Yan Guo1, Wangjie Xu1, Puxun Tu1, Jing Han2, Chenping Zhang2, Jiannan Liu3, Xiaojun Chen4,5. 1. Room A925, School of Mechanical Engineering, Shanghai Jiao Tong University, Dongchuan Road 800, Minhang District, Shanghai, 200240, China. 2. Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 3. Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. laurence_ljn@163.com. 4. Room A925, School of Mechanical Engineering, Shanghai Jiao Tong University, Dongchuan Road 800, Minhang District, Shanghai, 200240, China. xiaojunchen@sjtu.edu.cn. 5. Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China. xiaojunchen@sjtu.edu.cn.
Abstract
PURPOSE: Free fibula flap is the gold standard for the treatment of mandibular defects. However, the existing preoperative planning protocol is cumbersome to execute, costly to learn, and poorly collaborative with the robot-assisted cutting of the fibular osteotomy plane. METHODS: A surgical planning system for robotic assisted mandibular reconstruction with fibula free flap is proposed in this study. A fibular osteotomy planning algorithm is presented so that the virtual surgical planning of the fibular osteotomy segments can be obtained automatically with selected mandibular anatomical landmarks. The planned osteotomy planes are then converted into the motion path of the robotic arm, and the automatic fibula osteotomy is completed under optical navigation. RESULTS: Surgical planning was performed on 35 patients to verify the feasibility of our system's virtual surgical planning module, with an average time of 13 min. Phantom experiments were performed to evaluate the reliability and stability of this system. The average distance and angular deviations of the osteotomy planes are 1.04 ± 0.68 mm and 1.56 ±1.10°, respectively. CONCLUSIONS: Our system can achieve not only precise and convenient preoperative planning, but also safe and reliable osteotomy trajectory. The clinical applications of our system for mandibular reconstruction surgery are expected soon.
PURPOSE: Free fibula flap is the gold standard for the treatment of mandibular defects. However, the existing preoperative planning protocol is cumbersome to execute, costly to learn, and poorly collaborative with the robot-assisted cutting of the fibular osteotomy plane. METHODS: A surgical planning system for robotic assisted mandibular reconstruction with fibula free flap is proposed in this study. A fibular osteotomy planning algorithm is presented so that the virtual surgical planning of the fibular osteotomy segments can be obtained automatically with selected mandibular anatomical landmarks. The planned osteotomy planes are then converted into the motion path of the robotic arm, and the automatic fibula osteotomy is completed under optical navigation. RESULTS: Surgical planning was performed on 35 patients to verify the feasibility of our system's virtual surgical planning module, with an average time of 13 min. Phantom experiments were performed to evaluate the reliability and stability of this system. The average distance and angular deviations of the osteotomy planes are 1.04 ± 0.68 mm and 1.56 ±1.10°, respectively. CONCLUSIONS: Our system can achieve not only precise and convenient preoperative planning, but also safe and reliable osteotomy trajectory. The clinical applications of our system for mandibular reconstruction surgery are expected soon.
Authors: Albert H Chao; Katie Weimer; Joerg Raczkowsky; Yaokun Zhang; Mirko Kunze; Dianna Cody; Jesse C Selber; Matthew M Hanasono; Roman J Skoracki Journal: Microsurgery Date: 2015-12-11 Impact factor: 2.425
Authors: Germán L Farfalli; José I Albergo; Lucas E Ritacco; Miguel A Ayerza; Federico E Milano; Luis A Aponte-Tinao Journal: Clin Orthop Relat Res Date: 2016-02-25 Impact factor: 4.176