遥控操作机器人脑立体定向手术临床应用(附10例报道)

Clinical Application of Robotic Telemanipulation System in Stereotactic Surgery(10 Cases Reports)

目的 应用自行研制的CAS-BH5远程立体定向机器人系统,实施遥控操作无框架脑立体定向手术,评价此系统的临床实用性、操作精确性和手术安全性.方法 回顾性分析2005年9～12月,应用CAS-BH5型机器人系统临床实施遥控操作无框架脑立体定向手术10例.遥控操作是专家在北京通过数字专线控制机器人对位于远在1 300 km延安的患者实行手术.术后随访10～14个月（平均12个月）,观察定位精度及症状改善情况.结果 临床成功完成无框架定位脑手术10例,定位操作均一次性完成,远程定位精度是（1.05±0.13）mm,手术有效率90%,无相关手术并发症.结论 本结果提示无框架立体定向遥控操作是安全可行的.遥控操作手术有利于加强异地外科医师间合作,有利于技能训练和资源共享,在神经外科领域将有更广阔的应用前景.

Objective To assess the clinical usefulness, accuracy, and safety of telemanipulation for frameless stereotactic surgery using the CAS-BH5 robot system. Methods We prospectively evaluated 10 patients undergone telemanipulation frameless stereotactic operations during Sep-Dec 2005. Telemanipulation was performed via a digital data network by a neurosurgeon in Beijing while the patients were located in Yan＇ an, 1 300 kilometers away. The accuracy of position and improvement of symptoms were observed at 10 to 14 months （averaged 12 months） follow-up after operation. Results The surgical operations in 10 cases were successful without serious complications. Remote fiducial registration was performed with a mean accuracy of 1.05ram and the standard difference was 0.13 between the planned and actual trajectory. During the follow-up, 90% of the patients had neurological improvement. There were no complications. Conclusion This preliminary data indicates that telemanipulation in frameless stereotactic surgeries is reliable and safe. In the future, we believe that telemanipulation will facilitate collaboration between surgeons, enhance training, allow for sharing of resources,and have wide applications in the field of neurosurgery.