Britta Grüne, Ralph Burger, Dominik Bauer, Armin Schäfer, Andreas Rothfuss, Jan Stallkamp, Jens Rassweiler, Maximilian C Kriegmair, Marie-Claire Rassweiler-Seyfried
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RP were performed using a robotic assistance system (guidoo, BEC GmbH, Pfullingen, Germany) with a robotic arm (LBR med R800, KUKA AG, Augsburg, Germany) and a navigation software with a cone-beam-CT Artis zeego (Siemens Healthcare GmbH, Erlangen, Germany). MP were performed using the syngo iGuide Uro-Dyna Artis Zee Ceiling CT (Siemens Healthcare Solutions). Three urologists with varying experience performed 20 punctures each. Success rate, puncture accuracy, puncture planning time (PPT), and needle placement time (NPT) were measured and compared with ANOVA and Chi-Square Test.</p><p><strong>Results: </strong>One hundred eighteen punctures with a success rate of 100% for RP and 78% for MP were included. Puncture accuracy was significantly higher for RP. PPT (RP: 238 ± 90s, MP: 104 ± 21s) and NPT (RP: 128 ± 40s, MP: 81 ± 18s) were significantly longer for RP. The outcome variables did not differ significantly with regard to levels of investigators' experience.</p><p><strong>Conclusion: </strong>The accuracy of RP was superior to that of MP. 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引用次数: 0
摘要
简介和目的:具有挑战性的经皮肾穿刺进入肾脏需要引导横断面成像。为了测试机器人辅助ct引导穿刺(RP)的可行性，并将其与Uro Dyna-CT (Siemens Healthcare Solutions, Erlangen, Germany)的手动激光引导穿刺(MP)进行比较。材料与方法:硅肾假体包含三种大小的靶病变。RP使用机器人辅助系统(guidoo, BEC GmbH, Pfullingen, Germany)和机械臂(LBR med R800, KUKA AG, Augsburg, Germany)以及带有锥束ct Artis zeego的导航软件(Siemens Healthcare GmbH, Erlangen, Germany)进行。MP使用syngo guideurodyna Artis Zee天花板CT (Siemens Healthcare Solutions)进行。三名经验各异的泌尿科医生每人进行了20次穿刺。测量穿刺成功率、穿刺准确性、穿刺计划时间(PPT)、置针时间(NPT)，并采用方差分析和卡方检验进行比较。结果:共穿刺118次，RP成功率100%，MP成功率78%。RP穿刺精度明显更高。RP组的PPT (RP: 238±90秒，MP: 104±21秒)和NPT (RP: 128±40秒，MP: 81±18秒)明显延长。结果变量在调查人员经验水平方面没有显著差异。结论:RP法的准确度优于MP法。这项研究为这种机器人穿刺系统的首次人体应用铺平了道路。
Robotic-assisted versus manual Uro Dyna-CT-guided puncture in an ex-vivo kidney phantom.
Introduction and objectives: Challenging percutaneous renal punctures to gain access to the kidney requiring guidance by cross-sectional imaging. To test the feasibility of robotic-assisted CT-guided punctures (RP) and compare them with manual laser-guided punctures (MP) with Uro Dyna-CT (Siemens Healthcare Solutions, Erlangen, Germany).
Material and methods: The silicon kidney phantom contained target lesions of three sizes. RP were performed using a robotic assistance system (guidoo, BEC GmbH, Pfullingen, Germany) with a robotic arm (LBR med R800, KUKA AG, Augsburg, Germany) and a navigation software with a cone-beam-CT Artis zeego (Siemens Healthcare GmbH, Erlangen, Germany). MP were performed using the syngo iGuide Uro-Dyna Artis Zee Ceiling CT (Siemens Healthcare Solutions). Three urologists with varying experience performed 20 punctures each. Success rate, puncture accuracy, puncture planning time (PPT), and needle placement time (NPT) were measured and compared with ANOVA and Chi-Square Test.
Results: One hundred eighteen punctures with a success rate of 100% for RP and 78% for MP were included. Puncture accuracy was significantly higher for RP. PPT (RP: 238 ± 90s, MP: 104 ± 21s) and NPT (RP: 128 ± 40s, MP: 81 ± 18s) were significantly longer for RP. The outcome variables did not differ significantly with regard to levels of investigators' experience.
Conclusion: The accuracy of RP was superior to that of MP. This study paves the way for first in-human application of this robotic puncture system.
期刊介绍：
Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.
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