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Pre-programmed robotic osteotomies for fibula free flap mandible reconstruction: A preclinical investigation.
Chao, Albert H; Weimer, Katie; Raczkowsky, Joerg; Zhang, Yaokun; Kunze, Mirko; Cody, Dianna; Selber, Jesse C; Hanasono, Matthew M; Skoracki, Roman J.
Afiliación
  • Chao AH; Department of Plastic Surgery, the Ohio State University, Columbus, OH.
  • Weimer K; 3D Systems, Golden, CO.
  • Raczkowsky J; Institute for Anthropomatics and Robotics, Karlsruhe Institute of Technology, Karlsruhe, Germany.
  • Zhang Y; Institute for Anthropomatics and Robotics, Karlsruhe Institute of Technology, Karlsruhe, Germany.
  • Kunze M; Institute for Anthropomatics and Robotics, Karlsruhe Institute of Technology, Karlsruhe, Germany.
  • Cody D; Department of Plastic Surgery, MD Anderson Cancer Center, Houston, TX.
  • Selber JC; Department of Plastic Surgery, MD Anderson Cancer Center, Houston, TX.
  • Hanasono MM; Department of Plastic Surgery, MD Anderson Cancer Center, Houston, TX.
  • Skoracki RJ; Department of Plastic Surgery, the Ohio State University, Columbus, OH.
Microsurgery ; 36(3): 246-9, 2016 Mar.
Article en En | MEDLINE | ID: mdl-26663239
Bony free flap reconstruction of the facial skeleton remains a challenging area of reconstructive surgery. Despite technological advances that have aided planning and execution of these procedures, surgical inaccuracy is not insignificant. One source of error that has not been wholly addressed is that attributable to a human operator. In this study, we investigate the feasibility and accuracy of performing osteotomies robotically in pre-programmed fashion for fibula free flap mandible reconstruction as a method to reduce inaccuracies related to human error. A mandibular defect and corresponding free fibula flap reconstruction requiring six osteotomies were designed on a CAD platform. A methodology was developed to translate this virtual surgical plan data to a robot (KUKA, Augsburgs, Germany), which then executed osteotomies on three-dimensional (3D) printed fibula flaps with the aid of dynamic stereotactic navigation. Using high-resolution computed tomography, the osteotomized segments were compared to the virtually planned segments in order to measure linear and angular accuracy. A total of 18 robotic osteotomies were performed on three 3D printed fibulas. Compared to the virtual preoperative plan, the average linear variation of the osteotomized segments was 1.3 ± 0.4 mm, and the average angular variation was 4.2 ± 1.7°. This preclinical study demonstrates the feasibility of pre-programmed robotic osteotomies for free fibula flap mandible reconstruction. Preliminarily, this method exhibits high degrees of linear and angular accuracy, and may be of utility in the development of techniques to further improve surgical accuracy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteotomía / Trasplante Óseo / Colgajos Tisulares Libres / Peroné / Reconstrucción Mandibular / Procedimientos Quirúrgicos Robotizados Límite: Humans / Male Idioma: En Revista: Microsurgery Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteotomía / Trasplante Óseo / Colgajos Tisulares Libres / Peroné / Reconstrucción Mandibular / Procedimientos Quirúrgicos Robotizados Límite: Humans / Male Idioma: En Revista: Microsurgery Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos