Design of a robot-assisted system for transforaminal percutaneous endoscopic lumbar surgeries: study protocol
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(2020) 15:479
STUDY PROTOCOL
Open Access
Design of a robot-assisted system for transforaminal percutaneous endoscopic lumbar surgeries: study protocol Ning Fan1,2†, Shuo Yuan1,2†, Peng Du1,2, Wenyi Zhu1,2, Liang Li2,3, Yong Hai1,2, Hui Ding2,3, Guangzhi Wang2,3* and Lei Zang1,2*
Abstract Background: Transforaminal percutaneous endoscopic lumbar surgeries (PELS) for lumbar disc herniation and spinal stenosis are growing in popularity. However, there are some problems in the establishment of the working channel and foraminoplasty such as nerve and blood vessel injuries, more radiation exposure, and steeper learning curve. Rapid technological advancements have allowed robotic technology to assist surgeons in improving the accuracy and safety of surgeries. Therefore, the purpose of this study is to develop a robot-assisted system for transforaminal PELS, which can provide navigation and foraminoplasty. Methods: The robot-assisted system consists of three systems: preoperative planning system, navigation system, and foraminoplasty system. In the preoperative planning system, 3D visualization of the surgical segment and surrounding tissues are realized using the multimodal image fusion technique of computed tomography and magnetic resonance imaging, and the working channel planning is carried out to reduce the risk for injury to vital blood vessels and nerves. In the navigation system, the robot can obtain visual perception ability from a visual receptor and automatically adjust the robotic platform and robot arm to the appropriate positions according to the patient’s position and preoperative plan. In addition, the robot can automatically register the surgical levels through intraoperative fluoroscopy. After that, the robot will provide navigation using the 6 degree-of-freedom (DOF) robot arm according to the preoperative planning system and guide the surgeon to complete the establishment of the working channel. In the foraminoplasty system, according to the foraminoplasty planning in the preoperative planning system, the robot performs foraminoplasty automatically using the high speed burr at the end of the robot arm. The system can provide real-time feedback on the working status of the bur through multi-mode sensors such as multidimensional force, position, and acceleration. Finally, a prototype of the system is constructed and performance tests are conducted. (Continued on next page)
* Correspondence: [email protected]; [email protected] † Ning Fan and Shuo Yuan contributed equally to this work. 2 Chaoyang-Tsinghua Digitization & Artificial Intelligence Orthopedic Laboratory, Beijing, China 1 Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate
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