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Respiratory motion compensation for the robot-guided laser osteotome

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

The use of a robot-guided laser osteotome for median sternotomy is impeded by prohibiting cutting inaccuracies due to respiration-induced motions of the thorax. With this paper, we advance today’s methodologies in sternotomy procedures by introducing the concept of novel 3D functional cuts and a respiratory motion compensation algorithm for the computer-assisted and robot-guided laser osteotome, CARLO®.

Methods

We present a trajectory planning algorithm for performing 3D functional cuts at a constant cutting velocity. In addition, we propose the use of Gaussian process (GP) prediction in order to anticipate the sternum’s pose providing enough time for the CARLO® device to adjust the position of the laser source.

Results

We analysed the performance of the proposed algorithms on a computer-based simulation framework of the CARLO® device. The median position error of the laser focal point has shown to be reduced from 0.22 mm without GP prediction to 0.19 mm with GP prediction.

Conclusion

The encouraging simulation results support the proposed respiratory motion compensation algorithm for robot-guided laser osteotomy on the thorax. Successful compensation of the respiration-induced motion of the thorax opens doors for robot-guided laser sternotomy and the related novel cutting patterns. These functional cuts hold great potential to significantly improve postoperative sternal stability and therefore reduce pain and recovery time for the patient. By enabling functional cuts, we approach an important threshold moment in the history of osteotomy, creating innovative opportunities which reach far beyond the classic linear cutting patterns.

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Acknowledgements

The authors would like to thank all persons who voluntarily participated in this study. Furthermore, we wish to express our gratitude to the employees of AOT for their technical and advisory support.

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Authors and Affiliations

  1. Center for medical Image Analysis & Navigation, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, 4123, Allschwil, Switzerland

    Alina Giger, Christoph Jud & Philippe C. Cattin

Authors
  1. Alina Giger
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  2. Christoph Jud
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  3. Philippe C. Cattin
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Corresponding author

Correspondence to Alina Giger.

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Conflict of interest

Alina Giger and Christoph Jud declare that they have no conflict of interest. Philippe Cattin is a founder of AOT.

Ethical approval

For this type of study, formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Giger, A., Jud, C. & Cattin, P.C. Respiratory motion compensation for the robot-guided laser osteotome. Int J CARS 12, 1751–1762 (2017). https://doi.org/10.1007/s11548-017-1543-3

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  • DOI: https://doi.org/10.1007/s11548-017-1543-3

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