The use of time-of-flight camera for navigating robots in computer-aided surgery: monitoring the soft tissue envelope of minimally invasive hip approach in a cadaver study

USE OF COMPUTER NAVIGATION IN TOTAL HIP ARTHROPLASTY (LITERATURE REVIEW)

OBJECTIVE

The aim: Analyze the accuracy and ease of use of various computer navigations in total hip arthroplasty.

PATIENTS AND METHODS

Materials and methods: Data from about 50 literature sources for the last two decades have been analysed.

CONCLUSION

Conclusions: Analyzing the accuracy and ease of use of various computer navigations in total hip arthroplasty, we offer two the most promising for further study and improvement systems: a semi-active navigation system and augmented reality system in total hip arthroplasty.

Robots and Tools for Remodeling Bone

The field of robotic surgery has progressed from small teams of researchers repurposing industrial robots, to a competitive and highly innovative subsection of the medical device industry. Surgical robots allow surgeons to perform tasks with greater ease, accuracy, or safety, and fall under one of four levels of autonomy; active, semi-active, passive, and remote manipulator. The increased accuracy afforded by surgical robots has allowed for cementless hip arthroplasty, improved postoperative alignment following knee arthroplasty, and reduced duration of intraoperative fluoroscopy among other benefits. Cutting of bone has historically used tools such as hand saws and drills, with other elaborate cutting tools now used routinely to remodel bone. Improvements in cutting accuracy and additional options for safety and monitoring during surgery give robotic surgeries some advantages over conventional techniques. This article aims to provide an overview of current robots and tools with a common target tissue of bone, proposes a new process for defining the level of autonomy for a surgical robot, and examines future directions in robotic surgery.

Retracting Soft Tissue in Minimally Invasive Hip Arthroplasty Using a Robotic Arm: A Comparison Between a Semiactive Retractor Holder and Human Assistants in a Cadaver Study

BACKGROUND

All surgical procedures in orthopedics involve the retraction of soft tissue. In this study, the performance of 3 assistants holding the medial retractor during minimally invasive hip arthroplasty was compared with a semiactive retractor holder in a cadaver setup.

METHODS

A total of 40 measurements on 3 cadavers were carried out with each subject (3 human, 1 robot) measuring each cadaver 10 times. The retractor was equipped with a sensor array on both sides, to measure variations of the retracting pressures over a 2-minute interval.

RESULTS

The semiactive retractor holder showed an almost constant performance compared with the test subjects. There was no significant reduction of the applied pressure and almost no variation during the 2-minute interval and across all measurements.

CONCLUSIONS

The performance of the semiactive retractor holder was more stable than that of a human assistant, making it suitable for intraoperative usage.