BOOK
Robotics and Digital Guidance in ENT-H&N Surgery
Bertrand Lombard | Philippe Céruse | Carole FUMAT
(2017)
Additional Information
Book Details
Abstract
Robotics and Digital Guidance in ENT-H&N Surgery
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Cover\r | Cover | ||
Robotics and Digital Guidance in ENT–H&N Surgery\r | III | ||
Copyright | IV | ||
Editors | V | ||
List of contributors | VII | ||
Abbreviations | IX | ||
Table of content | XI | ||
Foreword | XV | ||
Preface | XVII | ||
Introduction | XIX | ||
Chapter 1 Using the past to understand the present : A short history of digital guidance in ENT\r | 1 | ||
From stereotactic frames to image-guided surgery | 2 | ||
The beginnings of stereotactic frame surgery | 2 | ||
Cranial and brain radiology | 3 | ||
Frameless stereotaxis | 5 | ||
Computer-assisted craniofacial surgery | 5 | ||
References | 5 | ||
From the hand-held motor to the motor-held hand | 6 | ||
References | 7 | ||
Chapter 2 Principles and concepts of surgical navigation | 9 | ||
Spatial localization | 10 | ||
Electromechanical systems | 10 | ||
Ultrasound-beam systems | 10 | ||
Opto-electronic systems | 10 | ||
Electromagnetic systems | 12 | ||
Other tracking technologies | 12 | ||
Image dataset registration | 13 | ||
Principle | 13 | ||
Paired points registration | 13 | ||
Surface registration | 13 | ||
Photo- and video-based registration | 14 | ||
Mathematical limits of registration | 14 | ||
Estimating registration accuracy | 14 | ||
Patient referencing system | 15 | ||
Navigated surgical instrument calibration | 15 | ||
Navigation with a surgical microscope | 15 | ||
Augmented reality navigation | 16 | ||
References | 17 | ||
Chapter 3 Surgical navigation in ENT | 19 | ||
Evidence of benefit of surgical navigation in ENT | 20 | ||
General rules for using navigation systems | 20 | ||
Imaging protocols | 21 | ||
Navigation for sinus and anterior skull base surgery | 21 | ||
Surgical planning | 21 | ||
Ethmoidectomy | 22 | ||
Sphenoid sinus surgery | 22 | ||
Arterial pedicle hemostasis | 22 | ||
Location and closure of meningeal breaches | 22 | ||
Frontal sinus surgery | 22 | ||
Anterior skull base surgery | 25 | ||
Infratemporal fossa surgery | 25 | ||
Navigation for sellar and parasellar approaches | 25 | ||
Computer-assisted (image-guided) surgery in pediatric ENT | 27 | ||
Introduction | 27 | ||
Specificities of pediatric image-guided surgery | 27 | ||
Instrumentation and technologies | 27 | ||
Comparisons between adults and children | 27 | ||
Indications | 29 | ||
Case reports | 29 | ||
Conclusion | 33 | ||
Image-guided neurotologic surgery | 33 | ||
Imaging protocol | 33 | ||
Translabyrinthine approach | 34 | ||
Retrosigmoid approaches | 34 | ||
Middle cranial fossa approach | 34 | ||
Lateral approaches to petrous apex cholesterol granuloma | 35 | ||
References | 35 | ||
Chapter 4 Fundamentals of surgical robotics | 37 | ||
Degrees of freedom of a manipulator | 38 | ||
Kind of joints possibly involved in a manipulator | 38 | ||
Kinematic structures | 38 | ||
Serial manipulators | 39 | ||
Parallel manipulators | 40 | ||
Hybrid manipulators | 40 | ||
Continuum robots | 41 | ||
Spine continuum manipulators | 41 | ||
Concentric tubes | 41 | ||
Virtual RCM kinematics | 42 | ||
SCARA structure | 43 | ||
Robot actuators | 43 | ||
Electromagnetic motors | 43 | ||
Piezoelectric actuators | 43 | ||
Pneumatic actuators | 44 | ||
Hydraulic actuators | 44 | ||
Cartesian direct magnetic actuators | 44 | ||
Cable-driven actuation | 44 | ||
Flexible cable-conduits | 45 | ||
Cables and pulleys | 45 | ||
Thermo-electric actuators | 45 | ||
Artificial muscles (electro-active polymers) | 46 | ||
Speed-to-torque converters | 46 | ||
Motors encoders and brakes | 46 | ||
Knowing and ordering the pose of a robot: computational kinematics | 46 | ||
Trajectory planners | 46 | ||
Robot movement dynamics | 47 | ||
Controlling a robot (the control loop) | 48 | ||
Robot end effector precision | 49 | ||
Working volume | 50 | ||
Manipulability index | 51 | ||
References | 51 | ||
Chapter 5 Surgical robots at work | 53 | ||
Classes of surgical robots | 54 | ||
Master-slave manipulators | 54 | ||
Automated machines | 55 | ||
Collaborative robots | 55 | ||
In vivo microrobots | 55 | ||
Hand-held surgical robots | 55 | ||
NOTES-robots | 56 | ||
Human-robot input interfaces | 56 | ||
Haptic and force feedbacks | 57 | ||
Linking robots to navigation systems | 58 | ||
Virtual fixtures | 58 | ||
Giving robots surgical intelligence | 59 | ||
Surgical workflows\r | 59 | ||
Artificial intelligence: neural networks, deep learning and hidden Markov models | 59 | ||
Knot-tying | 60 | ||
Comparing surgeon to robot | 62 | ||
References | 62 | ||
Chapter 6 The da Vinci® system: technology and surgical analysis | 65 | ||
The main parts of the da Vinci® | 66 | ||
Slave design® | 67 | ||
Passive arms® | 67 | ||
Actuated arms | 67 | ||
EndoWrist® instruments | 67 | ||
3D endoscopes | 70 | ||
The master control | 70 | ||
Handles | 70 | ||
Foot pedals | 70 | ||
Control touch screen | 70 | ||
Video display | 71 | ||
The control unit and motion mapping between master and slave | 71 | ||
Force and haptic feedbacks | 73 | ||
Dual master control and simulator | 73 | ||
Technical critical analysis | 73 | ||
Surgical critical analysis | 74 | ||
References | 76 | ||
Chapter 7 Transoral robotic surgery (with the da Vinci® system) | 79 | ||
Chapter 8 Other ENT applications of the da Vinci® system | 117 | ||
Robot-assisted surgery in thyroid procedures | 118 | ||
Introduction | 118 | ||
Surgical technique | 118 | ||
Indications and contraindications | 118 | ||
Oncologic aspects and safety in robot-assisted surgery | 119 | ||
Functional issues and patient satisfaction | 120 | ||
Operating time and learning curve | 120 | ||
Future prospects | 120 | ||
References | 121 | ||
Robot-assisted neck dissection in thyroid and head and neck squamous cell carcinoma | 122 | ||
Clinical background | 122 | ||
Advantages and disadvantages of various surgical methods of neck dissection | 122 | ||
Indications and contraindications | 123 | ||
Special equipment | 123 | ||
Surgical procedure | 124 | ||
Selective neck dissection (levels I–III) | 124 | ||
Skin incision design | 124 | ||
Work-space creation | 124 | ||
Upper neck dissection under direct vision | 124 | ||
Robot-assisted neck dissection (RAND) technique | 125 | ||
Modified radical neck dissection (levels I–V or II–V) | 125 | ||
Skin incision and flap elevation | 125 | ||
Upper neck dissection under direct vision | 128 | ||
Robot-assisted neck dissection (RAND) technique | 129 | ||
Postoperative care and results | 130 | ||
Future perspectives | 131 | ||
References | 131 | ||
Robotic surgery of the nasopharynx | 132 | ||
Robotic surgery approaches to the nasopharynx | 132 | ||
Minimally invasive surgery for nasopharyngeal tumors | 132 | ||
Exclusive transoral robotic approach for nasopharyngeal surgery | 132 | ||
Combined transoral and transnasal approaches in robotic surgery of the nasopharynx | 132 | ||
Combined transantral and transnasal approaches in robotic surgery of the nasopharynx | 133 | ||
Next-generation flexible single-port robotic surgery of the nasopharynx | 133 | ||
Indications and contraindications for robotic surgery of the nasopharynx | 134 | ||
Preoperative assessment | 134 | ||
Consensual features based on experience with open and transnasal endoscopic approaches | 134 | ||
Contraindications for robotic nasopharyngectomy result from the previously described assessment of resectability | 134 | ||
Results of robotic salvage nasopharyngectomy | 135 | ||
Conclusion | 135 | ||
References | 135 | ||
Transoral robotic surgery for sellar tumor | 136 | ||
Introduction | 136 | ||
Cadaveric study | 136 | ||
Anatomical study | 136 | ||
Clinical study | 136 | ||
References | 137 | ||
Attempts at robotic surgery for the anterior skull base | 137 | ||
Introduction | 137 | ||
Rationale | 137 | ||
Limitations | 138 | ||
References | 139 | ||
Chapter 9 Alternative solutions for transoral robotic surgery (TORS) | 141 | ||
Micro-technologies and systems for robot-assisted laser phonomicrosurgery (μRALP): a new microrobot prototype driven b ... | 142 | ||
A new three-dimensional vision with augmented reality | 142 | ||
Interactive laser focus positioning | 142 | ||
Motion compensation during planning | 144 | ||
New surgeon-robot interfaces with dynamic planning | 144 | ||
The teleoperation control console | 144 | ||
Cognitive controllers for incision and ablation depth control | 145 | ||
Safety supervision | 146 | ||
Microrobot | 147 | ||
Micromechatronic design | 147 | ||
Control of laser displacement on the vocal folds | 148 | ||
Fluorescence-based cancer detection | 148 | ||
Medical robot design | 151 | ||
References | 153 | ||
The Flex® Robotic System for transoral surgery | 154 | ||
Introduction | 154 | ||
Technology and device design | 154 | ||
Limitations of the Medrobotics Flex® Robotic System | 156 | ||
Conclusions | 156 | ||
References | 156 | ||
Chapter 10 Robot-assisted endo- and transnasal surgery | 157 | ||
The challenge of endo- and transnasal surgery | 158 | ||
What to expect from a robotized manipulator in endonasal surgery | 158 | ||
Improving surgical workflow by restoring two-hand surgery | 158 | ||
Management of the introduction and removal of surgical instruments | 159 | ||
Managing several instruments simultaneously | 159 | ||
Navigation-based endonasal robotics | 160 | ||
Augmented endoscopy | 161 | ||
Endoscope fulcrum points and reaction forces/torques | 162 | ||
Summary of experimental work in endonasal robotics | 163 | ||
The SurgiMotion Project | 164 | ||
Objectives | 165 | ||
Project development iterations | 165 | ||
Current status | 167 | ||
Prototype K-1\r | 167 | ||
Prototype K-2\r | 168 | ||
Prototype K-3\r | 168 | ||
Set-up, control and surgical workflow | 168 | ||
Preclinical evaluation | 171 | ||
Conclusion and future work | 172 | ||
References | 176 | ||
Chapter 11 Robot-based otological surgery | 177 | ||
Introduction | 178 | ||
Robot-based devices for middle ear and otosclerosis surgery | 178 | ||
Specific requirements of middle ear surgery, and in particular in otosclerosis surgery | 178 | ||
Expectations for robot-based assistance in middle-ear and otosclerosis surgery | 179 | ||
Examples of robot-based applications for middle-ear and otosclerosis surgery | 180 | ||
The Steady Hand (Johns Hopkins University) | 180 | ||
The smart micro-drill (Birmingham University, UK) | 180 | ||
The Micromanipulator System II (MMSII; Technische Universität München, University Hospital of Leipzig) | 181 | ||
The RobOtol System (Pierre et Marie Curie University, Paris) | 181 | ||
Specifications | 181 | ||
External workspace requirements | 182 | ||
Internal workspace requirements | 183 | ||
Minimal force requirement and accuracy to set actuation specifications | 183 | ||
Kinematic choice and topological optimization | 183 | ||
Description of the system | 185 | ||
Components | 185 | ||
Command | 186 | ||
Concept validation in cadaveric assessment | 186 | ||
External workspace evaluation | 186 | ||
Internal workspace and task achievement evaluation | 187 | ||
Where we are now, and future developments of the RobOtol system | 188 | ||
Robot-based devices for cochlear implantation | 188 | ||
Introduction | 188 | ||
Prerequisites of cochlear implant surgery and expectations for robot-based assistance | 189 | ||
First step: access to the cochlea | 189 | ||
Second step: opening the cochlea | 189 | ||
Third step: insertion of the electrode array | 190 | ||
Examples of robot-based devices for cochlear implantation | 191 | ||
First step: access to cochlea | 191 | ||
Minimally Invasive Robotic-Assisted Cochlear Implantation (ARTOG, University of Bern, Switzerland) | 191 | ||
System overview | 191 | ||
Surgical procedure | 191 | ||
Preoperative imaging and surgical planning | 191 | ||
Robotic middle-ear access | 192 | ||
Implant management | 193 | ||
Clinical validation | 193 | ||
Results | 193 | ||
Preoperative imaging and planning | 193 | ||
Robotic middle-ear access | 194 | ||
Implant management and electrode array insertion | 196 | ||
Surgical outcome | 198 | ||
Discussion | 198 | ||
The Hannover device (Hannover University, Germany) | 199 | ||
The Vanderbilt system (Nashville, United States) | 200 | ||
Modification of the Steady Hand device (Johns Hopkins University) | 201 | ||
Hannover insertion tool with Vanderbilt modification (Hannover, Germany; Nashville, TN) | 202 | ||
The ARMA steerable cochlear implant (Advanced Robotics and Mechanism Applications, Columbia University/Vanderbilt Univer ... | 202 | ||
The Parisian insertion tool (UMR-S 1159, Inserm/Université Pierre et Marie Curie) | 202 | ||
Second step: cochlea opening | 201 | ||
Third step: array insertion | 201 | ||
Robot-based devices for otology: other applications | 205 | ||
Endoscopic surgery | 205 | ||
Other temporal bone approaches | 206 | ||
Conclusion and perspectives | 206 | ||
References | 207 | ||
Chapter 12 Robot-assisted suturing and microsurgery | 213 | ||
The Smart Tissue Autonomous Robot (STAR): the role of intelligence and autonomy in surgical robotics | 214 | ||
Unmet need | 214 | ||
Paradigm shift | 214 | ||
Democratization of surgery | 214 | ||
Smart Tissue Autonomous Robot (STAR) | 214 | ||
Robot-assisted microsurgery: the next step in reconstructive surgery | 215 | ||
Chapter 13 Surgical simulation and training for ENT surgery | 219 | ||
Surgical simulation: gadget, teaching tool, or surgical strategy aid? | 220 | ||
Introduction | 220 | ||
Why bother about simulation? | 220 | ||
Traditional surgical simulation | 220 | ||
Low-fidelity” models | 220 | ||
Integrating virtual reality simulation in clinical practice | 221 | ||
Advantages of surgery simulation | 221 | ||
Limitations | 221 | ||
Research | 221 | ||
Conclusion | 221 | ||
References | 221 | ||
Simulation in endoscopic endonasal surgery: review and perspectives | 222 | ||
Introduction | 222 | ||
Review of simulation supports | 222 | ||
Physical supports | 222 | ||
High-fidelity supports | 222 | ||
Cadaver dissection | 222 | ||
Animal dissection | 223 | ||
Artificial supports | 223 | ||
Low-fidelity supports | 223 | ||
Virtual reality | 223 | ||
Cyrano | 223 | ||
Role of simulation in endoscopic endonasal surgery training | 224 | ||
Conclusion | 225 | ||
References | 225 | ||
Surgical robotics: safety, legal, ethical and economic aspects | 227 | ||
Safety and normalization in surgical robotics | 228 | ||
General safety design strategies | 228 | ||
European directives applicable to surgical robotics | 229 | ||
CE mark | 229 | ||
Norms involved in medical robotics | 229 | ||
Risk management at the surgeon's level | 229 | ||
References | 231 | ||
Economic assessment of transoral robotic-assisted surgery | 231 | ||
Introduction | 231 | ||
Extra costs of the robotic system | 231 | ||
Cost-savings | 231 | ||
Comparison with laparoscopic surgery | 232 | ||
Availability of the robot | 232 | ||
Conclusion | 232 | ||
References | 232 | ||
Law, ethics, robots and surgery | 232 | ||
General aspects | 232 | ||
The particularities of robotic surgery | 233 | ||
Conclusion | 234 | ||
References | 234 | ||
Concluding remarks | 235 | ||
Index | 237 | ||
Imprint\r | 241 |