Literature DB >> 30443933

Real-time robotic airway measurement: An additional benefit of a novel steady-hand robotic platform.

Christopher R Razavi1, Francis X Creighton1, Paul R Wilkening2, Joseph Peine2, Russell H Taylor2, Lee M Akst1.   

Abstract

OBJECTIVE: Describe the secondary capability of a robotic system to provide real-time measurements of airway dimensions with high fidelity.
METHODS: Seven unique phantoms of laryngotracheal stenosis (LTS) were modeled using a computer-aided design tool and were three dimensionally printed. These stenoses were of different dimensions and orientations, and some were purposefully oblique. The dimensions of the stenoses were then measured with the novel Robotic ENT (Ear, Nose, and Throat) Microsurgery System (REMS; Galen Robotics, Inc., Sunnyvale, CA) because it is capable of tool position memory in three dimensional (3D) space. Five participants (two laryngologists, two otolaryngology-head and neck surgery residents, one neurotology fellow) measured each axis of stenosis (anteroposterior, lateral, and craniocaudal) three times for each of the seven stenosis phantoms. These measurements were then compared to the known design dimensions. Mean magnitude of error (MOE) and interrater reliability (IRR) using an intraclass correlation coefficient (ICC) were then calculated.
RESULTS: Mean MOE and standard deviation for all measurements was 0.306 ± 0.247 mm. Mean MOE was 0.374 ± 0.292 mm, 0.300 ± 0.237 mm, and 0.244 ± 0.185 mm for the anteroposterior, lateral, and craniocaudal dimensions of stenosis, respectively. Eighty-two percent of all measurements had MOE < 0.5 mm. ICC was 0.945 (95% confidence interval [CI]: 0.847-0.989), 0.995 (95% CI: 0.984-0.999), and 0.993 (95% CI: 0.987-0.999) for anteroposterior, lateral, and craniocaudal dimensions, respectively, indicating excellent agreement among participants.
CONCLUSION: The REMS can be used to reliably and accurately measure airway dimensions in 3D regardless of the orientation of stenosis. This ability may be easily extrapolated to the measurement of any airway lesion during laryngotracheal surgery. LEVEL OF EVIDENCE: 4 Laryngoscope, 129:324-329, 2019.
© 2018 The American Laryngological, Rhinological and Otological Society, Inc.

Entities:  

Keywords:  3D-printing; Robotic surgery; airway modeling

Mesh:

Year:  2018        PMID: 30443933      PMCID: PMC6344260          DOI: 10.1002/lary.27435

Source DB:  PubMed          Journal:  Laryngoscope        ISSN: 0023-852X            Impact factor:   3.325


  22 in total

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Authors:  Lee M Akst; Kevin C Olds; Marcin Balicki; Preetham Chalasani; Russell H Taylor
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8.  Subglottic stenosis: correlation between computed tomography and bronchoscopy.

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