Öz
Amaç: Çalışmamızın amacı robotik cerrahinin kalça artroskopisinde kullanılıp kullanılamayacağını test etmekti.
Çalışma planı: Kalça artroskopisi taze dondurulmuş bir erkek insan kadavrasının iki kalça ekleminde denendi. Femur başı, femur boynu ve asetabular labrumun artroskopik kontrolü da Vinci Cerrahi Sistemi kullanılarak yapıldı.
Bulgular: Robotik sistemin yerleştirilişi ve cerrahi aletlerin manipülasyonu başarılıydı. Standart artroskopi ile ulaşılabilen çoğu alana robotik set ile de ulaşılmasına rağmen, aletin eklem yapan kısmının uzunluğu nedeniyle 5 mm’lik enstrümanlarda hareket kısıtlıydı. Daha kısa eklemli bölüme sahip olan 8 mm’lik enstrümanlar, eklem içerisinde tam bir hareket açıklığı sergiledi. Ekipmanın rijiditesi nedeniyle femur başının posterioru ile posteroinferior asetabular labrum izlenemedi.
Çıkarımlar: Robotik kalça artroskopisi kadavra modelinde uygulanabilir görünmekteyse de bazı önemli kısıtlamalara sahiptir. Büyük veya küçük eklemlerin robotik cerrahi ile artroskopisinin yapılması, özel aletlerin geliştirilmesi ile mümkün olabilir. Robotik cerrahi ile cerrahın dar alanlarda daha kompleks ve kusursuz işler yapmasına da olanak sağlanabilir.
Anahtar Kelimeler
da Vinci Cerrahi Sistemi; kalça artroskopisi; robotik cerrahi
Kaynakça
- Kelly BT, Williams RJ 3rd, Philippon MJ. Hip arthroscopy: current indications, treatment options, and management issues. Am J Sports Med 2003;31:1020-37.
- Burman M. Arthroscopy or the direct visualization of joints: an experimental cadaver study. J Bone Joint Surg Am 1931;13:669-95.
- Takagi K. The arthroscope: the second report. J Japanese Orthop Assoc 1939;14:441-66.
- Johnson LL. Diagnostic and surgical arthroscopy. Clin Symp 1982;34:2-32.
- Nord RM, Meislin RJ. Hip arthroscopy in adults. Bull NYU Hosp Jt Dis 2010;68:97-102.
- Iranmanesh P, Morel P, Wagner OJ, Inan I, Pugin F, Hagen ME. Set-up and docking of the da Vinci surgical system: prospective analysis of initial experience. Int J Med Robot 2010;6:57-60.
- Jacobs S, Falk V. Pearls and pitfalls: lessons learned in endoscopic robotic surgery- the da Vinci experience. Heart Surg Forum 2001;4:307-10.
- Kather J, Hagen ME, Morel P, Fasel J, Markar S, Schueler M. Robotic hip arthroscopy in human anatomy. Int J Med Robot 2010;6:301-5.
- Bozkurt M, Apaydin N, Işik C, Bilgetekin YG, Acar HI, Elhan A. Robotic arthroscopic surgery: a new challenge in arthroscopic surgery Part-I: Robotic shoulder arthroscopy; a cadaveric feasibility study. Int J Med Robot 2011;7:496-500.
- Sackier JM, Wang Y. Robotically assisted laparoscopic surgery. From concept to development. Surg Endosc 1994;8:63-6.
Öz
Objective: The aim of this study was to test if robotic surgery can be used while performing hip arthroscopy.
Methods: Hip arthroscopy was performed on two hip joints of a fresh-frozen male human cadaver. The arthroscopic control of the femoral head and neck and acetabular labrum were evaluated using the da Vinci Surgical System.
Results: Docking of the robotic system and manipulation of the instruments were successful. Although most regions reached in standard arthroscopy were also reached with this robotic setting, the 5-mm instrument was limited in movement due to its long articulation section. The 8-mm instrument had shorter articulation section and exhibited a full range of motion inside the joints. The posterior part of the femoral head and the posteroinferior portion of the acetabular labrum could not be observed because of the rigidity of the equipment.
Conclusion: Robotic hip arthroscopy appears feasible in a cadaveric model but has some significant limitations. With the development of special instrumentations, arthroscopy of the large or small joints may be possible with robotic surgery. Robotic surgery may also enable surgeons to perform more complex and precise tasks in restricted spaces.
Anahtar Kelimeler
Kaynakça
- Kelly BT, Williams RJ 3rd, Philippon MJ. Hip arthroscopy: current indications, treatment options, and management issues. Am J Sports Med 2003;31:1020-37.
- Burman M. Arthroscopy or the direct visualization of joints: an experimental cadaver study. J Bone Joint Surg Am 1931;13:669-95.
- Takagi K. The arthroscope: the second report. J Japanese Orthop Assoc 1939;14:441-66.
- Johnson LL. Diagnostic and surgical arthroscopy. Clin Symp 1982;34:2-32.
- Nord RM, Meislin RJ. Hip arthroscopy in adults. Bull NYU Hosp Jt Dis 2010;68:97-102.
- Iranmanesh P, Morel P, Wagner OJ, Inan I, Pugin F, Hagen ME. Set-up and docking of the da Vinci surgical system: prospective analysis of initial experience. Int J Med Robot 2010;6:57-60.
- Jacobs S, Falk V. Pearls and pitfalls: lessons learned in endoscopic robotic surgery- the da Vinci experience. Heart Surg Forum 2001;4:307-10.
- Kather J, Hagen ME, Morel P, Fasel J, Markar S, Schueler M. Robotic hip arthroscopy in human anatomy. Int J Med Robot 2010;6:301-5.
- Bozkurt M, Apaydin N, Işik C, Bilgetekin YG, Acar HI, Elhan A. Robotic arthroscopic surgery: a new challenge in arthroscopic surgery Part-I: Robotic shoulder arthroscopy; a cadaveric feasibility study. Int J Med Robot 2011;7:496-500.
- Sackier JM, Wang Y. Robotically assisted laparoscopic surgery. From concept to development. Surg Endosc 1994;8:63-6.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Deneysel Çalışma |
| Yazarlar | |
| Yayımlanma Tarihi | 21 Nisan 2014 |
| Yayımlandığı Sayı | Yıl 2014 |