PDF(Pubmed)
Abstract：
Objectives: We recently introduced a frameless, navigated, robot-driven laser tool for depth electrode implantation as an alternative to frame-based procedures. This method has only been used in cadaver and non-recovery studies. This is the first study to test the robot-driven laser tool in an in vivo recovery animal study. Methods: A preoperative computed tomography (CT) scan was conducted to plan trajectories in sheep specimens. Burr hole craniotomies were performed using a frameless, navigated, robot-driven laser tool. Depth electrodes were implanted after cut-through detection was confirmed. The electrodes were cut at the skin level postoperatively. Postoperative imaging was performed to verify accuracy. Histopathological analysis was performed on the bone, dura, and cortex samples. Results: Fourteen depth electrodes were implanted in two sheep specimens. Anesthetic protocols did not show any intraoperative irregularities. One sheep was euthanized on the same day of the procedure while the other sheep remained alive for 1 week without neurological deficits. Postoperative MRI and CT showed no intracerebral bleeding, infarction, or unintended damage. The average bone thickness was 6.2 mm (range 4.1-8.0 mm). The angulation of the planned trajectories varied from 65.5° to 87.4°. The deviation of the entry point performed by the frameless laser beam ranged from 0.27 mm to 2.24 mm. The histopathological analysis did not reveal any damage associated with the laser beam. Conclusion: The novel robot-driven laser craniotomy tool showed promising results in this first in vivo recovery study. These findings indicate that laser craniotomies can be performed safely and that cut-through detection is reliable.
摘要：
目标：我们最近推出了一种无框架，导航,机器人驱动的激光工具，用于深度电极植入，作为基于框架的程序的替代方案。此方法仅用于尸体和非回收研究。这是第一项在体内恢复动物研究中测试机器人驱动激光工具的研究。方法：进行术前计算机断层扫描（CT）扫描以规划绵羊标本的轨迹。骨洞开颅手术是用无框手术进行的，导航,机器人驱动的激光工具。在确认穿透检测后植入深度电极。术后在皮肤水平切割电极。术后进行成像以验证准确性。对骨骼进行组织病理学分析，dura,和皮质样本。结果：在两个绵羊标本中植入了14个深度电极。麻醉方案未显示任何术中不规则。一只绵羊在手术的同一天被安乐死,而另一只绵羊存活1周,没有神经缺陷。术后MRI和CT显示无脑出血，梗塞,或意外损坏。平均骨厚度为6.2mm（范围4.1-8.0mm）。计划轨迹的角度从65.5°变化到87.4°。由无框激光束执行的进入点的偏差范围为0.27mm至2.24mm。组织病理学分析未发现与激光束相关的任何损伤。结论：新型机器人驱动的激光开颅手术工具在这项首次体内恢复研究中显示出了有希望的结果。这些发现表明，激光开颅手术可以安全地进行，并且穿透检测是可靠的。
