scholarly journals CT-guided robotic-assisted percutaneous interventions: first experience

2019 ◽  
pp. 27-35 ◽  
Author(s):  
I. A. Burovik ◽  
G. G. Prohorov ◽  
P. A. Lushina ◽  
A. V. Vasiliev ◽  
E. A. Degtiareva
Keyword(s):  
Robotic System ◽  
Technical Solution ◽  
Ct Scanner ◽  
Tumor Biopsy ◽  
Modern Approach ◽  
Ct Guided ◽  
Percutaneous Interventions ◽  
Percutaneous Procedures ◽  
Conventional Ct ◽  
Traditional Approaches

Computed tomography is an effective method of monitoring of percutaneous interventions. Conventional CT guidance and CT-fluoroscopy are used most frequently for proce dure monitoring. Image-guided robotic needle positioning is an alternative and relatively modern approach for interventional procedures.Purpose: to demonstrate convenience, effectiveness and safety of robotic system for CT-guided interventions.Materials and methods. CT-guided percutaneous interventions were performed in FSBI “N.N. Petrov NMRC of Oncology” Ministry of Healthcare of The Russian Federation using the Philips Ingenuity CT scanner and Maxio Perfint robotic system. This article presents clinical observations of adrenal tumor biopsy and cryoablation of a renal cell carcinoma. For cryoablation the Medical Cryotherapeutic System was used.Results. The robotic system for CT-guided interventions allowed to perform corresponding surgical procedures.Conclusions. The Maxio robotic console seems to be a promising technical solution for CT-guided interventions. Evaluation of the effectiveness of the robotic and traditional approaches of CT control in percutaneous procedures requires further investigations and analysis on larger data sample in longer periods of observation.

scholarly journals A new robotic system for CT-guided percutaneous procedures with haptic feedback

2004 ◽  
Vol 1268 ◽  
pp. 515-520 ◽  
Author(s):  
B Maurin ◽  
O Piccin ◽  
B Bayle ◽  
J Gangloff ◽  
M de Mathelin ◽  
...  
Keyword(s):  
Haptic Feedback ◽  
Robotic System ◽  
Ct Guided ◽  
Percutaneous Procedures

Clinical evaluation of a robotic system for precise CT-guided percutaneous procedures

2021 ◽  
Author(s):  
Shiran Levy ◽  
S. Nahum Goldberg ◽  
Ido Roth ◽  
Moran Shochat ◽  
Jacob Sosna ◽  
...  
Keyword(s):  
Clinical Evaluation ◽  
Robotic System ◽  
Ct Guided ◽  
Percutaneous Procedures

scholarly journals Place and Possibilities of the Robotic System Lokomat in the Rehabilitation of Patients After Ischemic Stroke

2019 ◽  
Vol 12 (1) ◽  
pp. 131-140
Author(s):  
Medvedev I. N.
Keyword(s):  
Ischemic Stroke ◽  
Robotic System ◽  
The Body ◽  
High Tech ◽  
Comprehensive Treatment ◽  
Common Disease ◽  
Main Task ◽  
Early Recovery ◽  
Modern Approach ◽  
Post Stroke

Ischemic stroke is still a very common disease with quite serious consequences. Modern medicine considers in this regard its main task in the curation of such patients, the maximum possible restoration of the functions of the affected brain and the volume of its control over the body. Due to the rapid development of medicine associated with the emergence of innovative technologies in the field of rehabilitation, hardware methods of rehabilitation today have gone far ahead and have in their arsenal a lot of high-tech tools. For this purpose, a search is being made for means of increasing the activity of brain cells located in the affected area. Of particular importance in this regard are the methods of rehabilitation in the early recovery period after ischemic stroke using robotic methods of mechanotherapy, one of which is the use of the Lokomat system. Among them, a prominent place is occupied by the walking training system - Lokomat, consisting of robotic orthoses and a body support device, which are combined with a treadmill. Information about the successful use of Lokomat during the rehabilitation of patients with movement disorders is still scattered, and this required their generalization and understanding. The main advantage of this system is the ability to effectively control and ensure high intensity, repeatability (reproducibility) and purposefulness of the trained movements. The convincing advantages of automated training on the Lokomat system compared to traditional rehabilitation in terms of various clinical indicators in patients with post-stroke hemiparesis have been identified. It was shown that in patients trained on the Lokomat system, a single support on the paretic leg intensified, which contributed to a more symmetrical gait. This system is more than other devices and technologies designed for learning to walk, in line with the modern approach to the restoration of impaired motor functions. The inclusion of training sessions on the Lokomat robotic system in the comprehensive treatment of patients with post-stroke hemiparesis leads to a marked improvement in movement skills. This is associated with a pronounced restructuring against the background of its use of the motor stereotype of walking, which makes it possible to increase the effectiveness of recreational activities in post-stroke patients.

The Role of 3D Reconstruction True-Volume Analysis in Osteochondral Lesions of the Talus: A Case Series

2018 ◽  
Vol 39 (9) ◽  
pp. 1113-1119 ◽  
Author(s):  
Kempland C. Walley ◽  
Tyler A. Gonzalez ◽  
Ryan Callahan ◽  
Aubree Fairfull ◽  
Evan Roush ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Case Series ◽  
Osteochondral Lesions ◽  
Ct Reconstruction ◽  
Ct Scanner ◽  
Level Of Evidence ◽  
Volume Analysis ◽  
Orthopedic Surgeons ◽  
Reconstructive Analysis ◽  
Conventional Ct

Background: Evaluation and management of osteochondral lesions of the talus (OLTs) often warrant advanced imaging studies, especially in revision or cases with cystic defects. It is possible that orthopedic surgeons may overestimate the size and misinterpret the morphology of OLT from conventional computed tomography (CT), thereby influencing treatment strategies. The purpose of this study was to determine the utility of a novel means to estimate the true-volume of OLTs using 3D reconstructed images and volume analysis. Methods: With Institutional Review Board approval, an institutional radiology database was queried for patients with cystic OLTs that failed previous microfracture, having compatible CT scans and magnetic resonance imaging (MRI) between 2011 and 2016. Fourteen patients met inclusion criteria. Of these, 5 cases were randomly selected for 3D CT reconstruction modeling. Ten orthopedic surgeons independently estimated the volume of these 5 OLTs via standard CT. Then 3D reconstructions were made and morphometric true-volume (MTV) analysis measurements of each OLT were generated. The percent change in volumes from CT were compared to MTVs determined from 3D reconstructive analysis. Results: On average, the volume calculated by conventional CT scanner grossly overestimated the actual size of the OLTs. The volume calculated on conventional CT scanner overestimated the size of OLTs compared to the 3D MTV reconstructed analysis by 285% to 864%. Conclusions: Our results showed that conventional measurements of OLTS with CT grossly overestimated the size of the lesion. The 3D MTV analysis of cystic osteochondral lesions may help clinicians with preoperative planning for graft selection and appropriate volume while avoiding unnecessary costs incurred with overestimation. Level of Evidence: Level IV, case series.

scholarly journals The Role of 3D Reconstruction True Volume Analysis in Osteochondral Lesions of the Talus

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0012
Author(s):  
Kempland Walley ◽  
Tyler Gonzalez ◽  
Evan Roush ◽  
Kaitlin Saloky ◽  
Ryan Callahan ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Cartilage Damage ◽  
Ct Scans ◽  
Osteochondral Lesions ◽  
Ct Scanner ◽  
3D Reconstructions ◽  
Volume Analysis ◽  
Orthopedic Surgeons ◽  
Damage Stability ◽  
Conventional Ct

Category: Other Introduction/Purpose: Evaluation and management of osteochondral lesions of the talus (OLTs) often warrant advanced imaging studies such as CT and/or MRI. While MRI has its advantages in determining the degree of cartilage damage, stability of the fragment and edema, CT imaging is better delineates the osseous anatomy and extent of the lesion. The latter imaging modality offers increasing acuity and resolution in characterizing the complex osteochondral landscape via three-dimensional (3D) reconstructions. It is possible that orthopedic surgeons may overestimate the size and misinterpret the morphology of OLT from conventional MRI and CT thereby influencing treatment strategies. The purpose of this study is to determine the utility of a novel means to estimate the true-volume of OLTs using 3D reconstructed images and volume analysis. Methods: After IRB approval, an institutional radiology database was queried for patients with OLTs and compatible CT scans between 2011 and 2016. Fourteen patients were found to have OLT compatible with the software used to approximate true-volumes of 3D reconstructed images. 3D reconstructions were created using Mimics software (Materialise, Belgium). From the 14 reconstructed OLTs, 5 were randomly selected for evaluation. 10 orthopedic surgeons independently estimated the volume of these 5 OLTs via standard CT scans. Then 3D reconstructions were made and true-volume (TV) analysis measurements of each OLT were generated. The percent change in volumes from CT were compared to TVs determined from 3D reconstructive analysis. Results: On average the volume calculated by conventional CT scanner grossly overestimated the actual size of the OLTs. The volume calculated on conventional CT scanner overestimated the size of OLTs compared to the 3D TV reconstructed analysis by 285-864%. Conclusion: Our results show that conventional measurements of OLTS with CT grossly overestimates the size of the lesion by up to 8-times the actual lesion size. This overestimation of volumes of the lesion can drastically change surgical planning and may lead to unnecessary costs associated with specific surgical treatments. With the use of our newly defined model for volume measurement in OLTs, we can more accurately predict the exact size of the OLT. This can better guide surgeons to choices both the correct cartilage restoring procedure as well as the need for bone grafting.

From conventional CT to cone-beam CT-guided percutaneous biopsies: An institutional transition

2017 ◽  
Vol 28 (2) ◽  
pp. S110
Author(s):  
K Harper ◽  
H Al-Dujaili ◽  
B Mussari ◽  
A Nasirzadeh ◽  
A Menard
Keyword(s):  
Cone Beam Ct ◽  
Cone Beam ◽  
Ct Guided ◽  
Institutional Transition ◽  
Conventional Ct

scholarly journals CT-guided procedures: an initial experience

2018 ◽  
Vol 91 (4) ◽  
pp. 427-434
Author(s):  
Andrei Roman ◽  
Patriciu Achimas-Cadariu ◽  
Bogdan Fetica ◽  
Vlad Gata ◽  
Andrada Seicean
Keyword(s):  
Tension Pneumothorax ◽  
Lesion Size ◽  
Target Lesion ◽  
Seldinger Technique ◽  
Histopathological Diagnosis ◽  
Complication Rates ◽  
Ct Scanner ◽  
Ct Guided ◽  
Low Profile ◽  
Endoscopic Guidance

Background and aims. Despite their usefulness, CT-guided procedures have a low profile in Romania. The current study has the purpose of describing a first experience in performing these procedures.Methods. Tumors and fluid collections that were inaccessible for biopsy or drainage by ultrasound or endoscopic guidance were included. The procedures were performed using a 64-slice GE Optima CT660 CT scanner. The biopsies were carried out using the coaxial technique with an 18 G semiautomatic needle. The drainages were performed using 10 F pig-tail drains that were inserted using the Seldinger technique. Data regarding the size and location of the target lesion, puncture technique, success and complication rates were recorded.Results. Between May 2017 and April 2018, 30 procedures were performed, of which 26 biopsies and 4 drainage insertions. Of the biopsies 3 were mediastinal, 8 pulmonary, 6 retroperitoneal, 4 pelvic, and 5 of the bone. The drainages were performed for pelvic lymphoceles. The average lesion size was 3.2 cm (0.7-9 cm), with a depth from the skin of 9.1 cm (0.6-15.2 cm). The average procedure duration was 58 minutes (31-93 minutes). A conclusive histopathological diagnosis was set after 92.3% of biopsies. Three procedures resulted in complications, two being minor (hemothorax, soft tissue hematoma) and one severe (tension pneumothorax requiring drainage).Conclusions. CT guidance offers safe access to lesions that cannot be biopsied or drained under ultrasound or endoscopic guidance.

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.

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