Cutting Tool Protects for Soft Tissues in Bone-Milling Machining

2009 ◽  
Vol 3 (2) ◽  
pp. 185-192
Author(s):  
Naohiko Sugita ◽  
◽  
Taiga Nakano ◽  
Takayuki Osa ◽  
Yoshikazu Nakajima ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Orthopedic Surgery ◽  
Tissue Damage ◽  
Soft Tissues ◽  
Cutting Tool ◽  
Geometric Optimization ◽  
Protective Mechanism ◽  
Milling Machine ◽  
Surrounding Soft Tissue

Minimally invasive orthopedic surgery using a milling machine presents challenges. The milling machine we developed has a redundant axis to minimize cutting-tool contact with surrounding soft tissue. Important components are modeled based on physical requirements, and model-based geometric optimization improves performance. Here we discuss the protective mechanism, hardware, and software we developed to cover the nonworking cutting-edge portion and to protect against soft-tissue damage. We evaluated the effectiveness of this approach using cadaveric bone.

scholarly journals Less iatrogenic soft-tissue damage utilizing robotic-assisted total knee arthroplasty when compared with a manual approach

2019 ◽  
Vol 8 (10) ◽  
pp. 495-501 ◽  
Author(s):  
Emily L. Hampp ◽  
Nipun Sodhi ◽  
Laura Scholl ◽  
Matthew E. Deren ◽  
Zachary Yenna ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Tissue Damage ◽  
Soft Tissues ◽  
Soft Tissue Damage ◽  
Anatomical Structures ◽  
Cruciate Retaining ◽  
Robotic Assisted ◽  
Total Knee

Objectives The use of the haptically bounded saw blades in robotic-assisted total knee arthroplasty (RTKA) can potentially help to limit surrounding soft-tissue injuries. However, there are limited data characterizing these injuries for cruciate-retaining (CR) TKA with the use of this technique. The objective of this cadaver study was to compare the extent of soft-tissue damage sustained through a robotic-assisted, haptically guided TKA (RATKA) versus a manual TKA (MTKA) approach. Methods A total of 12 fresh-frozen pelvis-to-toe cadaver specimens were included. Four surgeons each prepared three RATKA and three MTKA specimens for cruciate-retaining TKAs. A RATKA was performed on one knee and a MTKA on the other. Postoperatively, two additional surgeons assessed and graded damage to 14 key anatomical structures in a blinded manner. Kruskal–Wallis hypothesis tests were performed to assess statistical differences in soft-tissue damage between RATKA and MTKA cases. Results Significantly less damage occurred to the PCLs in the RATKA versus the MTKA specimens (p < 0.001). RATKA specimens had non-significantly less damage to the deep medial collateral ligaments (p = 0.149), iliotibial bands (p = 0.580), poplitei (p = 0.248), and patellar ligaments (p = 0.317). The remaining anatomical structures had minimal soft-tissue damage in all MTKA and RATKA specimens. Conclusion The results of this study indicate that less soft-tissue damage may occur when utilizing RATKA compared with MTKA. These findings are likely due to the enhanced preoperative planning with the robotic software, the real-time intraoperative feedback, and the haptically bounded saw blade, all of which may help protect the surrounding soft tissues and ligaments. Cite this article: Bone Joint Res 2019;8:495–501. DOI: 10.1302/2046-3758.810.BJR-2019-0129.R1.

scholarly journals Ultrasound-guided removal of soft tissue foreign bodies in companion animals: A case series

2020 ◽  
Vol 65 (No. 2) ◽  
pp. 49-55
Author(s):  
S Manfredi ◽  
G Covi ◽  
M Bonazzi ◽  
G Gnudi ◽  
M Fumeo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Foreign Bodies ◽  
Soft Tissues ◽  
Companion Animals ◽  
Case Series ◽  
Invasive Technique ◽  
Surgical Removal ◽  
Small Animals ◽  
Ultrasound Guided

Foreign bodies (FBs) retained in the subcutaneous tissues are a common reason for medical consultation. In small animals, FBs usually consist of vegetal materials, especially grass awns. Failure to remove the FBs is likely to give rise to acute or late complications. The surgical removal of the FBs can be invasive, costly and technically challenging. Ultrasound has become a mainstay in the detection of FBs and it can be used to guide the extraction of the FBs with a minimally invasive technique. This study describes the detection and extraction of soft-tissue FBs in small animals. One hundred-sixty-two patients, presenting at two veterinary clinics with suspected FBs retained in the soft tissues of various body districts, were considered. Once an ultrasound diagnosis was established, the ultrasound-guided removal of the FB was performed. A high-frequency linear transducer, a skin disinfection, sedation or anaesthesia was used when needed and a scalpel and some Hartmann forceps were also used. One hundred-eighty-two FBs were successfully removed in all the patients. In six cases, the FB was identified during a second ultrasonographic examination, after recurrence of the fistula. No complications were reported after the procedure. The extraction of the FB was performed in an echographic suite in 138 cases and in a surgery room with surgical intervention in 24 cases. In the latter situation, the surgical minimally invasive dissection of tissues under ultrasound guidance was performed before the removal of the FB. In conclusion, the ultrasound-guided removal of the FBs retained in the superficial soft tissue can be considered a good alternative to surgery. However, failure to remove a FB does not preclude the removal by traditional surgery.

2A1-K08 Toolpath generation to protect soft tissue for minimally invasive orthopedic surgery

2009 ◽  
Vol 2009 (0) ◽  
pp. _2A1-K08_1-_2A1-K08_3
Author(s):  
Taiga NAKANO ◽  
Yusuke TORIGOE ◽  
Naohiko SUGITA ◽  
Yoshikazu NAKAJIMA ◽  
Takeharu KATO ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Orthopedic Surgery ◽  
Toolpath Generation

scholarly journals Interdisciplinary Management of Gummy Smile and Fluorosis – A Case Report

2021 ◽  
Vol 10 (9) ◽  
pp. 645-648
Author(s):  
Arun V. Mavely ◽  
Akanksha Mittal ◽  
Suman Basavaraju ◽  
Paras Mull Gehlot ◽  
Vinutha Manjunath
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Social Relations ◽  
Clinical Condition ◽  
Soft Tissues ◽  
Interdisciplinary Treatment ◽  
Treatment Modalities ◽  
Gingival Tissue ◽  
Interdisciplinary Management ◽  
Gummy Smile

An unpleasant smile can have a psychosocial effect leading to lack of self-esteem and a challenge in social relations. A perfect smile is a balance among 3 parameters: the white (teeth), the pink (gum) and the lips. A predictable smile correction warrants a multidisciplinary approach and good treatment planning. We planned for a minimally invasive interdisciplinary treatment approach for the restoration of a gummy smile with dental fluorosis in a young female patient. An interdisciplinary management of smile correction is crucial for successful results. Lasers for soft tissue management and minimal tooth preparation for direct composite veneer restorations being minimally invasive periodontal and restorative approaches were the key to success with exceptional patient satisfaction. Minimally invasive procedures in interdisciplinary dentistry should be embraced in the management of procedures requiring correction of both hard and soft tissues, for successful outcomes. Pre-treatment mock-up can build patients' confidence in dentistry and are useful tools for planning treatments with a predictable outcome. A beautiful smile is the fruit of a coordinated and balanced interplay between teeth, gingiva and lips. A compromise in any of these cornerstones can impair the beauty of a smile. Thorough knowledge and understanding about the various elements involved and their harmonious synchronisation makes smile makeovers a challenging task. One such challenge is the treatment of gummy smile. A gummy smile is a clinical condition that has gained tremendous focus and attention recently. Gummy smile is the excessive gingival display when a person smiles. It has been defined as a nonpathological condition causing aesthetic disharmony in which more than 3 mm of gingival tissue is exposed while smiling.1 Aetiology of a gummy smile can be multifactorial and the main factors being altered passive eruption (APE), vertical maxillary excess and upper lip hypermobility. The diagnosis must be accurate to deliver the appropriate line of treatment. Based on the complexity of the underlying aetiological factors involved, the treatment modalities also change from conservative approaches like aesthetic restorations and orthodontic tooth movements to periodontal and maxillofacial surgical procedures.2 Altered passive eruption (APE) also knows as “impaired passive eruption” is a clinical condition characterised by the coronally positioned marginal gingiva in relation to the cementoenamel junction (CEJ). Passive eruption is a physiological phase involved in the process of tooth eruption. As the teeth meet the occlusal plane, the soft tissue covering the teeth migrates apically till the CEJ is reached. Retardation in this process causes failure of the gingiva to migrate apically, resulting in short clinical crowns and excessive soft tissue exposure while smiling. This is visualised as a gummy smile.

scholarly journals A Novel Minimally Invasive Reduction Technique by Balloon and Distractor for Intra-Articular Calcaneal Fractures: A Report of 2 Cases

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
M. Prod’homme ◽  
S. Pour Jafar ◽  
P. Zogakis ◽  
P. Stutz
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Soft Tissues ◽  
Weight Bearing ◽  
Calcaneal Fracture ◽  
Invasive Technique ◽  
Calcaneal Fractures ◽  
Early Weight Bearing ◽  
Articular Fractures ◽  
Minimally Invasive Reduction

Treatment of displaced intra-articular fractures of the calcaneus remains a challenge for the orthopaedic surgeon. Conservative therapy is known to produce functional impairment. Surgical approach is plagued by soft-tissue complications and insufficient fracture reduction. We describe a minimally invasive technique that will hopefully improve these issues. We want to present our first experience through two cases. The first was a 46-year-old man who presented with a Sanders type IIBC calcaneal fracture, and the second was a 86-year-old woman with a type IIIBC calcaneal fracture. We introduced 2 Schanz screws in the talus and the calcaneus. After distraction, we introduced an inflatable balloon inside the calcaneus. By inflating the balloon, the articular surface was reduced by lifting it up. Then bone cement was injected in order to maintain the reduction. Additional screw fixation was used in the young patient. Postoperative imaging showed good congruence of the subtalar joint without leakage of cement, for the two cases. After 2 months, the patients had no pain and were without soft-tissue complications. We advocate this technique to perform a minimally invasive reduction and fixation of intra-articular calcaneal fractures because it preserves soft-tissues and provides good clinical results with early weight-bearing.

Interference Free Tool Path Generation in Multi-Axis Milling Machine for Orthopedic Surgery

2009 ◽  
Vol 3 (5) ◽  
pp. 514-522 ◽  
Author(s):  
Taiga Nakano ◽  
◽  
Naohiko Sugita ◽  
Takeharu Kato ◽  
Kazuo Fujiwara ◽  
...  
Keyword(s):  
Orthopedic Surgery ◽  
Tool Path ◽  
Soft Tissues ◽  
Cutting Tool ◽  
Force Sensor ◽  
Toolpath Generation ◽  
Novel Approach ◽  
Tool Interference ◽  
Definition Of ◽  
Milling Robot

Tool interference causes serious damage to surrounding soft tissue in minimally invasive orthopedic surgery with a milling robot. The objective of this study is to avoid the collision of cutting tool with complicated shapes, and a novel approach of interference-free toolpath generation in a short intraoperative time is proposed. In order to resolve this issue, we propose the following two methods: intraoperative modeling of soft tissues as an interference area and interference-free toolpath generation based on the model. A model is constructed to represent the opening area and the internal tissues by using a 3-dimensional optical position sensor to measure them. Based on the constructed model, interference-free toolpath is immediately determined by the preliminary definition of evacuating direction. The effectiveness of the proposed method is evaluated with artificial models on the system that the authors have developed so far. A tool contact force against the model was measured by a force sensor mounted on the cutting tool. The result revealed that the tool interference was greatly reduced by implementing the proposed method.

scholarly journals Soft tissue damage after minimally invasive THA

2010 ◽  
Vol 81 (6) ◽  
pp. 696-702 ◽  
Author(s):  
Jakob van Oldenrijk ◽  
Piet VJM Hoogland ◽  
Gabriëlle JM Tuijthof ◽  
Ruby Corveleijn ◽  
Tom WH Noordenbos ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Tissue Damage ◽  
Soft Tissue Damage
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