Development of the Needle Insertion Robot for Percutaneous Vertebroplasty

Abstract

Abstract. Percutaneous Vertebroplasty (PVP) is an effective and less invasive medical treatment for vertebral osteoporotic compression fractures. However, this operative procedure is quite difficult because an arcus vertebra, which is narrow, is needled with accuracy, and an operator's hand is exposed to X-ray continuously. We have developed a needle insertion robot for Percutaneous Vertebroplasty. Its experimental evaluation on the basic performance of the system and needle insertion accuracy are presented. A needle insertion robot is developed for PVP. This robot can puncture with accuracy and an operator does not need to be exposed to X-ray. The mechanism of the robot is compact in size (350 mm × D 400 mm × H270 mm, weight: 15 kg) so that the robot system can be inserted in the space between C-arm and the patient on the operating table. The robot system is controlled by the surgical navigation system where the appropriate needle trajectory is planned based on pre-operative three-dimensional CT images. The needle holding part of the robot is X-ray lucent so that the needle insertion process can be monitored by fluoroscopy. The position of the needle during insertion process can be continuously monitored. In vitro evaluation of the system showed that average position and orientation errors were less than 1.0 mm and 1.0 degree respectively. Experimental results showed that the safety mechanism called mechanical fuse released the needle holding disk properly when excessive force was applied to the needle. These experimental results demonstrated that the developed system has the satisfactory basic performance as needle insertion robot for PVP.

A review of surgical robots for spinal interventions

“…For this purpose, the needle holder was built with plastic material to make it partially radiolucent. In addition, this mechanical device could be automatically detached from the robot by a safety mechanism, triggered when excessive forces were applied to the needle . In 2009, Onogi et al .…”

“…Examples are SpineNav , RSSS and the studies by Onogi et al . . This shift has been caused by safety requirements: industrial robots are designed to perform tasks – usually involving high torque or speed – in the absence of humans, whereas surgical robots must constantly interact with the surgeon, clinical staff and the patient (who is absolutely unable to react in case of emergency).…”

Robot-assisted radiofrequency ablation of primary and secondary liver tumours: early experience

“…Earlier robotic guidance devices required extensive installation and were often cumbersome and occupied a lot of space in the operation room [6, 11, 12]. Devices that are time consuming in terms of pre-arrangement and usage are economically unattractive and are therefore not likely to be used in daily routine.…”

Bone material properties and fracture analysis: Needle insertion for spinal surgery

“…The second approach is robotic needle insertion (Onogi et al, 2005;Matsumiya et al, 2003;Fichtinger et al, 2004). Robotic needle insertion is safer compared to manual insertion with smaller axial force (Matsumiya et al, 2003).…”