A Novel Cable-driven based Puncture Robotic System for CT Guided Needle Position

2021 ◽  
Author(s):  
Haocheng Liu ◽  
Xinyi Huang ◽  
Jin Wang ◽  
Jing Guo ◽  
Shuting Cai ◽  
...  
Keyword(s):  
Robotic System ◽  
Ct Guided ◽  
Needle Position

scholarly journals Percutaneous Epidural Hydrogel Sealant for the Treatment of Spontaneous Intracranial Hypotension: A Case Report of Chronic Thoracic Neuralgia and Technical Lessons Learned

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Michael G. Hillegass ◽  
Samuel F. Luebbert ◽  
Maureen F. McClenahan
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension ◽  
Lessons Learned ◽  
Injection Velocity ◽  
Thoracic Spinal Cord ◽  
Ct Guided ◽  
Thoracic Spinal ◽  
Needle Position

We report a case in which a 34-year-old female with refractory intracranial hypotension headaches due to a spontaneous dural tear was ultimately treated with CT-guided transforaminal epidural placement of a synthetic absorbable sealant (DuraSeal®). The procedure successfully resolved her headaches; however she subsequently developed thoracic neuralgia presumably due to mass effect of the sealant material on the lower thoracic spinal cord and nerve roots. This case report describes the potential for significant spinal cord and nerve root compression as well as the development of chronic neuralgia with the placement of epidural hydrogel and fibrin glue sealants. Careful consideration should be taken into the needle gauge, needle position, injectate volumes, and injection velocity when delivering the sealant to the epidural space. Use of an 18-gauge Tuohy needle with a slow but steady injection pressure, constant patient feedback, and a conservative injectate volume (less than 2 ml per level) may best optimize sealant delivery to minimize the risk of spinal cord compression and neurologic injury.

Computed Tomography Guidance for Percutaneous Glycerol Rhizotomy for Trigeminal Neuralgia

2019 ◽  
Vol 19 (2) ◽  
pp. E117-E121
Author(s):  
Bradley T Schmidt ◽  
Conrad D Pun ◽  
Wendell B Lake ◽  
Daniel K Resnick
Keyword(s):  
Computed Tomography ◽  
Trigeminal Neuralgia ◽  
Radiation Exposure ◽  
Skull Base ◽  
Ct Guidance ◽  
Foramen Ovale ◽  
Ct Scanner ◽  
Ct Guided ◽  
Needle Position ◽  
Scout Image

Abstract Background Percutaneous glycerol rhizotomy (PGR) is a well-described treatment for trigeminal neuralgia; however, the technique in using surface landmarks and fluoroscopy has not drastically changed since being first introduced. In this paper, we describe a protocol for PGR using computed tomography (CT) guidance based on an experience of over 7 yr and 200 patients. Objective To introduce an approach for PGR using CT guidance and, in doing so, demonstrate possible benefits over the traditional fluoroscopic technique. Methods Using a standard CT scanner, patients are placed supine with head in extension. Barium paste and a CT scout image are used to identify and plan a trajectory to the foramen ovale. A laser localization system built into the CT scanner helps to guide placement of the spinal needle into the foramen ovale. The needle position in the foramen is confirmed with a short-sequence CT scan. Results CT-guided PGR provides multiple benefits over standard fluoroscopy, including improved visualization of the skull base and significant reduction in radiation exposure to the surgeon and staff. Side benefits include improved procedure efficiency, definitive imaging evidence of correct needle placement, and potentially increased patient safety. We have had no significant complications in over 200 patients. CONCLUSION CT-guided PGR is a useful technique for treating trigeminal neuralgia based on better imaging of the skull base, better efficiency of the procedure, and elimination of radiation exposure for the surgeon and staff compared to traditional fluoroscopic based techniques.

Design and validation of a CT-guided robotic system for lung cancer brachytherapy

2017 ◽  
Vol 44 (9) ◽  
pp. 4828-4837 ◽  
Author(s):  
Huaisu Dou ◽  
Shan Jiang ◽  
Zhiyong Yang ◽  
Luqing Sun ◽  
Xiaodong Ma ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Robotic System ◽  
Ct Guided

Evaluation of a CT-Guided Robotic System for Precise Percutaneous Needle Insertion

2018 ◽  
Vol 29 (10) ◽  
pp. 1440-1446 ◽  
Author(s):  
Eliel Ben-David ◽  
Moran Shochat ◽  
Ido Roth ◽  
Isaac Nissenbaum ◽  
Jacob Sosna ◽  
...  
Keyword(s):  
Needle Insertion ◽  
Robotic System ◽  
Ct Guided

Single-needle Celiac Plexus Block 

1997 ◽  
Vol 87 (6) ◽  
pp. 1301-1308 ◽  
Author(s):  
Marcello De Cicco ◽  
Mira Matovic ◽  
Luca Balestreri ◽  
Augusto Fracasso ◽  
Sandro Morassut ◽  
...  
Keyword(s):  
Pain Relief ◽  
Celiac Artery ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Ct Guided ◽  
Needle Position ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Plexus Block

Background The "single-needle" celiac plexus block is becoming a popular technique. Despite different approaches and methods used to place the needle, the success of the block depends on adequate spread of the injectate in the celiac area. In the present retrospective study, the influence of needle tip position in relation to the celiac artery on injectate spread was evaluated. Methods Among 138 cancer patients subjected, via an anterior approach, to computed tomography (CT)-guided single-needle neurolytic celiac plexus block, a radiologist, blinded to the aim of the study, retrospectively selected 53 cases with normal anatomy of the celiac area as judged by CT. The decision was based on images obtained before the block. Patients were then classified into either group A (29 patients), in whom the needle tip was caudad to the celiac artery, and group B (24 patients), in whom it was cephalad. To evaluate CT patterns of neurolytic (mixed with contrast) spread, the celiac area was divided on the frontal plane into four quadrants: upper right and left and lower right and left, as related to the celiac artery. Patient assessments by visual analog scale were reviewed to evaluate the degree of pain relief. Pain relief 30 days after block was judged as long-lasting. The patterns of contrast spread in relation to the needle position and pain relief according to the number of quadrants with contrast were analyzed. Results The percentage of cases with four quadrants with contrast was higher when the needle tip was cephalad (58%, group B) than when it was caudad (14%, group A) to the celiac artery (P < 0.01). The percentage of patients with four and three quadrants with contrast was also higher in group B at 79% than in group A at 38% (P < 0.01). A significant difference in long-lasting pain relief was observed between patients with four quadrants with contrast (18 of 18, 100%; 95% confidence interval [CI], 81-100%) and patients with three quadrants with contrast (5 of 12, 42%; 95% CI, 15-72%) (P < 0.01). No patients showing two or one quadrant with contrast had long-lasting pain relief. Conclusions These findings suggest that, when the celiac area is free from anatomic distortions, and the single-needle neurolytic celiac plexus block technique is used, the needle tip should be positioned cephalad to the celiac artery to achieve a wider neurolytic spread. It also appears that only a complete (four quadrants) neurolytic spread in the celiac area can guarantee long-lasting analgesia.

Preliminary clinical experience with a dedicated interventional robotic system for CT-guided biopsies of lung lesions: a comparison with the conventional manual technique

2014 ◽  
Vol 25 (5) ◽  
pp. 1310-1316 ◽  
Author(s):  
Michele Anzidei ◽  
Renato Argirò ◽  
Andrea Porfiri ◽  
Fabrizio Boni ◽  
Marco Anile ◽  
...  
Keyword(s):  
Clinical Experience ◽  
Robotic System ◽  
Ct Guided ◽  
Lung Lesions

scholarly journals Augmented reality simulator for CT-guided interventions

2021 ◽  
Author(s):  
D. Amiras ◽  
T. J. Hurkxkens ◽  
D. Figueroa ◽  
P. J Pratt ◽  
B. Pitrola ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Training Session ◽  
Virtual Patient ◽  
Face Validity ◽  
Ct Guided ◽  
Software Application ◽  
Training Tool ◽  
Head Mounted Display ◽  
Needle Position ◽  
Key Points

Abstract Introduction CT-guided interventions are taught using a mentored approach on real patients. It is well established that simulation is a valuable training tool in medicine. This project assessed the feasibility and acceptance of replicating a CT-guided intervention using a bespoke software application with an augmented reality head-mounted display (ARHMD). Methods A virtual patient was generated using a CT dataset obtained from The Cancer Imaging Archive. A surface mesh of a virtual patient was projected into the field-of-view of the operator. ChArUco markers, placed on both the needle and agar jelly phantom, were tracked using RGB cameras built into the ARHMD. A virtual CT slice simulating the needle position was generated on voice command. The application was trialled by senior interventional radiologists and trainee radiologists with a structured questionnaire evaluating face validity and technical aspects. Results Sixteen users trialled the application and feedback was received from all. Eleven felt the accuracy and realism was adequate for training and twelve felt more confident about their CT biopsy skills after this training session. Discussion The study showed the feasibility of simulating a CT-guided procedure with augmented reality and that this could be used as a training tool. Key Points • Simulating a CT-guided procedure using augmented reality is possible. • The simulator developed could be an effective training tool for clinical practical skills. • Complexity of cases can be tailored to address the training level demands.

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