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 |