1.Comparative study of orthopaedic robot-assisted minimally invasive surgery and open surgery for limb osteoid osteoma.
Junwei FENG ; Weimin LIANG ; Yue WANG ; Zhi TANG ; MuFuSha A ; Baoxiu XU ; Niezhenghao HE ; Peng HAO
Chinese Journal of Reparative and Reconstructive Surgery 2024;38(1):40-45
OBJECTIVE:
To compare the accuracy and effectiveness of orthopaedic robot-assisted minimally invasive surgery versus open surgery for limb osteoid osteoma.
METHODS:
A clinical data of 36 patients with limb osteoid osteomas admitted between June 2016 and June 2023 was retrospectively analyzed. Among them, 16 patients underwent orthopaedic robot-assisted minimally invasive surgery (robot-assisted surgery group), and 20 patients underwent tumor resection after lotcated by C-arm X-ray fluoroscopy (open surgery group). There was no significant difference between the two groups in the gender, age, lesion site, tumor nidus diameter, and preoperative pain visual analogue scale (VAS) scores ( P>0.05). The operation time, lesion resection time, intraoperative blood loss, intraoperative fluoroscopy frequency, lesion resection accuracy, and postoperative analgesic use frequency were recorded and compared between the two groups. The VAS scores for pain severity were compared preoperatively and at 3 days and 3 months postoperatively.
RESULTS:
Compared with the open surgery group, the robot-assisted surgery group had a longer operation time, less intraoperative blood loss, less fluoroscopy frequency, less postoperative analgesic use frequency, and higher lesion resection accuracy ( P<0.05). There was no significant difference in lesion resection time ( P>0.05). All patients were followed up after surgery, with a follow-up period of 3-24 months (median, 12 months) in the two groups. No postoperative complication such as wound infection or fracture occurred in either group during follow-up. No tumor recurrence was observed during follow-up. The VAS scores significantly improved in both groups at 3 days and 3 months after surgery when compared with preoperative value ( P<0.05). The VAS score at 3 days after surgery was significantly lower in robot-assisted surgery group than that in open surgery group ( P<0.05). However, there was no significant difference in VAS scores at 3 months between the two groups ( P>0.05).
CONCLUSION
Compared with open surgery, robot-assisted resection of limb osteoid osteomas has longer operation time, but the accuracy of lesion resection improve, intraoperative blood loss reduce, and early postoperative pain is lighter. It has the advantages of precision and minimally invasive surgery.
Humans
;
Robotics
;
Osteoma, Osteoid/surgery*
;
Orthopedics
;
Blood Loss, Surgical
;
Retrospective Studies
;
Neoplasm Recurrence, Local
;
Minimally Invasive Surgical Procedures
;
Bone Neoplasms/surgery*
;
Analgesics
;
Treatment Outcome
3.Robot-assisted PVP for the treatment of osteoporotic fractures of the upper thoracic vertebra.
Ju-Yi LAI ; Huang-Sheng TAN ; Hua-Long FENG ; Zhi-Ming LAN ; Zhi-Tao SUN ; Ye-Guang WANG ; Jian WANG ; Yuan-Fei FU ; Shen-Ghua HE
China Journal of Orthopaedics and Traumatology 2023;36(9):859-865
OBJECTIVE:
To investigate the clinical effect of "Tianji" orthopedic robot-assisted percutaneous vertebro plasty(PVP) surgery in the treatment of upper thoracic osteoporotic fracture.
METHODS:
A retrospective analysis was performed on 32 patients with upper thoracic osteoporotic fracture who underwent PVP surgery in Shenzhen Hospital of Traditional Chinese Medicine from August 2016 to June 2022. There were 8 males and 24 females, ranging in age from 58 to 90 years old, with a mean of (67.75±12.27) years old. Fifteen patients were treated with robot-assisted PVP surgery (robot group), including 3 males and 12 females, with an average age of (68.5±10.3) years. Fracture location:1 case of T2 fracture, 1 case of T3 fracture, 3 cases of T4 fracture, 3 cases of T5 fracture, and 7 cases of T6 fracture. The follow-up period ranged from 1.0 to 3.0 months, with a mean of (1.6±0.7) months. Seventeen patients underwent routine PVP surgery (conventional group), including 5 males and 12 females, with an average age of (66.8±11.6) years old. Fracture location:1 case of T1 fracture, 5 cases of T4 fracture, 2 cases of T5 fracture and 9 cases of T6 fracture. The follow-up period ranged from 0.5 to 4.0 months, with a mean of (1.5±0.6) months. Preoperative and postoperative visual analogue scale(VAS) and Oswestry disability index(ODI) scores were compared between the two groups, and the number of punctures, perspective times, operation time, intraoperative blood loss, bone cement distribution, bone cement leakage, and intraoperative radiation dose were compared between the two groups.
RESULTS:
Number of punctures times, perspective times, operation time, intraoperative blood loss, bone cement distribution, bone cement leakage and intraoperative radiation dose in the robot group were all significantly better than those in the conventional group(P<0.05). VAS of 2.03±0.05 and ODI of (22.16±4.03) % in the robot group were significantly better than those of the robot group before surgery, which were (8.67±0.25) score and (79.40±7.72)%(t=100.869, P<0.001;t=25.456, P<0.001). VAS of 2.17±0.13 and ODI of (23.88±6.15)% in the conventional group were significantly better than those before surgery, which were (8.73±0.18) score and (80.01±7.59)%(t=121.816, P<0.001;t=23.691, P<0.001). There was no significant difference in VAS and ODI between the two groups after operation (t=-3.917, P=0.476;t=-0.922, P=0.364).
CONCLUSION
Robot-assisted PVP in the treatment of upper thoracic osteoporotic fractures can further improve surgical safety, reduce bone cement leakage, and achieve satisfactory clinical efficacy.
Female
;
Male
;
Humans
;
Middle Aged
;
Aged
;
Aged, 80 and over
;
Osteoporotic Fractures/surgery*
;
Robotics
;
Blood Loss, Surgical
;
Bone Cements
;
Retrospective Studies
;
Thoracic Vertebrae/surgery*
4.Research progress of functional alignment robot assisted knee replacement.
Yong-Ze YANG ; Qing-Hao CHENG ; An-Ren ZHANG ; Yi QIU ; Hong-Zhang GUO
China Journal of Orthopaedics and Traumatology 2023;36(11):1106-1110
The correct alignment of the knee joint is considered to be one of the most influential factors in determining the long-term prognosis after total knee arthroplasty(TKA). In order to achieve the correct alignment goal, many different alignment concepts and surgical techniques have been established. For example, mechanical alignment(MA), kinematic alignment(KA) and functional alignment(FA) have their own characteristics. MA focuses on achieving neutral alignment of the limbs, parallel and equal bone gaps during stretching and flexion. KA aims to restore the patient 's natural joint line, make the joint level and angle normal and improve the physiological soft tissue balance, and strive to reproduce the normal knee function;among them, functional alignment(FA) developed with robot-assisted surgery technology is a relatively new alignment concept. It not only considers the alignment of the body, but also aims to achieve flexion and extension balance, while respecting the native soft tissue capsule. It not only restores the plane and slope of the in situ joint line accurately during the operation, but also takes into account the balance of soft tissue, which is a better alignment method. Therefore, it is of great significance to correctly construct the lower limb force line of patients, which is helpful to restore knee joint function, relieve pain symptoms and prolong the service life of prosthesi. However, compared with traditional TKA, the operation time of robot-assisted FA-TKA is prolonged, which means that the probability of postoperative infection will be greater. At present, most studies of FA technology report short-term results, and the long-term efficacy of patients is not clear. Therefore, long-term research results are needed to support the application of this technology. Therefore, the author makes a review on the research status of functional alignment.
Humans
;
Arthroplasty, Replacement, Knee/methods*
;
Robotics
;
Knee Joint/surgery*
;
Osteoarthritis, Knee/surgery*
;
Knee
;
Knee Prosthesis
;
Biomechanical Phenomena
5.Medical Institution's Multiple Role in the Collaborative Innovation Transformation Mode of "Industry-University-Research-Medicine" on Domestic Surgical Robots.
Zhiqun SHU ; Jialu QU ; Shuxian ZHANG ; Yirou TIE ; Yuan CHE ; Junting LI ; Letong JIANG ; Huiqing SHEN
Chinese Journal of Medical Instrumentation 2023;47(5):582-586
In recent years, with the rapid development of Chinese domestic surgical robot technology and the expansion of the application market, the "industry-university-research-medicine" collaborative innovation transformation mode has gradually developed and formed. Medical institutions play an important role in multi-party cooperation with enterprises, universities, and research institutes, as well as in product planning, technology research and development, achievement transformation, and personnel training. On the basis of reviewing the current situation of the development of the "industry-university-research-medicine" collaborative innovation transformation mode of domestic surgical robots, this study explores the multiple roles played by medical institutions in this mode and challenges, further putting forward corresponding recommendations.
Humans
;
Robotics
;
Universities
;
Medicine
;
Industry
;
Technology
6.Uncalibrated Positioning Method for Puncture Robots Based on Optical Navigation.
Qiwan WANG ; Ting FENG ; Rongqian YANG ; Yinwei ZHAN
Chinese Journal of Medical Instrumentation 2023;47(6):591-597
Robotic puncture system has been widely used in modern minimally invasive surgery, which usually uses hand-eye calibration to calculate the spatial relationship between the robot and the optical tracking system. However, the hand-eye calibration process is time-consuming and sensitive to environmental changes, which makes it difficult to guarantee the puncture accuracy of the robot. This study proposes an uncalibrated positioning method for puncture robot based on optical navigation. The method divides the target path positioning into two stages, angle positioning and position positioning, and designs angle image features and position image features respectively. The corresponding image Jacobian matrix is constructed based on the image features and updated by online estimation with a cubature Kalman filter to drive the robot to perform target path localization. The target path positioning results show that the method is more accurate than the traditional hand-eye calibration method and saves significant preoperative preparation time by eliminating the need for calibration.
Robotics
;
Robotic Surgical Procedures
;
Calibration
;
Minimally Invasive Surgical Procedures
;
Optical Devices
7.Research Progress and Prospect Analysis of Vascular Interventional Surgical Robot.
Peifeng GUAN ; Shihan WEN ; Rongqian YANG
Chinese Journal of Medical Instrumentation 2023;47(6):638-644
Vascular interventional surgery is an important means to treat cardiovascular and cerebrovascular diseases, but the particularity of its working environment will bring greater radiation threat to doctors. Vascular interventional surgery robots can effectively improve the working environment of doctors and can provide more stable operations, improve the success rate of surgery. This study mainly introduces the current research status, key technologies, and future application of vascular interventional surgical robots.
Robotics
;
Vascular Surgical Procedures/methods*
;
Heart
;
Technology
8.Review of Research Advances in Medical Service Robotics.
Jing DONG ; An'an WANG ; Kunpeng LI ; Xiaojian JI ; Tao LI ; Kunlun HE
Chinese Journal of Medical Instrumentation 2023;47(6):645-650
With the progress of science and technology and the increase of clinical demand, medical robots have developed rapidly and played a important role in promoting the medical cause. Service robot is a branch of medical robot, which is mainly oriented to medical service and assistance needs, and has been applied in many medical scenarios and achieved demonstration effects. This research first describes the development of medical service robots, and then summarizes the key technologies and clinical applications of robots. Finally, it points out the challenges and directions that medical service robots face at present, and puts forward prospects for their further development in the medical field.
Robotics
;
Technology
9.Robotic urologic surgery using the KangDuo-Surgical Robot-01 system: A single-center prospective analysis.
Shengwei XIONG ; Shubo FAN ; Silu CHEN ; Xiang WANG ; Guanpeng HAN ; Zhihua LI ; Wei ZUO ; Zhenyu LI ; Kunlin YANG ; Zhongyuan ZHANG ; Cheng SHEN ; Liqun ZHOU ; Xuesong LI
Chinese Medical Journal 2023;136(24):2960-2966
BACKGROUND:
The KangDuo-Surgical Robot-01 (KD-SR-01) system is a new surgical robot recently developed in China. The aim of this study was to present our single-center experience and mid-term outcomes of urological procedures using the KD-SR-01 system.
METHODS:
From August 2020 to April 2023, consecutive urologic procedures were performed at Peking University First Hospital using the KD-SR-01 system. The clinical features, perioperative data, and follow-up outcomes were prospectively collected and analyzed.
RESULTS:
A total of 110 consecutive patients were recruited. Among these patients, 28 underwent partial nephrectomy (PN), 41 underwent urinary tract reconstruction (26 underwent pyeloplasty, 3 underwent ureteral reconstruction and 12 underwent ureterovesical reimplantation [UR]), and 41 underwent radical prostatectomy (RP). The median operative time for PN was 112.5 min, 157.0 min for pyeloplasty, 151.0 min for ureteral reconstruction, 142.5 min for UR, and 138.0 min for RP. The median intraoperative blood loss was 10 mL for PN, 10 mL for pyeloplasty, 30 mL for ureteral reconstruction, 20 mL for UR, and 50 mL for RP. All procedures were successfully completed without conversion, and there were no major complications in any patient. The median warm ischemia time of PN was 17.3 min, and positive surgical margin was not noted in any patient. The overall positive surgical margin rate of RP was 39% (16/41), and no biochemical recurrence was observed in any RP patient during the median follow-up of 11.0 months. The surgical success rates of pyeloplasty and UR were 96% (25/26) and 92% (11/12) during the median follow-up of 29.5 months and 11.5 months, respectively.
CONCLUSION
The KD-SR-01 system appears feasible, safe, and effective for most urological procedures, based on our single-center experience.
Male
;
Humans
;
Robotic Surgical Procedures/methods*
;
Robotics
;
Treatment Outcome
;
Retrospective Studies
;
Ureter/surgery*
;
Urologic Surgical Procedures/methods*
;
Laparoscopy/methods*
10.Research Progress in the Application of Ultrasound-Guided Robot in Minimally Invasive Surgery.
Acta Academiae Medicinae Sinicae 2023;45(5):853-858
With the continuous advances in modern medical technology and equipment,minimally invasive surgery (MIS) is widely applied in clinical practice.Ultrasound (US) as a real-time,portable,and radiation-free medical imaging method can be used for the intraoperative guidance in MIS to ensure safe and effective surgery.However,the physical characteristics of conventional US fail to display some tissue structures of the human body due to the existence of gas and bone.US-based navigation can make up for the deficiencies by advanced imaging technologies including spatial orientation,image reconstruction,and multi-modality image fusion,being real-time,accurate,and radiation-free.Therefore,US-guided robots can achieve safe,effective,and minimally invasive operation in MIS.This paper reviews the studies of US-guided robots in MIS and prospects the development of this field.
Humans
;
Robotics/methods*
;
Minimally Invasive Surgical Procedures/methods*
;
Ultrasonography
;
Spinal Fusion/methods*
;
Ultrasonography, Interventional/methods*

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