机器人支气管镜系统对比格犬肺外周预置弹簧圈定位及移除的有效性和安全性初步探究

Effectiveness and safety of robotic assisted-bronchoscopy system in locating and removing spring coils placed in the peripheral lung of beagle dogs:a pilot study

目的评价机器人支气管镜系统对比格犬肺外周预置弹簧圈定位及移除的有效性和安全性。方法2021年6月18—20日,全身麻醉下使用机器人支气管镜系统对2只成年雄性比格犬肺外周置入金属肺部弹簧圈,定位标记模拟病灶,使用机器人支气管镜系统内置的导航系统规划路径。经培训的操作者操作机器人支气管镜系统导航定位并取出弹簧圈,评价导航成功率、取样成功率、弹簧圈靶点位置、导航时间、取样时间、手术时间;并记录操作过程对气道黏膜损伤情况和操作过程比格犬生命体征,操作完成后复查胸部CT了解是否出现气胸、出血等并发症。采用SPSS 20.0软件进行统计学分析。结果2只比格犬共成功置入12枚弹簧圈。所有模拟病灶均成功规划路径,导航成功率为12/12,导航时间(43.9±19.8)s。导航系统测量的操作柔性内镜臂前端距目标靶点距离为(6.93±2.15)mm。模拟病灶位置分布于6~8级支气管。取样成功率为12/12。取样时间为(42.4±11.3)s。置入弹簧圈后无气胸和纵隔气肿。操作全程比格犬生命体征稳定,未发生操作相关并发症和术后并发症。结论机器人支气管镜系统取出比格犬肺外周预置的弹簧圈操作简便,过程顺利,安全性好。提示机器人支气管镜系统在肺外周病灶的取材和诊断上有很大的临床意义。

Objective To evaluate the effectiveness and safety of the robotic assisted bronchoscope system for localizing and removing the spring coils that placed in the peripheral lung of beagle dogs.Methods The study was conducted from June 18th to June 20th,2021.Metallic lung coils were placed as the simulated lesions to the periphery of the lungs of two adult male beagle dogs using a bronchoscope under general anesthesia.The navigation path was planned by the navigation function that built in the robotic bronchoscope system.After training,the doctors operated the robotic bronchoscope system to locate and remove the coils from the lung.The navigation success rate,sampling success rate,position of the coil,navigation time,sampling time,and operation time were evaluated.The damage to the airway mucosa during the operation and the vital signs of the beagles during and post-operation were accessed.Chest computerized tomography(CT)was performed post-operation to detect if there were complications such as pneumothorax and bleeding.Results A total of 12 spring coils were successfully inserted into the two beagles.All the navigation paths of the simulated lesions were successfully planned.The navigation success rate was 12/12.The navigation time was(43.9±19.8)seconds.The distance between the tip of the flexible endoscope arm and the target point measured by the navigation system was(6.93±2.15)mm.The locations of the simulated lesions were distributed in the 6th-8th generation of bronchi.The sampling success rate was 12/12.The sampling time was(42.4±11.3)seconds.There was no pneumothorax or mediastinal emphysema after the placement of the coil.The vital signs of the beagle dogs were stable throughout the operation,and no operation-related or postoperative complications occurred.Conclusions The robotic bronchoscope system can be used to locate and remove the spring coils from the peripheral lung of beagle dogs,and the procedure is simple and safe.It suggests that the robotic bronchoscopy system has great clinical significance in the sampling and diagnosis of peripheral lung lesions.