PDF(Pubmed)
Abstract：
The aim of the current study was to test the technical and clinical feasibility of a robotic system and investigate its potential in the surgical repair of perforated Schneiderian membranes using an ex-vivo porcine model. Eight pig heads were operated conventionally via a surgical loop and eight pig heads with the surgical robot \"Symani® Surgical System\" (Medical Microinstruments, Inc., Pisa, Italy). On each specimen, the Schneiderian membrane was incised over a length of 0.7 mm resembling a perforation. Operation time, the maximum sinusoidal pressure, the course of the pressure and the filling volume were measured. Additionally, adaptation of the wound edges has been detected via scanning electron microscopy. There were no significant differences for the pressure maximum (p = 0.528), for the time until the pressure maximum was reached (p = 0.528), or for the maximum filling volume (p = 0.674). The time needed for the suturing of the membrane via robotic surgery was significantly longer (p < 0.001). However, the scanning electron microscope revealed a better adaptation of the wound edges with robotic surgery. The technical feasibility of robot-assisted suturing of Schneiderian membrane laceration using the robotic system has been confirmed for the first time. No differences considering the pressure resistance compared to the conventional repair could be observed, but advantages in wound adaptation could be found with an electron microscope. Regarding the material and training costs and limited indications spectrum, robotic surgery systems still might not present financially feasible options in the daily dental practice yet.
摘要：
本研究的目的是测试机器人系统的技术和临床可行性，并研究其在使用离体猪模型手术修复穿孔的施耐德膜中的潜力。八个猪头通过手术环进行常规操作，八个猪头使用手术机器人“Symani®手术系统”（医用微型仪器，Inc.,比萨,意大利）。在每个样本上，将Schneiderian膜切开0.7mm的长度，类似于穿孔。操作时间,最大正弦压力，测量压力和填充体积的过程。此外,通过扫描电子显微镜检测到伤口边缘的适应。最大压力没有显着差异（p=0.528），达到压力最大值的时间（p=0.528），或最大填充量（p=0.674）。通过机器人手术缝合膜所需的时间明显更长(p<0.001)。然而,扫描电子显微镜显示，通过机器人手术更好地适应伤口边缘。首次证实了使用机器人系统进行机器人辅助缝合Schneiderian膜裂伤的技术可行性。考虑到与常规修复相比的耐压性没有差异，但是用电子显微镜可以发现伤口适应的优势。关于材料和培训费用以及有限的适应症，机器人手术系统在日常牙科实践中仍然可能没有财务上可行的选择。
