Review of robotic-assisted surgery: what the future looks like through a spine oncology lens

Sayari, Arash J.; Pardo, Coralie; Basques, Bryce A.; Colman, Matthew W.

doi:10.21037/atm.2019.04.69

Cited by 41 publications

(23 citation statements)

References 67 publications

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“…The preliminary clinical experience of the medical robot is positive, and it has higher accuracy compared with the traditional handheld method [ 25 , 26 ]. The designed breast interventional robot can not only reduce the pain of patients but also reduce the workload of doctors.…”

Section: Discussionmentioning

confidence: 99%

Design and Workspace Analysis of a Differential Motion Rotary Style Breast Interventional Robot

Zhang

Sun

Liang

et al. 2020

Applied Bionics and Biomechanics

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Introduction. Magnetic Resonance Imaging has better resolution for soft tissue; at the same time, the robot can work in a stable manner for a long time. MRI image-guided breast interventional robots have attracted much attention due to their minimally invasive nature and accuracy. In this paper, a hydraulic-driven MRI-compatible breast interventional robot is proposed to perform breast interventional procedure. Methods. First is the analysis of the design requirements of the hydraulic-driven MRI-compatible breast interventional robot, and then the design scheme is determined. Second, the three-dimensional model and the link frames are established. The workspace of the robot end point is solved by MATLAB/Simulink software. Then, the 3D printing technology is used to make a physical model of the MRI-compatible breast interventional robot. After assembly and debugging, the physical model is used for workspace verification, and the simulation result of the workspace shows that it is correct. Finally, the experimental research on the positioning error of the hydraulic drive is carried out, which established the theoretical foundation for the follow-up control research of the robot. Results. The positioning error has nothing to do with the motion distance, speed, and length of the selected tubing. The errors are 0.564 mm, 0.534 mm, and 0.533 mm at different distances of 40 mm, 80 mm, and 120 mm, respectively. The errors are 0.552 mm, 0.564 mm, and 0.559 mm at different speeds of 3 mm/s, 5 mm/s, and 8 mm/s, respectively. The errors are 0.564 mm, 0.568 mm, and 0.548 mm for different lengths of 0.5 m, 1 m, and 1.6 m, respectively. Then, the robot’s working space on the X O Z plane and the X O Y plane meets the conditions. Conclusion. The structure of a differential rotary breast interventional robot is determined, with the link frames assigned to the mechanism and the Denavit-Hartenberg parameters given. Workspace simulation of MRI-compatible breast interventional robot is done in MATLAB. The 3D printed MRI-compatible breast interventional robot is assembled and debugged to verify that its working space and positioning error meet the requirements.

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Section: Discussionmentioning

confidence: 99%

Design and Workspace Analysis of a Differential Motion Rotary Style Breast Interventional Robot

Zhang

Sun

Liang

et al. 2020

Applied Bionics and Biomechanics

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“…Advancing technology and improvement in surgical techniques have contributed to the rising incidence of patients receiving surgical treatment for spinal metastatic tumours (1,2). In the last two decades, significant efforts have been made to develop image-guided neurosurgery (IGNS) systems for spine oncology in traditional open surgery (3,4), in minimally invasive and robotic surgeries (5)(6)(7) and in ablative therapy (8)(9)(10)(11). Neuronavigation performed by IGNS allows the digital tracking of surgical instruments with respect to diagnostic imaging, therefore facilitating tumour localization, anatomy visualization and monitoring surgical progress.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an Ultrasound-Based Navigation System for Spine Neurosurgery: A Porcine Cadaver Study

et al. 2021

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BackgroundWith the growing incidence of patients receiving surgical treatment for spinal metastatic tumours, there is a need for developing cost-efficient and radiation-free alternatives for spinal interventions. In this paper, we evaluate the capabilities and limitations of an image-guided neurosurgery (IGNS) system that uses intraoperative ultrasound (iUS) imaging for guidance.MethodsUsing a lumbosacral section of a porcine cadaver, we explored the impact of CT image resolution, ultrasound depth and ultrasound frequency on system accuracy, robustness and effectiveness. Preoperative CT images with an isotropic resolution of , and were acquired. During surgery, vertebrae L1 to L6 were exposed. For each vertebra, five iUS scans were acquired using two depth parameters (5 cm and 7 cm) and two frequencies (6 MHz and 12 MHz). A total of 120 acquisition trials were evaluated. Ultrasound-based registration performance is compared to the standard alignment procedure using intraoperative CT. We report target registration error (TRE) and computation time. In addition, the scans’ trajectories were analyzed to identify vertebral regions that provide the most relevant features for the alignment.ResultsFor all acquisitions, the median TRE ranged from 1.42 mm to 1.58 mm and the overall computation time was 9.04 s ± 1.58 s. Fourteen out of 120 iUS acquisitions (11.66%) yielded a level-to-level mismatch (and these are included in the accuracy measurements reported). No significant effect on accuracy was found with CT resolution (F(2,10) = 1.70, p = 0.232), depth (F(1,5) = 0.22, p= 0.659) nor frequency (F(1,5) = 1.02, p = 0.359). While misalignment increases linearly with the distance from the imaged vertebra, accuracy was satisfactory for directly adjacent levels. A significant relationship was found between iUS scan coverage of laminae and articular processes, and accuracy.ConclusionIntraoperative ultrasound can be used for spine surgery neuronavigation. We demonstrated that the IGNS system yield acceptable accuracy and high efficiency compared to the standard CT-based navigation procedure. The flexibility of the iUS acquisitions can have repercussions on the system performance, which are not fully identified. Further investigation is needed to understand the relationship between iUS acquisition and alignment performance.

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“…Spine is a common organ for metastatic cancer, and in patients with advanced cancer, spinal metastasis can lead to signi cant pain or neurological dysfunction, which impacting the quality of life [4,5]. Although advanced radiotherapy and surgical techniques are available for patients with advanced spinal metastases [6,7], some of them have a persistent pain during or shortly after radiotherapy and surgery treatment [8]. Current targeted drugs have many limitations, such as unsatisfactory e cacy and uncontrollable dosage.…”

Section: Introductionmentioning

confidence: 99%

Decreased Expression of ENPP6 Predicts the Occurrence of Pain in Malignant Spinal Tumour

Hu¹,

Zhong²,

Guo³

2021

Preprint

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Background: Neuropathic pain (NeP) characterized by neuroplasticity and neuroinflammatory change is a common complication associated with spinal metastasis. However, there are no reliable candidates for diagnosis and treatment. Recently, cancer research has incorporated molecules into the treatment of patients with NeP, therefore, it is necessary to find key molecules of NeP to provide new targets for diagnosis and treatment.Methods: We analyzed RNA-seq data around the expression of ENPP6 based on bioinformatic methods, including differentially expressed genes (DEGs), Gene Ontology (GO), protein-protein interaction (PPI) network, Kyoto Encyclopedia of Genes and Genomes (KEGG) and GSEA analyses, receiver operating characteristic (ROC) curve, immune cell infiltration and mutation analysis.Results: We divided with pain samples into the High and Low ENPP6 expression groups. A total of 231 DEGs were identified. GO and KEGG analysis showed that DEGs were mainly enriched in Inflammation and cancer associated pathways. GSEA analysis showed that DEGs was significantly enriched in ARF3 and P38/MK2, RHO and RAS, and BRAFT and AKT1/E17K pathway. Pearson’s correlation analysis showed that the expression of ENPP6 was significantly correlated with autophagy phenotype and immunophenotype. Immune infiltrating analysis showed that activated NK cells were significantly highly expressed in Low group. ROC analysis of ENPP6 suggested that the area under the ROC curve was 0.925. Mutation sites analysis showed that most of the mutations in ENPP4-7 were phosphorylation sites.Conclusion: This study provides novel insights into molecular mechanisms underlying NeP, and identifying ENPP6 may serve as potentially diagnostic biomarkers and/or therapeutic targets for NeP.

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Review of robotic-assisted surgery: what the future looks like through a spine oncology lens

Cited by 41 publications

References 67 publications

Design and Workspace Analysis of a Differential Motion Rotary Style Breast Interventional Robot

Design and Workspace Analysis of a Differential Motion Rotary Style Breast Interventional Robot

Evaluation of an Ultrasound-Based Navigation System for Spine Neurosurgery: A Porcine Cadaver Study

Decreased Expression of ENPP6 Predicts the Occurrence of Pain in Malignant Spinal Tumour

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