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1.
Adv Tech Stand Neurosurg ; 50: 295-305, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38592535

RESUMO

Surgical approaches directed toward craniovertebral junction (CVJ) can be addressed to the ventral, dorsal, and lateral aspects through a variety of 360° surgical corridors Herein, we report features, advantages, and limits of the updated technical support in CVJ surgery in clinical setting and dissection laboratories enriched by our preliminary surgical results of the simultaneous application of O-arm intraoperative neuronavigation and imaging system along with the 3D-4K EX in TOA for the treatment of CVJ pathologies.In the past 4 years, eight patients harboring CVJ compressive pathologies underwent one-step combined anterior neurosurgical decompression and posterior instrumentation and fusion technique with the aid of exoscope and O-arm. In our equipped Cranio-Vertebral Junction Laboratory, we use fresh cadavers (and injected "head and neck" specimens) whose policy, protocols, and logistics have already been elucidated in previous works. Five fresh-frozen adult specimens were dissected adopting an FLA. In these specimens, a TOA was also performed, as well as a neuronavigation-assisted comparison between transoral and transnasal explorable distances.A complete decompression along with stable instrumentation and fusion of the CVJ was accomplished in all the cases at the maximum follow-up (mean: 25.3 months). In two cases, the O-arm navigation allowed the identification of residual compression that was not clearly visible using the microscope alone. In four cases, it was not possible to navigate C1 lateral masses and C2 isthmi due to the angled projection unfitting with the neuronavigation optical system, so misleading the surgeon and strongly suggesting changing surgical strategy intraoperatively. In another case (case 4), it was possible to navigate and perform both C1 lateral masses and C2 isthmi screwing, but the screw placement was suboptimal at the immediate postoperative radiological assessment. In this case, the hardware displacement occurred 2 months later requiring reoperation.


Assuntos
Imageamento Tridimensional , Cirurgia Assistida por Computador , Adulto , Humanos , Tomografia Computadorizada por Raios X , Parafusos Ósseos , Cadáver
2.
BMC Oral Health ; 24(1): 415, 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38575886

RESUMO

BACKGROUND: The objective of the present study was to evaluate the reliability of an augmented reality drilling approach and a freehand drilling technique for the autotransplantation of single-rooted teeth. MATERIALS AND METHODS: Forty samples were assigned to the following surgical techniques for drilling guidance of the artificial sockets: A. augmented reality technique (AR) (n = 20) and B. conventional free-hand technique (FT) (n = 20). Then, two models with 10 teeth each were submitted to a preoperative cone-beam computed tomography (CBCT) scan and a digital impression by a 3D intraoral scan. Afterwards, the autotrasplanted teeth were planned in a 3D dental implant planning software and transferred to the augmented reality device. Then, a postoperative CBCT scan was performed. Data sets from postoperative CBCT scans were aligned to the planning in the 3D implant planning software to analize the coronal, apical and angular deviations. Student's t-test and Mann-Whitney non-parametric statistical analysis were used to analyze the results. RESULTS: No statistically significant differences were shown at coronal (p = 0.123) and angular (p = 0.340) level; however, apical deviations between AR and FT study groups (p = 0.008) were statistically significant different. CONCLUSION: The augmented reality appliance provides higher accuracy in the positioning of single-root autotransplanted teeth compared to the conventional free-hand technique.


Assuntos
Realidade Aumentada , Implantes Dentários , Cirurgia Assistida por Computador , Humanos , Transplante Autólogo , Reprodutibilidade dos Testes , Desenho Assistido por Computador , Tomografia Computadorizada de Feixe Cônico/métodos , Imageamento Tridimensional
3.
J Robot Surg ; 18(1): 160, 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38578350

RESUMO

Robotic assisted (RA) total hip arthroplasty (THA) offers improved acetabular component placement and radiographic outcomes, but inconsistent assessment methods of its learning curves render the evaluation of adopting novel platforms challenging. Therefore, we conducted a systematic review to assess the learning curve associated with RA-THA, both tracking a surgeon's performance across initial cases and comparing their performance to manual THA (M-THA). PubMed, MEDLINE, EBSCOhost, and Google Scholar were searched on June 16, 2023, to identify studies published between January 1, 2000 and June 16, 2023 (PROSPERO registration: CRD42023437339). The query yielded 655 unique articles, which were screened for eligibility. The final analysis included 11 articles, evaluating 1351 THA procedures. Risk of bias was assessed via the Methodological Index for Nonrandomized Studies (MINORS) tool. The mean MINORS score was 21.3 ± 0.9. RA-THA provided immediate improvements in acetabular component placement accuracy and radiographic outcomes compared to M-THA, with little to no experience required to achieve peak proficiency. A modest learning curve (12-17 cases) was associated with operative time, which was elevated compared to M-THA (+ 9-13 min). RA-THA offers immediate advantages to M-THA for component placement accuracy and radiographic outcomes. Surgeons should expect to experience increased operative times, which become less pronounced or equivalent to M-THA after a modest caseload.


Assuntos
Artroplastia de Quadril , Procedimentos Cirúrgicos Robóticos , Cirurgia Assistida por Computador , Humanos , Artroplastia de Quadril/métodos , Curva de Aprendizado , Procedimentos Cirúrgicos Robóticos/métodos , Acetábulo/diagnóstico por imagem , Acetábulo/cirurgia , Cirurgia Assistida por Computador/métodos
4.
BMJ Open Ophthalmol ; 9(1)2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38575345

RESUMO

OBJECTIVE: Preclinical validation study to assess the feasibility and accuracy of electromagnetic image-guided systems (EM-IGS) in orbital surgery using high-fidelity physical orbital anatomy simulators. METHODS: EM-IGS platform, clinical software, navigation instruments and reference system (StealthStation S8, Medtronic) were evaluated in a mock operating theatre at the Royal Victoria Eye and Ear Hospital, a tertiary academic hospital in Dublin, Ireland. Five high-resolution 3D-printed model skulls were created using CT scans of five anonymised patients with an orbital tumour that previously had a successful orbital biopsy or excision. The ability of ophthalmic surgeons to achieve satisfactory system registration in each model was assessed. Subsequently, navigational accuracy was recorded using defined anatomical landmarks as ground truth. Qualitative feedback on the system was also attained. RESULTS: Three independent surgeons participated in the study, one junior trainee, one fellow and one consultant. Across models, more senior participants were able to achieve a smaller system-generated registration error in a fewer number of attempts. When assessing navigational accuracy, submillimetre accuracy was achieved for the majority of points (16 landmarks per model, per participant). Qualitative surgeon feedback suggested acceptability of the technology, although interference from mobile phones near the operative field was noted. CONCLUSION: This study suggests the feasibility and accuracy of EM-IGS in a preclinical validation study for orbital surgery using patient specific 3D-printed skulls. This preclinical study provides the foundation for clinical studies to explore the safety and effectiveness of this technology.


Assuntos
Cirurgia Assistida por Computador , Humanos , Órbita/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Software , Fenômenos Eletromagnéticos
5.
Sci Rep ; 14(1): 8332, 2024 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-38594498

RESUMO

Augmented reality (AR) has been used for navigation during total hip arthroplasty (THA). AR computed tomography (CT)-based navigation systems and AR-based portable navigation systems that use smartphones can also be used. This study compared the accuracy of cup insertion during THA using AR-CT-based and portable AR-based navigation systems. Patients with symptomatic hip disease who underwent primary THA in the supine position using both AR CT-based and portable AR-based navigation systems simultaneously between October 2021 and July 2023 were included. The primary outcome of this study was the absolute difference between cup angles in the intraoperative navigation record and those measured on postoperative CT. The secondary outcome was to determine the factors affecting the absolute value of the navigation error in radiographic inclination (RI) and radiographic anteversion (RA) of the cup, including sex, age, body mass index, left or right side, approach, and preoperative pelvic tilt. This study included 94 consecutive patients. There were 11 men and 83 women, with a mean age of 68 years. The mean absolute errors of RI were 2.7° ± 2.0° in the AR CT-based and 3.3° ± 2.4° in the portable AR-based navigation system. The mean absolute errors of RA were 2.5° ± 2.1° in the AR CT-based navigation system and 2.3° ± 2.2° in the portable AR-based navigation system. No significant differences were observed in RI or RA of the cup between the two navigation systems (RI: p = 0.706; RA: p = 0.329). No significant factors affected the absolute value of the navigation errors in RI and RA. In conclusion, there were no differences in the accuracy of cup insertion between the AR CT-based and portable AR-based navigation systems.


Assuntos
Artroplastia de Quadril , Realidade Aumentada , Prótese de Quadril , Cirurgia Assistida por Computador , Masculino , Humanos , Feminino , Idoso , Artroplastia de Quadril/métodos , Tomografia Computadorizada por Raios X , Cirurgia Assistida por Computador/métodos , Acetábulo/cirurgia
6.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 43(2): 91-99, Mar-Abr. 2024. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-231818

RESUMO

IntroducciónAnte el aumento constante de la demanda asistencial de exploraciones relacionadas con cirugía radioguiada (CRG), nuestro hospital adoptó incluir en el equipo de CRG nuevos perfiles profesionales con el fin de reducir parcialmente el tiempo de dedicación de los médicos nucleares a esta tarea.Objetivos: Analizar el proceso de incorporación de los perfiles de Técnico Superior en Imagen para el Diagnóstico (TSID) y Enfermera Referente de Ganglio Centinela (ERGC), evaluando su despliegue en los procedimientos ligados a la técnica. Material y métodos: Análisis de la actividad de CRG durante el periodo 2018-2022, centrándolo en los procedimientos prequirúrgicos y quirúrgicos relativos a cáncer de mama (CaM) y melanoma maligno (MM), por ser aquellas patologías en las que se concentró la transferencia de competencias asistenciales. Evolución cronológica de las competencias asumidas por los diferentes perfiles durante su integración en el equipo de CRG. Resultados: La actividad asistencial de CRG durante el periodo analizado experimentó un incremento del 109%. CaM y MM son las patologías que aglutinaron con diferencia una mayor demanda asistencial. La transferencia de competencias en estas dos patologías se ha producido de manera progresiva, asumiendo en 2022 el 74% (460/622) de la fase de administración el ERGC y el 64% (333/519) de las cirugías el TSID. Conclusiones: La creación de un equipo multidisciplinar de CRG, que incluye distintos perfiles profesionales (MN, ERGC y TSID), es una eficaz estrategia para dar respuesta al incremento de la complejidad y número de todos los procedimientos relacionados con la CRG.(AU)


Introduction: Given the constant increase in the healthcare demand for examinations related to radio-guided surgery (RGS), our hospital adopted new professional profiles in the RGS team, in order to partially reduce the time spent by nuclear medicine physicians on this task. Aim: To analyze the process of incorporating the profiles of Superior Diagnostic Imaging Technician (TSID) and Sentinel Node Referent Nurse (ERGC), evaluating their deployment in the procedures linked to the technique. Material and methods: Analysis of RGS activity during the period 2018-2022, focusing on pre-surgical and surgical procedures related to breast cancer (BC) and malignant melanoma (MM), as they are those pathologies on which the transfer of care competencies was concentrated. Chronological evolution of the competencies assumed by the different profiles during their integration into the RGS team. Results: RGS's healthcare activity during the analyzed period experienced an increase of 109%. BC and MM were the pathologies that accounted for by far the greatest demand for care. The transfer of competencies in these two pathologies occurred in a progressive and staggered manner, with 74% (460/622) of the administration phase being carried out by the ERGC and 64% (333/519) of the surgeries by the TSID in 2022. Conclusions: The creation of a multidisciplinary RGS team that includes different professional profiles (NM, ERGC and TSID) is an effective strategy to respond to the increase in the complexity and number of all procedures related to RGS.(AU)


Assuntos
Humanos , Masculino , Feminino , Linfocintigrafia , Linfonodo Sentinela/diagnóstico por imagem , Biópsia de Linfonodo Sentinela , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Cirurgia Assistida por Computador , Medicina Nuclear , Imagem Molecular , Estudos Retrospectivos
7.
Sensors (Basel) ; 24(5)2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38475148

RESUMO

Ensuring precise angle measurement during surgical correction of orientation-related deformities is crucial for optimal postoperative outcomes, yet there is a lack of an ideal commercial solution. Current measurement sensors and instrumentation have limitations that make their use context-specific, demanding a methodical evaluation of the field. A systematic review was carried out in March 2023. Studies reporting technologies and validation methods for intraoperative angular measurement of anatomical structures were analyzed. A total of 32 studies were included, 17 focused on image-based technologies (6 fluoroscopy, 4 camera-based tracking, and 7 CT-based), while 15 explored non-image-based technologies (6 manual instruments and 9 inertial sensor-based instruments). Image-based technologies offer better accuracy and 3D capabilities but pose challenges like additional equipment, increased radiation exposure, time, and cost. Non-image-based technologies are cost-effective but may be influenced by the surgeon's perception and require careful calibration. Nevertheless, the choice of the proper technology should take into consideration the influence of the expected error in the surgery, surgery type, and radiation dose limit. This comprehensive review serves as a valuable guide for surgeons seeking precise angle measurements intraoperatively. It not only explores the performance and application of existing technologies but also aids in the future development of innovative solutions.


Assuntos
Cirurgia Assistida por Computador , Cirurgia Assistida por Computador/métodos , Fluoroscopia/métodos
8.
BMC Med Imaging ; 24(1): 61, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38481130

RESUMO

OBJECTIVE: The paper aimed to improve the accuracy limitations of traditional two-dimensional ultrasound and surgical procedures in the diagnosis and management of congenital heart disease (chd), and to improve the diagnostic and therapeutic level of chd. METHOD: This article first collected patient data through real-time imaging and body surface probes, and then diagnosed 150 patients using three-dimensional echocardiography. In order to verify the effectiveness of the combination therapy, 60 confirmed patients were divided into a control group and an experimental group. The control group received conventional two-dimensional ultrasound and surgical treatment, while the experimental group received three-dimensional ultrasound and image guided surgical treatment. RESULT: In the second diagnosis, the diagnostic accuracy of type 1, type 2, and type 3 in the control group was 84.21%, 84.02%, and 83.38%, respectively. The diagnostic accuracy rates of type 1, type 2, and type 3 in the experimental group were 92.73%, 92.82%, and 92.83%, respectively. In the control group, 2 males and 1 female experienced heart failure after surgery. However, in the experimental group, 0 males and 0 females experienced heart failure after surgery. CONCLUSION: The combination of three-dimensional echocardiography and image guided surgery can improve diagnostic accuracy and surgical treatment effectiveness, thereby reducing risks and complications, and improving surgical success rate.


Assuntos
Ecocardiografia Tridimensional , Cardiopatias Congênitas , Insuficiência Cardíaca , Cirurgia Assistida por Computador , Masculino , Humanos , Feminino , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/cirurgia , Ecocardiografia Tridimensional/métodos , Ultrassonografia
9.
Int J Med Robot ; 20(2): e2627, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38523327

RESUMO

BACKGROUND: The aim of this scoping review was to understand the development of robotics and its accuracy in placing dental implants when compared to other forms of guided surgery. METHODS: An electronic search was conducted on the electronic databases of PubMed, Cochrane, and Science direct with the following queries: ((robotics) AND (dental implant)) AND (accuracy). The search timeline was between 2017 and 2022. RESULTS: A total of 54 articles were screened for title and abstract, of which 16 were deemed eligible for inclusion. Thirty-one articles were excluded mainly because they were out of topic (not relevant) or not in English. In total, 16 articles were included for analysis. CONCLUSIONS: This review thoroughly analyses 5 years of literature concerning the evolution of robotics in dental implant surgery, underscoring the necessity for additional research on nascent technologies reported and a comparative study with static and dynamic systems for clinical efficacy evaluation.


Assuntos
Implantes Dentários , Robótica , Cirurgia Assistida por Computador , Humanos , Resultado do Tratamento , Bases de Dados Factuais , Implantação Dentária Endóssea , Desenho Assistido por Computador , Imageamento Tridimensional , Tomografia Computadorizada de Feixe Cônico
10.
PLoS One ; 19(3): e0299273, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38452128

RESUMO

PURPOSE: This study aims to evaluate the efficacy and satisfaction of using a multi-angle laser device (MLD) for C-arm fluoroscopy to assist novice learners during lumbar spine surgery. METHODS: Forty novice learners were randomly assigned to Group A using an MLD-equipped C-arm or Group B using a traditional C-arm. Both groups performed X-ray fluoroscopy on a lumbar spine model in supine and rotated positions. Time, number of shots, and deviation from the target were compared. A questionnaire was used to assess the learning experience. RESULTS: Group A required less time (13.66 vs. 25.63 min), and fewer shots (15.05 vs. 32.50), and had a smaller deviation (22.9% vs. 61.5%) than Group B (all p<0.05). The questionnaire revealed higher scores in Group A for comfort, efficiency, and knowledge mastery (all p<0.05). CONCLUSION: The MLD significantly improves novice learning of C-arm fluoroscopy during lumbar spine surgery.


Assuntos
Vértebras Lombares , Cirurgia Assistida por Computador , Fluoroscopia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Inquéritos e Questionários , Humanos
11.
BMC Res Notes ; 17(1): 80, 2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38500215

RESUMO

A technique for the design of a hybrid tooth and bone-supported implant drilling guide is described. The patient was scanned using cone beam computed tomography and an optical intraoral scanner. The dicom file was segmented according to the area of interest composed of bone and the remaining natural teeth. The Standard Tessellation Language (STL) file was trimmed to only the teeth providing support, followed by merging between the bone and teeth files in one STL. The implant drilling guide was designed with the Real Guide software program, and the file was 3-dimensionally printed in clear surgical guide resin. This technique offers an accurate, cost-effective digitally designed implant placement guide for patients with long-span distal extension edentulous areas and few remaining natural dentitions providing distal bone support. It can also be used in patients with hemi maxillectomy for zygomatic implant placement. This type of surgical guide provides more accuracy in implant surgeries that require flab elevation by gaining more support from the remaining natural dentition.


Assuntos
Implantes Dentários , Cirurgia Assistida por Computador , Humanos , Desenho Assistido por Computador , Imageamento Tridimensional , Tomografia Computadorizada de Feixe Cônico , Software
12.
Int J Implant Dent ; 10(1): 14, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38507139

RESUMO

PURPOSE: To comprehensively assess the existing literature regarding the rapidly evolving in vivo application of magnetic resonance imaging (MRI) for potential applications, benefits, and challenges in dental implant surgery. METHODS: Electronic and manual searches were conducted in PubMed MEDLINE, EMBASE, Biosis, and Cochrane databases by two reviewers following the PICOS search strategy. This involved using medical subject headings (MeSH) terms, keywords, and their combinations. RESULTS: Sixteen studies were included in this systematic review. Of the 16, nine studies focused on preoperative planning and follow-up phases, four evaluated image-guided implant surgery, while three examined artifact reduction techniques. The current literature highlights several MRI protocols that have recently investigated and evaluated the in vivo feasibility and accuracy, focusing on its potential to provide surgically relevant quantitative and qualitative parameters in the assessment of osseointegration, peri-implant soft tissues, surrounding anatomical structures, reduction of artifacts caused by dental implants, and geometric accuracy relevant to implant placement. Black Bone and MSVAT-SPACE MRI, acquired within a short time, demonstrate improved hard and soft tissue resolution and offer high sensitivity in detecting pathological changes, making them a valuable alternative in targeted cases where CBCT is insufficient. Given the data heterogeneity, a meta-analysis was not possible. CONCLUSIONS: The results of this systematic review highlight the potential of dental MRI, within its indications and limitations, to provide perioperative surgically relevant parameters for accurate placement of dental implants.


Assuntos
Implantes Dentários , Cirurgia Assistida por Computador , Implantação Dentária Endóssea/métodos , Osseointegração , Imageamento por Ressonância Magnética
13.
BMC Oral Health ; 24(1): 359, 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38509530

RESUMO

This systematic review explores the accuracy of computerized guided implant placement including computer-aided static, dynamic, and robot-assisted surgery. An electronic search up to February 28, 2023, was conducted using the PubMed, Embase, and Scopus databases using the search terms "surgery", "computer-assisted", "dynamic computer-assisted", "robotic surgical procedures", and "dental implants". The outcome variables were discrepancies including the implant's 3D-coronal, -apical and -angular deviations. Articles were selectively retrieved according to the inclusion and exclusion criteria, and the data were quantitatively meta-analysed to verify the study outcomes. Sixty-seven articles were finally identified and included for analysis. The accuracy comparison revealed an overall mean deviation at the entry point of 1.11 mm (95% CI: 1.02-1.19), and 1.40 mm (95% CI: 1.31-1.49) at the apex, and the angulation was 3.51˚ (95% CI: 3.27-3.75). Amongst computerized guided implant placements, the robotic system tended to show the lowest deviation (0.81 mm in coronal deviation, 0.77 mm in apical deviation, and 1.71˚ in angular deviation). No significant differences were found between the arch type and flap operation in cases of dynamic navigation. The fully-guided protocol demonstrated a significantly higher level of accuracy compared to the pilot-guided protocol, but did not show any significant difference when compared to the partially guided protocol. The use of computerized technology clinically affirms that operators can accurately place implants in three directions. Several studies agree that a fully guided protocol is the gold standard in clinical practice.


Assuntos
Implantes Dentários , Procedimentos Cirúrgicos Robóticos , Cirurgia Assistida por Computador , Humanos , Implantação Dentária Endóssea/métodos , Computadores , Desenho Assistido por Computador , Tomografia Computadorizada de Feixe Cônico , Imageamento Tridimensional
14.
Int J Med Robot ; 20(1): e2608, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38536715

RESUMO

Sinaflex robotic telesurgery system has been introduced recently to provide ergonomic postures for the surgeon along with dexterous workspace for robotic telesurgery. The robot is described, and the forward and inverse kinematics are derived and validated by an experiment. The robot and operational workspaces and their dexterity are investigated and compared using the data collected during a dog vasectomy robotic telesurgery by Sinaflex. According to the simulation results, the workspace of the end effector is as large as 914.56 × 105 mm3, which can completely cover the ergonomic human hand workspace. The dexterity of the robot for the total and operational workspace is 0.4557 and 0.6565, respectively. In terms of the workspace size and the amount of dexterity, Sinaflex master robot can be considered a good choice to fulfil the requirements of the surgeon side robot in robotic telesurgery systems.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Cirurgiões , Cirurgia Assistida por Computador , Humanos , Animais , Cães , Cirurgia Assistida por Computador/métodos , Mãos
15.
Int J Comput Assist Radiol Surg ; 19(4): 723-733, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38492147

RESUMO

PURPOSE: For tumor resection, surgeons need to localize the tumor. For this purpose, a magnetic seed can be inserted into the tumor by a radiologist and, during surgery, a magnetic detection probe informs the distance to the seed for localization. In this case, the surgeon still needs to mentally reconstruct the position of the tumor from the probe's information. The purpose of this study is to develop and assess a method for 3D localization and visualization of the seed, facilitating the localization of the tumor. METHODS: We propose a method for 3D localization of the magnetic seed by extending the magnetic detection probe with a tracking-based localization. We attach a position sensor (QR-code or optical marker) to the probe in order to track its 3D pose (respectively, using a head-mounted display with a camera or optical tracker). Following an acquisition protocol, the 3D probe tip and seed position are subsequently obtained by solving a system of equations based on the distances and the 3D probe poses. RESULTS: The method was evaluated with an optical tracking system. An experimental setup using QR-code tracking (resp. using an optical marker) achieves an average of 1.6 mm (resp. 0.8 mm) 3D distance between the localized seed and the ground truth. Using a breast phantom setup, the average 3D distance is 4.7 mm with a QR-code and 2.1 mm with an optical marker. CONCLUSION: Tracking the magnetic detection probe allows 3D localization of a magnetic seed, which opens doors for augmented reality target visualization during surgery. Such an approach should enhance the perception of the localized region of interest during the intervention, especially for breast tumor resection where magnetic seeds can already be used in the protocol.


Assuntos
Realidade Aumentada , Neoplasias , Cirurgia Assistida por Computador , Humanos , Imagens de Fantasmas , Fenômenos Magnéticos , Cirurgia Assistida por Computador/métodos
16.
No Shinkei Geka ; 52(2): 248-253, 2024 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-38514113

RESUMO

Recently, three-dimensional(3D)holograms from mixed-reality(MR)devices have become available in the medical field. 3D holographic images can provide immersive and intuitive information that has been reported to be very useful for preoperative simulations. Compared with conventional 3D images on a two-dimensional(2D)monitor, 3D holograms offer a higher level of realism, allowing observation of the images anytime and anywhere if the MR device is operational. Even during surgery, surgeons can check realistic 3D holograms in front of them, above the surgical field, without having to turn their heads toward a 2D monitor on the wall. 3D holograms can also be used for neuronavigation if the hologram is tracked to the patient's real head. This method can be defined as 3D augmented reality(AR)navigation, which shows a hologram of a target, such as a tumor or aneurysm, inside the head and brain. In the future, interventions using these techniques with 3D holograms from MR devices are expected to evolve and develop new types of treatments for endoscopic surgery or fluoroscopy-guided endovascular surgery.


Assuntos
Realidade Aumentada , Holografia , Cirurgia Assistida por Computador , Humanos , Cirurgia Assistida por Computador/métodos , Neuronavegação/métodos , Imageamento Tridimensional/métodos , Holografia/métodos
17.
Clin Exp Dent Res ; 10(2): e878, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-38506282

RESUMO

OBJECTIVES: Guided implant systems can be used as a training approach for placing implants. This in vitro prospective randomized pilot study evaluated the learning progression and skill development in freehand placement of two implants supporting a three-unit fixed prosthesis on a simulation model among novice operators. MATERIAL AND METHODS: Four senior dental students with no prior implant placement experience participated in the study. As a baseline, each student placed two mandibular and two maxillary implants by freehand technique on a simulation model. Sixteen consecutive guided placements using a static guide, dynamic navigation, and template-based guide followed totaling 32 guided implant placements into maxillary and mandibular models. Freehand implant placements before and after the various guided navigation attempts were compared to assess their impact on freehand skill. Metrics compared included surgical time, horizontal, vertical, and angulation discrepancies between the planned and placed implant positions measured on superimposed CBCT scans and analyzed with repeated measures regression with Tukey's adjusted pairwise comparisons (α = .05). RESULTS: Before training with guided techniques, the average baseline freehand implant placement took 10.2 min and decreased to 8.2 after training but this difference was not statistically significant (p = .1670) There was marginal evidence of a significant difference in the 3D apex deviation with an average improvement of 0.89 mm (95% CI: -0.38, 2.16, p = .1120); and marginal evidence of a significant improvement in the overall angle with an average improvement of 3.74° (95% CI: -1.00, 8.48, p = .0869) between baseline and final freehand placement attempts. CONCLUSIONS: Within the limitations of this pilot study, guided implant placement experiences did not significantly benefit or hinder freehand placement skills. Dental students should be exposed to various placement techniques to prepare them for clinical practice and allow them to make informed decisions on the best technique based on their skills and a given clinical scenario.


Assuntos
Implantes Dentários , Cirurgia Assistida por Computador , Humanos , Projetos Piloto , Estudos Prospectivos , Implantação Dentária Endóssea/métodos
19.
Prim Dent J ; 13(1): 64-73, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38424692

RESUMO

AIM: This paper provides a comprehensive review of the established concepts and newer developments related to computer-assisted implant rehabilitation. METHODS: Two independent researchers searched the English literature published to 31st December 2023 in the PubMed/Medline database for primary and secondary research and related publications on computer-assisted implant planning, computer-assisted implant placement and computer-assisted implant restoration. RESULTS: A total of 58,923 papers were identified, 198 relevant papers were read in full text and 110 studies were finally included. Computer-assisted implant rehabilitation was found to result in more precise implant positioning than freehand placement. Advantages include reduced trauma and surgery time; disadvantages include reduced primary implant stability and higher cost. CONCLUSION: Computer-assisted surgery is particularly indicated in cases of critical anatomy, but may encounter limitations in terms of cost, restricted mouth opening, visibility and adjustment of the surgical guides and the need for prior familiarisation with the procedure. Nonetheless, this surgical technique reduces the post-implant placement complication rate.


Assuntos
Implantes Dentários , Cirurgia Assistida por Computador , Humanos , Implantação Dentária Endóssea/métodos , Tomografia Computadorizada de Feixe Cônico , Computadores , Desenho Assistido por Computador
20.
J Orthop Surg (Hong Kong) ; 32(1): 10225536241243166, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38546214

RESUMO

Background: Over the last few decades, shoulder surgery has undergone rapid advancements, with ongoing exploration and the development of innovative technological approaches. In the coming years, technologies such as robot-assisted surgeries, virtual reality, artificial intelligence, patient-specific instrumentation, and different innovative perioperative and preoperative planning tools will continue to fuel a revolution in the medical field, thereby pushing it toward new frontiers and unprecedented advancements. In relation to this, shoulder surgery will experience significant breakthroughs. Main body: Recent advancements and technological innovations in the field were comprehensively analyzed. We aimed to provide a detailed overview of the current landscape, emphasizing the roles of technologies. Computer-assisted surgery utilizing robotic- or image-guided technologies is widely adopted in various orthopedic specialties. The most advanced components of computer-assisted surgery are navigation and robotic systems, with functions and applications that are continuously expanding. Surgical navigation requires a visual system that presents real-time positional data on surgical instruments or implants in relation to the target bone, displayed on a computer monitor. There are three primary categories of surgical planning that utilize navigation systems. The initial category involves volumetric images, such as ultrasound echogram, computed tomography, and magnetic resonance images. The second type is based on intraoperative fluoroscopic images, and the third type incorporates kinetic information about joints or morphometric data about the target bones acquired intraoperatively. Conclusion: The rapid integration of artificial intelligence and deep learning into the medical domain has a significant and transformative influence. Numerous studies utilizing deep learning-based diagnostics in orthopedics have remarkable achievements and performance.


Assuntos
Robótica , Cirurgia Assistida por Computador , Humanos , Inteligência Artificial , Ombro , Fluoroscopia
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