Intraoperative image‐guided transoral robotic surgery: pre‐clinical studies. Issue 2 (28th July 2014)

• Record Type: Journal Article
• Authors: Liu, Wen P.; Reaugamornrat, Sureerat; Sorger, Jonathan M.; Siewerdsen, Jeffrey H.; Taylor, Russell H.; Richmon, Jeremy D.
• Is Part Of: International journal of medical robotics and computer assisted surgery. Volume 11:Issue 2(2015)
• Page Start: 256
• Page End: 267
• Publication Date: 2014-07-28
• Subjects: Robotics in medicine -- Periodicals; Surgery -- Technological innovations -- Periodicals; Imaging systems in medicine -- Periodicals; 617.90285
• DOI: 10.1002/rcs.1602
• Languages: English
• ISSNs: 1478-5951

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="rcs1602-sec-0001" sec-type="section"> <title>Background</title> <p>Adequate resection of oropharyngeal neoplasms with transoral robotic surgery (TORS) poses multiple challenges, including difficulty with access, inability to palpate the tumor, loss of landmarks, and intraoperative patient positioning with mouth retractor and tongue extended creating significant tissue distortion from preoperative imaging.</p> </sec> <sec id="rcs1602-sec-0002" sec-type="section"> <title>Methods</title> <p>This study evaluates a workflow integrating intraoperative cone beam computed tomography (CBCT) for image‐guided TORS through robotic experimentation locating 8–10 embedded targets in five porcine tongues and a cadaveric head phantom, conducted under various modes of visualization and integration of preoperative/intraoperative imaging.</p> </sec> <sec id="rcs1602-sec-0003" sec-type="section"> <title>Results</title> <p>A statistically significant improvement in mean target localization error was achieved for both the porcine tongue ((9.8 ± 4.0) mm vs. (5.3 ± 1.3) mm, <italic>P</italic>‐value = 0.0151) and cadaver ((11.2 ± 5.0) mm vs. (5.8 ± 2.5) mm <italic>P</italic>‐value = 0.0189) in experiments comparing scenarios simulating current standard‐of‐care practice and the proposed image guidance system.</p> </sec> <sec id="rcs1602-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Intraoperative image guidance with augmentation of critical surgical structures has the potential to improve target localization for TORS. Copyright © 2014 John Wiley & Sons, Ltd.</p> </sec> </abstract>