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1.
Vet Clin North Am Small Anim Pract ; 52(1): 221-234, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34838251

RESUMO

Virtual surgical planning and three-dimensional (3D) printing are preoperative processes requiring the acquisition of high-quality imaging data. A surgical treatment plan is created and rehearsed virtually as the operator manipulates the 3D images of the patient within the software. When the operator is satisfied with the plan, including anticipated osteotomies, tumor excision margins, and reconstruction options, physical 3D prints can be produced. This article introduces the reader to the basic concepts involved in virtual surgical planning and 3D printing as well as their implementation in veterinary oromaxillofacial surgery.


Assuntos
Desenho Assistido por Computador , Cirurgia Assistida por Computador , Animais , Odontologia , Imageamento Tridimensional/veterinária , Impressão Tridimensional , Cirurgia Assistida por Computador/veterinária
2.
Ann Anat ; 239: 151834, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34547412

RESUMO

BACKGROUND: Harvesting vascularized bone grafts with computer-assisted surgery represents the gold standard for mandibular reconstruction. However, current augmented reality (AR) approaches are limited to invasive marker fixation. This trial compared a markerless AR-guided real-time navigation with virtually planned and 3D printed cutting guides for harvesting iliac crest grafts. MATERIAL AND METHODS: Two commonly used iliac crest transplant configurations were virtually planned on 10 cadaver hips. Transplant harvest was performed with AR guidance and cutting guide technology. The harvested transplants were digitalized using cone beam CT. Deviations of angulation, distance and volume between the executed and planned osteotomies were measured. RESULTS: Both AR and cutting guides accurately rendered the virtually planned transplant volume. However, the cumulative osteotomy plane angulation differed significantly (p = 0.018) between AR (14.99 ± 11.69°) and the cutting guides (8.49 ± 5.42°). The cumulative osteotomy plane distance showed that AR-guided navigation had lower accuracy (2.65 ± 3.32 mm) than the cutting guides (1.47 ± 1.36 mm), although without significant difference. CONCLUSION: This study demonstrated the clinical usability of markerless AR-guided navigation for harvesting iliac crest grafts. Further improvement of accuracy rates might bring clinical implementation closer to reality.


Assuntos
Realidade Aumentada , Cirurgia Assistida por Computador , Cadáver , Humanos , Ílio/cirurgia , Tecnologia
3.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(11): 1492-1498, 2021 Nov 15.
Artigo em Chinês | MEDLINE | ID: mdl-34779179

RESUMO

Objective: To compare the application effects between personal specific instrumentation (PSI) and computer-assisted navigation surgery (CAS) in total knee arthroplasty (TKA). Methods: The literature comparing the application effects of PSI and CAS in TKA in recent years was widely consulted, and the difference between PSI-TKA and CAS-TKA in operation time, lower limb alignment, blood loss, and knee function were compared. Results: Compared to CAS-TKA, PSI-TKA simplifies operation procedures and shortens operation time but probably has worse lower limb alignment. It is still controversial in comparison of perioperative blood loss and knee function between two techniques. Conclusion: PSI-TKA and CAS-TKA both have advantages and disadvantages, and their differences need to be confirmed by further high-quality clinical trial.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Cirurgia Assistida por Computador , Computadores , Humanos , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia
4.
Artigo em Inglês | MEDLINE | ID: mdl-34769865

RESUMO

This systematic review was aimed at gathering technical and clinical applications of CAD/CAM technology for the preoperative planning of craniofacial implants placement, designing of molds and substructures and fabrication of orbital prostheses. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, an electronic search was executed. Human studies that utilized digital planning systems for the prosthetic rehabilitation of orbital defects were included. A total of 16 studies of 30 clinical cases, which were virtually planned through various digital planning and designing software, were included. The most common preoperative data required for digital planning were CT scans in 15 cases, the 3DSS-STD-II scanning system in 5 cases, an Artec Color 3D scanner in 3 cases and a NextEngine Desktop 3D laser scanner in 2 cases. Meanwhile, the digital designing software were Ease Orbital Implant Planning EOIPlan software in eight cases, Geomagic software in eight cases, Simplant software in four cases and Artec Studio 12 Professional in three cases. Surgical templates were fabricated for 12 cases to place 41 craniofacial implants in the orbital defect area. An image-guided surgical navigation system was utilized for the placement of five orbital implants in two cases. Digital designing and printing systems were reported for the preoperative planning of craniofacial implants placement, designing of molds and substructures and fabrication of orbital prostheses. The studies concluded that the digital planning, designing and fabrication of orbital prostheses reduce the clinical and laboratory times, reduces patient visits and provide a satisfactory outcome; however, technical skills and equipment costs are posing limitations on the use of these digital systems.


Assuntos
Implantes Orbitários , Cirurgia Assistida por Computador , Desenho Assistido por Computador , Humanos , Software , Tecnologia
5.
Comput Methods Programs Biomed ; 212: 106460, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34736173

RESUMO

OBJECTIVE: Fluoroscopic guidance is a critical step for the puncture procedure in percutaneous endoscopic transforaminal discectomy (PETD). However, two-dimensional observations of the three-dimensional anatomic structure suffer from the effects of projective simplification. To accurately assess the spatial relations between the patient vertebra tissues and puncture needle, a considerable number of fluoroscopic images from different orientations need to be acquired by the surgeons. This process significantly increases the radiation risk for both the patient and surgeons. METHODS: In this paper, we propose an augmented reality (AR) surgical navigation system for PETD based on multi-modality information, which contains fluoroscopy, optical tracking, and depth camera. To register the fluoroscopic image with the intraoperative video, we design a lightweight non-invasive fiducial with markers and detect the markers based on the deep learning method. It can display the intraoperative video fused with the registered fluoroscopic images. We also present a self-adaptive calibration and transformation method between a 6-DOF optical tracking device and a depth camera, which are in different coordinate systems. RESULTS: With the substantially reduced frequency of fluoroscopy imaging, the system can accurately track and superimpose the virtual puncture needle on fluoroscopy images in real-time. From operating theatre in vivo animal experiments, the results illustrate that the system average positioning accuracy can reach 1.98mm and the orientation accuracy can reach 1.19∘. From the clinical validation results, the system significantly lower the frequency of fluoroscopy imaging (42.7%) and reduce the radiation risk for both the patient and surgeons. CONCLUSION: Coupled with the user study, both the quantitative and qualitative results indicate that our navigation system has the potential to be highly useful in clinical practice. Compared with the existing navigation systems, which are usually equipped with a variety of large and high-cost medical equipments, such as O-arm, cone-beam CT, and robots, our navigation system does not need special equipment and can be implemented with common equipment in the operating room, such as C-arm, desktop, etc., even in small hospitals.


Assuntos
Imageamento Tridimensional , Cirurgia Assistida por Computador , Animais , Discotomia , Fluoroscopia , Humanos , Tomografia Computadorizada por Raios X
6.
Sensors (Basel) ; 21(22)2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34833581

RESUMO

Robot-assisted minimally invasive surgery (MIS) has received increasing attention, both in the academic field and clinical operation. Master/slave control is the most widely adopted manipulation mode for surgical robots. Thus, sensing the force of the surgical instruments located at the end of the slave manipulator through the main manipulator is critical to the operation. This study mainly addressed the force detection of the surgical instrument and force feedback control of the serial surgical robotic arm. A measurement device was developed to record the tool end force from the slave manipulator. An elastic element with an orthogonal beam structure was designed to sense the strain induced by force interactions. The relationship between the acting force and the output voltage was obtained through experiment, and the three-dimensional force output was decomposed using an extreme learning machine algorithm while considering the nonlinearity. The control of the force from the slave manipulator end was achieved. An impedance control strategy was adopted to restrict the force interaction amplitude. Modeling, simulation, and experimental verification were completed on the serial robotic manipulator platform along with virtual control in the MATLAB/Simulink software environment. The experimental results show that the measured force from the slave manipulator can provide feedback for impedance control with a delay of 0.15 s.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Cirurgia Assistida por Computador , Desenho de Equipamento , Retroalimentação , Procedimentos Cirúrgicos Minimamente Invasivos
7.
Zhongguo Gu Shang ; 34(11): 1029-33, 2021 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-34812020

RESUMO

OBJECTIVE: To investigate the related problems of three-dimension CT navigation system applied to craniocervical junction malformation diseases surgery. METHODS: The clinical data of 61 patients with craniocervical junction malformation disease who underwent surgical treatment from July 2015 to March 2018 was retrospectively analyzed. There were 39 males and 22 females aged from 25 to 73 years old with a mean of (46.20±12.09) years. According to the different ways of screw placements, these patients were divided into navigation group (30 cases) and non navigation group (31 cases). The screws insertion in the navigation group were guided under three-dimension CT computer-aided navigation system, while the screws insertion were guided by C-arm fluoroscopy and intraoperative anatomical landmarks in non-navigation group. All surgeries were performed by the same group of surgeons. All cases were scanned by CT after operation to assess the accuracy of the screw insertion. RESULTS: A total of 122 screws were inserted in the study, including 60 screws in navigation group and 62 screws in non-navigation group. The screw positions in navigation group were all satisfactory, and there were no screw-related complications. The position of 3 screws (4.83%) in non-navigation group was not satisfactory, and there was no obvious neurological symptoms after operation. The operation time of navigation group was from 87.5 to 112.5 min with a mean of (99.6± 12.0) min;and non-navigation group was from 87.5 to 107.5 min, with a mean of (97.5±10.5) min. There was no statistically significant difference in the operation time between two groups (P>0.05). The screw insertion time in navigation group was from 1.50 to 4.20 min, with a mean of (2.51±1.02) min;and non navigation group was from 1.80 to 5.10 min, with a mean of (3.25±1.05) min. The screw insertion time in navigation group was shorter than that in non-navigation group (P<0.05). The intraoperative blood loss in navigation group was from 122 to 153 ml, with a mean of (137.57±9.48) ml, which in non-navigation group wasfrom 121 to 158 ml, with a mean of (138.75±8.56) ml, there was no statistically significant difference between two groups (P>0.05). CONCLUSION: The three-dimensional CT computer-aided navigation system has the characteristics of clear imaging and accurate positioning, which can help improve the accuracy and safety of the screw insertion in craniocervical junction malformation disease surgery.


Assuntos
Cirurgia Assistida por Computador , Adulto , Idoso , Parafusos Ósseos , Feminino , Fluoroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
8.
Nuklearmedizin ; 60(6): 425-433, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34768300

RESUMO

AIM: [99mTc]Tc-PSMA-based radioguided surgery (TPRS) represents a curative approach for localized relapse of prostate cancer. For its simplified regulatory permission, the radiation protection authorities require a 99mTc- activity below the exemption limit of 10 MBq at the time of surgery. Our aim was to determine the optimal amount of radioactivity (OAR) to comply with that limit and to estimate the maximum number of TPRS procedures per year and surgeon without triggering the full monitoring obligations. METHODS: In this retrospective study, a dose rate meter was calibrated using measurements on phantoms and from recently injected (1 min p. i.) patients to determine the activity in the patient from measured dose rates. The effective half-life of 99mTc-PSMA-I&S in patients was determined from repeated dose rate measurements to estimate dose parameters of relevance for radiation protection. External exposures of the surgeons were measured with personal dosimeters calibrated in Hp(10). The surgeon's finger dose Hp(0.07) is estimated from radioactivity measured in resected lymph nodes. Potenzial incorporations were estimated for an activity of 10 MBq. RESULTS: From the first 6 subsequent patients, an effective half-life of 4.15 h was observed. Assuming an operation time 24 h p. i., the OAR was 550 MBq. Operations lasting in average 2 h in a distance of 0.25 m to the patient imply a body dose for surgeons of 4.16 µSv per procedure. Based on these estimates, the surgeon's Hp(10) is less than 1 mSv per year with up to 241 operations per year. Hp(0.07) and potential incorporation of activity do not lead to further limitations. SUMMARY: All radiation protection regulations are met with adherence to OAR recommended here without triggering the full monitoring obligations from radiation protection regulations.


Assuntos
Exposição Ocupacional , Neoplasias da Próstata , Lesões por Radiação , Cirurgia Assistida por Computador , Humanos , Linfonodos , Masculino , Recidiva Local de Neoplasia/diagnóstico por imagem , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/radioterapia , Neoplasias da Próstata/cirurgia , Compostos Radiofarmacêuticos , Estudos Retrospectivos
9.
Anticancer Res ; 41(10): 5015-5023, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34593450

RESUMO

BACKGROUND/AIM: Limb-sparing procedures are frequently applied to improve patient outcomes. The use of vascularized bone grafts is associated with significant improvements in oncologic safety and functional satisfaction. This study highlights the clinical outcomes following tumor resection combined with vascularized bone graft reconstructions. PATIENTS AND METHODS: Twenty-five free vascularized bone grafts (17 fibulas, 5 iliac crests, 3 medial femoral condyles) were assessed with respect to consolidation and hypertrophy, functional and oncologic outcomes, and local complications. RESULTS: The rate of healing of fibular grafts after a median of 5 months was 86%. The rate of achieved unions of iliac crest grafts after a median of 5 months was 80%. In medial femoral condyle bone grafts, union occurred after a median of 4 months. Significant hypertrophy was observed in 13 patients. We identified six complications with highest rates in the fibula-group. Despite the high complications, functional results were highly satisfactory. CONCLUSION: Vascularized bone grafts represent a reconstructive approach, maintaining long-term functionality and cosmetic satisfaction without compromising tumor recurrence outcomes.


Assuntos
Neoplasias Ósseas/cirurgia , Transplante Ósseo/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Sarcoma/cirurgia , Cirurgia Assistida por Computador/métodos , Adolescente , Adulto , Neoplasias Ósseas/irrigação sanguínea , Neoplasias Ósseas/patologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Sarcoma/irrigação sanguínea , Sarcoma/patologia , Adulto Jovem
10.
Medicine (Baltimore) ; 100(37): e27206, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34664854

RESUMO

RATIONALE: We report a new scleral buckling technique using a 27-gauge endoilluminator and a wide-field viewing system to overcome the limitations of conventional indirect ophthalmoscope-methods and "chandelier-assisted" surgery. PATIENT CONCERNS: A 26-year-old female patient visited the local clinic for floaters and lower visual field defects in her left eye that had occurred 5 days prior. DIAGNOSES: On fundus examination, upper retinal detachment without macular involvement and an atrophic hole was observed in her left eye. INTERVENTIONS: Under general anesthesia and after perilimbal conjunctival incision, extraocular muscle isolation, and traction with black silk, a 27-gauge trocar-cannula was inserted 90° away from the retinal break, 4 mm away from the limbus. Under wide-field viewing using a contact lens, the fundus was observed through a surgical microscope. Retinal break was evaluated and cryopexy was performed with careful movement of the endoilluminator, paying attention to damage to the lens. The surgeon could accurately and freely control the direction of the illumination tip to obtain a brighter view of the region of interest. OUTCOMES: There were no complications associated with trocar cannula incision or the illuminator. The retina was successfully reattached. LESSONS: Twenty seven gauge endoilluminator-assisted scleral buckling is an easy and safe procedure and provides better control over and free adjustment of the light direction, thus overcoming the limitations of chandelier-assisted surgery.


Assuntos
Recurvamento da Esclera/métodos , Adulto , Feminino , Humanos , Iluminação/instrumentação , Iluminação/normas , Microscopia/instrumentação , Microscopia/métodos , Recurvamento da Esclera/instrumentação , Cirurgia Assistida por Computador/instrumentação , Cirurgia Assistida por Computador/métodos
11.
Clin Oral Implants Res ; 32 Suppl 21: 303-317, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34642994

RESUMO

AIM: To study the time and costs involved with computer-assisted versus non-computer-assisted implant planning and placement. MATERIAL AND METHODS: Based on the PICO question, "In patients receiving dental implants, is computer-assisted implant planning and surgery (CAIPS) compared to non-computer-assisted implant planning and surgery (non-CAIPS) beneficial in terms of treatment related costs and time involved?", a search path was created to perform an electronic search in the databases PubMed, PubMed Central, EMBASE, and Cochrane. The publication period of eligible publications extended from 01.01.2005 to 04.05.2020. Four independent reviewers reviewed the literature to identify studies that met the eligibility inclusion criteria. A further manual search of articles was performed, and gray literature was excluded. Corresponding authors of potentially eligible manuscripts were contacted for further information. RESULTS: Of the 1354 retrieved titles after the search were screened. Thirty-one articles have been identified to read the full text, resulting in four articles to be analyzed for the present review all of which were RCTs. In total, 182 partially and completely edentulous patients were treated with 416 implants following either non-computer-assisted or computer-assisted implant planning and surgery to determine the duration of the single working steps and the financial aspects of the different procedures. CONCLUSIONS: When evaluating the time and costs involved with the diagnostic and planning procedures in computer-assisted implant planning and surgery workflow protocols, one can summarize that these are higher than in the non-computer-assisted workflow protocols. The time involved with the procedures appears to be the driving factor when it comes to economic considerations. On the basis of the conclusions, also the time for the prosthetic restoration should be taken into account.


Assuntos
Implantes Dentários , Cirurgia Assistida por Computador , Computadores , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Humanos
12.
J Craniofac Surg ; 32(7): e663-e667, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34705369

RESUMO

ABSTRACT: This study aims to evaluate the use of customized surgical plates in patients with mandibular defects concerning postoperative aesthetics and functional outcomes during the 2-year follow-up. Preoperative virtual surgical plans and patient-specific three-dimensional printed plates were tailored for consecutive patients. Preoperative preparation, surgical produces, postoperative aesthetics, and functional outcomes were described in detail. The average follow-up period was over 2 years. In the presented clinical cases, aesthetic and functional outcomes were reported to be satisfactory.


Assuntos
Reconstrução Mandibular , Cirurgia Assistida por Computador , Placas Ósseas , Estética Dentária , Humanos , Mandíbula/cirurgia , Impressão Tridimensional
13.
Int J Oral Maxillofac Implants ; 36(5): e121-e140, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34698720

RESUMO

PURPOSE: Dynamic navigation is a technique that allows for the placement of dental implants using a computer-guided approach according to preoperative planning. Its accuracy has been assessed in several previous studies. The purpose of this study was to summarize data on implant placement accuracy using dynamic navigation, to synthesize the frequency of intraoperative complications and implant failures, and to compare this technique with static computer-guided surgery and a freehand approach. MATERIALS AND METHODS: Electronic and manual literature searches until December 2019 were performed. The outcome variables were implant placement accuracy using dynamic navigation, accuracy differences between dynamic and static techniques and between dynamic and freehand techniques, intraoperative complications, and implant failures. Random-effects meta-analyses were performed. RESULTS: A total of 32 studies were included; 29 reported accuracy values (2,756 implants), and 10 focused on complications and implant failures (1,039 implants). The pooled mean implant placement errors were 0.81 (95% CI: 0.677 to 0.943) mm at the entry point and 0.910 (95% CI: 0.770 to 1.049) mm at the apical point. The pooled mean vertical and angular deviations were 0.899 (95% CI: 0.721 to 1.078) mm and 3.807 (95% CI: 3.083 to 4.530) degrees. The navigation group showed significantly lower implant placement errors with respect to the freehand technique (P < .01) and similar accuracy values (P ≥ .05) compared with the static technique. The pooled prevalence of failures was 1% (95% CI: 0.00% to 2%). CONCLUSION: Dynamic navigation provided small implant placement errors, comparable with those obtained using static computer-guided surgery, and can be considered a more accurate technique than conventional freehand surgery.


Assuntos
Implantes Dentários , Cirurgia Assistida por Computador , Implantação Dentária Endo-Óssea , Falha de Equipamento , Humanos , Complicações Intraoperatórias
14.
Arch Orthop Trauma Surg ; 141(12): 2267-2276, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34652514

RESUMO

PURPOSE: It remains to be established whether optical computed tomography (CT)-free and acceleration-based navigation systems differ in terms of implantation accuracy and clinical outcomes for total knee arthroplasty. This randomised prospective study compared the implantation accuracy of these two navigation systems in total knee arthroplasty. METHODS: Optical CT-free navigation (ExactechGPS) or acceleration-based navigation (KneeAlign2) was randomly assigned to the left or right knee of 45 patients who underwent a single-stage bilateral total knee arthroplasty: the ExactechGPS (n = 45) and KneeAlign2 groups (n = 45) were compared. Component alignments were evaluated using three-dimensional computed tomography and radiography at pre- and post-surgery. Implantation accuracy of the component alignment, proportion of outliers, postoperative range of motion, and Japanese Orthopaedic Association (JOA) score were compared between the systems. RESULTS: The implantation accuracies of the lower-extremity mechanical alignment, coronal femoral component angle, coronal tibial component angle, sagittal femoral component, axial femoral angle, and axial tibial angle had no significant difference between the groups. The implantation accuracy of the sagittal tibial component angle was superior in the ExactechGPS than the KneeAlign2 group (1.3° vs. 1.8°, P = 0.034). The proportions of outliers, range of motion, and JOA score had no significant difference between the groups. CONCLUSION: In the tibial sagittal plane, there was a significant difference in the implantation accuracy, but its difference did not affect the clinical outcomes. Both navigation systems have clinically acceptable implantation accuracy.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Cirurgia Assistida por Computador , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Humanos , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Estudos Prospectivos , Tíbia/diagnóstico por imagem , Tíbia/cirurgia
15.
Arch Orthop Trauma Surg ; 141(12): 2227-2233, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34698930

RESUMO

INTRODUCTION: Many of the functional complications that arise after total knee arthroplasty (TKA) are caused by a non-optimal balance of the knee after surgery. Over the past 20 years, technology has been used in the Operating Room (OR) to help improve precision and balance. The results of Computer-Assisted Surgery (CAS) and robotic systems show improved accuracy regarding implant positioning but a relatively small improvement in patient-reported outcomes and implant survival compared to conventional TKA. Recently, Augmented Reality (AR) has been proposed as a technology that could improve accuracy in orthopaedic surgery, providing a more efficient and cost-effective solution. MATERIALS AND METHODS: This article describes a novel AR-based surgical guidance system that measures intra-operatively the effect of prosthesis alignment and positioning on soft tissue balance. The system is integrated in a pair of smart glasses and two small sensors and displays surgical targets directly in the field of view of the surgeon. RESULTS: The system has been used in a limited number of cases. While the preliminary experience has been positive, clinical research is ongoing to confirm to confirm the performance of the system and the impact on clinical outcomes. CONCLUSION: Augmented Reality can be a valuable tool to improve accuracy in TKA. The use of smart glasses and integrated sensors improves the efficiency of the procedure, particularly when coupled with single-use instrumentation. A novel protocol for soft tissue assessment allows for a 3-dimensional evaluation of the ligaments and a better measurement of the effect of tibial rotation.


Assuntos
Artroplastia do Joelho , Realidade Aumentada , Cirurgia Assistida por Computador , Humanos , Articulação do Joelho/cirurgia , Tíbia/cirurgia
16.
BMC Oral Health ; 21(1): 529, 2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34654418

RESUMO

BACKGROUND: This study aimed to assess the accuracy of virtual surgical planning (VSP) in segmental osteotomy in combination with bimaxillary orthognathic surgery with surgery first approach (SFA) by means of three-dimensional (3D) measuring and superimposition, so as to promote the application of digital technology in combined orthodontic-orthognathic treatment. METHODS: 20 patients treated with segmental osteotomy in combination with bimaxillary orthognathic surgery with SFA from 2018 to 2020 were included. All of them acquired VSP performed by ProPlan CMF 3.0 software (Materialise Corporation, Belgium). The preoperative (T0) 3D model of VSP and the postoperative (T1) 3D model, reconstructed by the cone-beam computed tomography (CBCT) data acquired one week after surgery, were compared by measuring the 3D coordinates of the landmarks as well as 3D model superimposition for deviation analysis. The deviation analysis was achieved by Geomagic Studio 2013 (3D Systems Corporation, USA). The differences which represented the accuracy of VSP were evaluated by the root mean square deviation (RMSD) and the Bland-Altman method. RESULTS: There was no statistically significant difference between the 3D coordinates of T1 and T0 (P > 0.05), and the mean overall RMSD was 1.37 mm, within the clinical relevance of 2 mm. The RMSD of sagittal direction (1.76 mm) was greater than that of coronal and vertical directions (1.09 mm and 1.24 mm), and the RMSD of maxillary and mandibular aspects were basically equal (1.30 mm and 1.45 mm). The Bland-Altman method showed the T0 and T1 measurements were in good agreement. The mean RMSD obtained from the deviation analysis was 1.85 mm, within the clinical relevance. CONCLUSIONS: VSP in segmental osteotomy in combination with bimaxillary orthognathic surgery with SFA proved to acquire accurate outcome in this study.


Assuntos
Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Cirurgia Assistida por Computador , Tomografia Computadorizada de Feixe Cônico , Humanos , Imageamento Tridimensional
17.
Comput Biol Med ; 138: 104864, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34634638

RESUMO

BACKGROUND: Augmented reality (AR) based fusion imaging in endoscopic surgeries rely on the quality of image-to-patient registration and camera calibration, and these two offline steps are usually performed independently to get the target transformation separately. The optimal solution can be obtained under independent conditions but may not be globally optimal. All residual errors will be accumulated and eventually lead to inaccurate AR fusion. METHODS: After a careful analysis of the principle of AR imaging, a robust online calibration framework was proposed for an endoscopic camera to enable accurate AR fusion. A 2D checkerboard-based homography estimation algorithm was proposed to estimate the local pose of the endoscopic camera, and the least square method was used to calculate the compensation matrix in combination with the optical tracking system. RESULTS: In comparison with conventional methods, the proposed compensation method improved the performance of AR fusion, which reduced physical error by up to 82%, reduced pixel error by up to 83%, and improved target coverage by up to 6%. Experimental results of simulating mechanical noise revealed that the proposed compensation method effectively corrected the fusion errors caused by the rotation of the endoscopic tube without recalibrating the camera. Furthermore, the simulation results revealed the robustness of the proposed compensation method to noises. CONCLUSIONS: Overall, the experiment results proved the effectiveness of the proposed compensation method and online calibration framework, and revealed a considerable potential in clinical practice.


Assuntos
Realidade Aumentada , Cirurgia Assistida por Computador , Algoritmos , Endoscopia , Humanos , Imageamento Tridimensional
18.
J Orthop Surg (Hong Kong) ; 29(1_suppl): 23094990211012865, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34711079

RESUMO

INTRODUCTION: Computer-assisted navigation (CAN) is a well-established tool in spinal instrumentation surgery. Different techniques - each with specific advantages and disadvantages - are used in the cervical spine. METHODS: A structured summary of different spinal navigation techniques and a review of the literature were done to discuss the advantages and disadvantages of specific navigation tools in the cervical spine. RESULTS: In cervical spine surgery, CAN increases the accuracy of pedicle screw placement, reduces screw mispositioning and leads to fewer revision surgeries. Due to the mobility of the cervical spine, preoperative CT followed by region matching or intraoperative CT are recommended. CONCLUSIONS: CAN increases pedicle screw placement accuracy and should be used in spinal instrumentation for the cervical spine whenever possible.


Assuntos
Parafusos Pediculares , Fusão Vertebral , Cirurgia Assistida por Computador , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Humanos , Reoperação , Coluna Vertebral
19.
Cir Cir ; 89(5): 595-602, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34665175

RESUMO

OBJECTIVE: To evaluate the clinical-surgical outcomes after dorso-lumbar instrumentation using O-arm assisted neuronavigation and minimally invasive surgery. METHOD: In this retrospective cohort, 104 patients who underwent dorso-lumbar instrumentation with the use of O-arm from September 2013 to May 2020 were studied. Variables investigated included: symptoms, number of screws, levels approached, bleeding, surgical time, hospital stay, complications and clinical improvement after the surgical procedure. RESULTS: The most frequent symptoms were: unilateral or bilateral radiculopathy of the pelvic extremities, paresthesia, mechanical low back pain and progressive decrease in strength. A total of 542 screws were placed, with the lumbar spine being the site with the highest prevalence. The average bleeding, surgical time, and hospital stay was: 50 ml, 160 minutes, and 24 hours, respectively. The most frequent complications were: Residual neuropathy, dura mater tear and surgical site infection. Clinical improvement at 24 hours, 4 weeks and 6 months was achieved in: 77.3%, 86.5% y 94.8% of the patients, respectively. CONCLUSIONS: Neuronavigation with the use of O-arm along with mini-open surgery approach results in good clinical-surgical outcomes in the correction of complex disorders of the dorso-lumbar spine.


Assuntos
Fusão Vertebral , Cirurgia Assistida por Computador , Humanos , Imageamento Tridimensional , Vértebras Lombares/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
20.
PLoS One ; 16(10): e0255481, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34673786

RESUMO

The aim of this study was to assess the potential use of a new advanced inertial navigation system for guiding dental implant placement and to compare this approach with standard stereolithographic template guiding. A movement processing unit with a 9-axis absolute orientation sensor was adapted to a surgical handpiece and wired to a computer navigation interface. Sixty implants were placed by 10 operators in 20 jaw models. The 30 implants of the test group were placed in 10 models guided by the new inertial navigation prototype. The 30 implants of the control group were placed in another 10 models using a CAD-CAM template. Both groups were subdivided into experienced and non-experienced operators. Pre- and postoperative computer tomography images were obtained and matched to compare the planned and final implant positions. Four deviation parameters (global, angular, depth, and lateral deviation) were defined and calculated. The primary outcome was the angular deviation between the standard stereolithographic approach and the new inertial navigation system. Results showed no significant differences between both groups, suggesting that surgical navigation based on inertial measurement units (IMUs) could potentially be useful for guiding dental implant placement. However, more studies are still needed to translate this new approach into clinical practice.


Assuntos
Implantação Dentária/métodos , Implantes Dentários , Mandíbula/cirurgia , Modelos Anatômicos , Cirurgia Assistida por Computador/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Implantação Dentária/instrumentação , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos
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