机器人辅助颏成形术行截骨操作的精度评价实验研究

Experimental study on the accuracy evaluation of robot-assisted osteotomy of genioplasty

目的·初步评价自主研发的颅颌面外科手术机器人(cranial-maxilofacial robot,CMF ROBOT)系统对头颅模型行颏成形术截骨操作的执行精度。方法·纳入2019年8月—2020年10月于上海交通大学医学院附属第九人民医院就诊的9例颏部畸形患者为研究对象。术前,采集患者的全头颅螺旋CT图像,通过三维打印制作头颅模型,并行虚拟手术规划。术中,实验组采用CMF ROBOT系统对9例头颅模型进行自动截骨;对照组采用三维打印手术导板辅助,由高年资外科医师对相同的9例头颅模型进行手动截骨。术后行螺旋CT扫描,对2组截骨平面的距离误差和方向误差进行三维测量,并对该2项误差的组间差异进行统计分析。结果·2组均顺利完成了颏成形术的截骨操作。实验组整体截骨的距离误差为(1.40±0.27)mm、方向误差为7.03°±3.02°,对照组整体截骨的距离误差为(1.23±0.27)mm、方向误差为6.08°±2.24°;且该2项误差的组间差异均无统计学意义(P=0.256,P=0.462)。结论·CMF ROBOT系统可根据术前规划完成颏成形术的自动截骨操作,其在截骨面的距离误差、方向误差均可达到以三维打印手术导板辅助的手动截骨操作的精度水平。

Objective·To preliminarily evaluate the execution accuracy of the self-developed cranial-maxilofacial robot(CMF ROBOT) system for genioplasty osteotomy of skull models. Methods·Nine patients with chin deformity who were admitted to Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from August 2019 to October 2020 were included in the study. Before the operation, the spiral CT images of the whole head of the patients were collected, the skull models were made by 3D printing, and the virtual surgical planning was carried out. During the operation, the experimental group used CMF ROBOT system to perform automatic osteotomy on 9 skull models;the control group was manually osteotomized by senior surgeons assisted by 3D printing surgical guide plate. After the operation, spiral CT scanning was performed to measure the distance error and the direction error of the osteotomy plane of the two groups in three dimensions, and the differences of the two errors between the two groups were statistically analyzed. Results·The osteotomy of genioplasty was successfully completed in the two groups. The distance error of the overall osteotomy in the experimental group was(1.40±0.27) mm and the direction error was7.03° ±3.02°, while the distance error of the overall osteotomy in the control group was(1.23±0.27) mm, and the direction error was 6.08°±2.24°. There was no significant difference between the two errors mentioned above(P=0.256, P=0.462). Conclusion·The CMF ROBOT system can complete the automatic osteotomy of genioplasty according to the preoperative planning, and the distance error and direction error of the osteotomy surface can reach the precision level of manual osteotomy assisted by 3D printing surgical guide plate.