An integrated system for planning, navigation and robotic assistance for mandible reconstruction surgery

A collaborative robotic platform for sensor-aware fibula osteotomies in mandibular reconstruction surgery

Precision and safety are crucial in performing fibula osteotomy during mandibular reconstruction with free fibula flap (FFF). However, current clinical methods, such as template-guided osteotomy, have the potential to cause damage to fibular vessels. To address the challenge, this paper introduces the development of the surgical robot for fibula osteotomies in mandibular reconstruction surgery and propose an algorithm for sensor-aware hybrid force-motion control for safe osteotomy, which includes three parts: osteotomy motion modeling from surgeons' demonstrations, Dynamic-system-based admittance control and osteotomy sawed-through detection. As a result, the average linear variation of the osteotomized segments was 1.08±0.41mm, and the average angular variation was 1.32±0.65∘. The threshold of osteotomy sawed-through detection is 0.5 at which the average offset is 0.5mm. In conclusion, with the assistance of surgical robot for mandibular reconstruction, surgeons can perform fibula osteotomy precisely and safely.

Design and implementation of a surgical planning system for robotic assisted mandible reconstruction with fibula free flap

PURPOSE

Free fibula flap is the gold standard for the treatment of mandibular defects. However, the existing preoperative planning protocol is cumbersome to execute, costly to learn, and poorly collaborative with the robot-assisted cutting of the fibular osteotomy plane.

METHODS

A surgical planning system for robotic assisted mandibular reconstruction with fibula free flap is proposed in this study. A fibular osteotomy planning algorithm is presented so that the virtual surgical planning of the fibular osteotomy segments can be obtained automatically with selected mandibular anatomical landmarks. The planned osteotomy planes are then converted into the motion path of the robotic arm, and the automatic fibula osteotomy is completed under optical navigation.

RESULTS

Surgical planning was performed on 35 patients to verify the feasibility of our system's virtual surgical planning module, with an average time of 13 min. Phantom experiments were performed to evaluate the reliability and stability of this system. The average distance and angular deviations of the osteotomy planes are 1.04 ± 0.68 mm and 1.56 ±1.10°, respectively.

CONCLUSIONS

Our system can achieve not only precise and convenient preoperative planning, but also safe and reliable osteotomy trajectory. The clinical applications of our system for mandibular reconstruction surgery are expected soon.

Evaluation of a custom-designed human-robot collaboration control system for dental implant robot

BACKGROUND

The purpose of this study is to develop a methodology to better control a human-robot collaboration for robotic dental implant placement. We have designed a human-robot collaborative implant system (HRCDIS) which is based on a zero-force hand-guiding concept and a operational task management workflow that can achieve highly accurate and stable osteotomy drilling based on a surgeon's decision and robotic arm movements during implant surgery.

METHOD

The HRCDIS brings forth the robot arm positions, exact drilling location, direction and performs automatic drilling. The HRCDIS can also avoid complex programing in the robot. The purpose of the study is to evaluate the accuracy of drilling resulting from our developed operational task management method (OTMM). The OTMM can enable the robot to switch, pause, and resume drilling tasks. The force required for hand-guiding in a zero-force control mode of the robot was detected by a 6D force sensor. We compared our force data to those provided by the manufacturer's manual. The study was conducted on a phantom head with a 3D-printed jaw bone to verify the validity of our HRCDIS. We appraised the discrepancies between free-hand drillings and the HRCDIS controlled drillings at apical centre and head centre of the implant and implant angulation to the baseline data from a virtual surgical planning model.

RESULTS

The average required force used by hand-guiding to operate the robot with HRCDIS was near 7 Newton which is much less than the manufacturer's specification (30 Newton). The results from our study showed that the average error at implant head was 1.04 ± 0.37 mm, 1.56 ± 0.52 mm at the implant apex, and deviation of implant angle was 3.74 ± 0.67°.

CONCLUSIONS

The results from this study validate the merit of the human-robot collaboration control by the HRCDIS. Based on the improved navigation system using HRCDIS, a robotic implant placement can provide seamless drilling with ease, efficiency and accuracy.

Collision Free Smooth Path for Mobile Robots in Cluttered Environment Using an Economical Clamped Cubic B-Spline

Mobile robots have various applications in agriculture, autonomous cars, industrial automation, planetary exploration, security, and surveillance. The generation of the optimal smooth path is a significant aspect of mobile robotics. An optimal path for a mobile robot is measured by various factors such as path length, path smoothness, collision-free curve, execution time, and the total number of turns. However, most of the planners generate a non-smooth less optimal and linear piecewise path. Post processing smoothing is applied at the cost of increase in path length. Moreover, current research on post-processing path smoothing techniques does not address the issues of post smoothness collision and performance efficiency. This paper presents a path smoothing approach based on clamped cubic B-Spline to resolve the aforementioned issues. The proposed approach has introduced an economical point insertion scheme with automated knot vector generation while eliminating post smoothness collisions with obstacles. It generates C2 continuous path without any stitching point and passes more closely to the originally planned path. Experiments and comparison with previous approaches have shown that the proposed approach generates better results with reduced path length, and execution time. The test cases used for experiments include a simple structure environment, complex un-structured environment, an environment full of random cluttered narrow obstacles, and a case study of an indoor narrow passage.

Development and preliminary evaluation of an autonomous surgical system for oral and maxillofacial surgery

BACKGROUND

Human-related factors affect the accuracy and safety of the oral and maxillofacial surgery (OMS). This study proposed an autonomous surgical system aiming to conduct the OMS under the assistance and surveillance of the surgeon.

METHODS

A markerless navigation module and a compact OMS robot were seamlessly integrated into this system. The specifications of each module and the working concept of the system were elaborated in this paper. A drilling experiment was conducted on five 3D-printed mandible models to test the pose detecting capability and evaluate the operational performance.

RESULTS

The experiment showed that this system could successfully guide the robot finishing the operation regardless of the mandible pose. The accuracy of software and hardware are acceptable and potential performance improvement can be achieved in positioning accuracy.

CONCLUSION

This system proposed a novel concept and a practical solution to decrease the human-related factors on the OMS, which may change the role of the surgeon in the future operating room and finally benefit the outcomes of OMS.

Modelling and Experiment Based on a Navigation System for a Cranio-Maxillofacial Surgical Robot

In view of the characteristics of high risk and high accuracy in cranio-maxillofacial surgery, we present a novel surgical robot system that can be used in a variety of surgeries. The surgical robot system can assist surgeons in completing biopsy of skull base lesions, radiofrequency thermocoagulation of the trigeminal ganglion, and radioactive particle implantation of skull base malignant tumors. This paper focuses on modelling and experimental analyses of the robot system based on navigation technology. Firstly, the transformation relationship between the subsystems is realized based on the quaternion and the iterative closest point registration algorithm. The hand-eye coordination model based on optical navigation is established to control the end effector of the robot moving to the target position along the planning path. The closed-loop control method, “kinematics + optics” hybrid motion control method, is presented to improve the positioning accuracy of the system. Secondly, the accuracy of the system model was tested by model experiments. And the feasibility of the closed-loop control method was verified by comparing the positioning accuracy before and after the application of the method. Finally, the skull model experiments were performed to evaluate the function of the surgical robot system. The results validate its feasibility and are consistent with the preoperative surgical planning.