onto skin, indicating an accurate target position to perpendicularly access an invisible distal hole. The proposed handle-integration-based fixation of the laser guidance module precisely defines the relative position of the module with respect to the distal hole. Consequently, unlike conventional systems, the proposed system can indicate the target insertion point without any help from bulky and costly external position-tracking equipment that is usually required for compensating disturbances generated by external impacts. After insertion, a correct drilling direction toward the distal hole is guided by real-time drilling angle measurement modules–one integrated with the nail handle and the other with the drill body. Each module contains a 9-axis inertial sensor and a Bluetooth communication device. These two modules work together to provide real-time drilling angle data, allowing calculation of the directional error toward the center of the distal hole in real time. The proposed system removes the need for fluoroscopy and provides a compact and cost-effective solution compared with conventional systems.

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A novel surgical navigation concept for Closed Intramedullary Nailing of femur using 4-DOF laser-guiding robot

Cited by 3 publications

References 5 publications

Diffuse reflectance spectroscopy-enhanced drill for bone boundary detection

Diffuse reflectance spectroscopy-enhanced drill for bone boundary detection

System integration of a fluoroscopic image calibration using robot assisted surgical guidance for distal locking process in closed intramedullary nailing of femur

A novel smart navigation system for intramedullary nailing in orthopedic surgery

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