Purpose: Decision-making and dexterity, features that become increasingly relevant in (robot-assisted) minimally invasive surgery, are considered key components in improving the surgical accuracy. Recently, DROP-IN gamma probes were introduced to facilitate radioguided robotic surgery. We now studied if robotic DROP-IN radioguidance can be further improved using tethered Click-On designs that integrate gamma detection onto the robotic instruments themselves. Methods: Using computer-assisted drawing software, 3D printing and precision machining, we created a Click-On probe containing two press-fit connections and an additional grasping moiety for a ProGrasp instrument combined with fiducials that could be video tracked using the Firefly laparoscope. Using a dexterity phantom, the duration of the specific tasks and the path traveled could be compared between use of the Click-On or DROP-IN probe. To study the impact on surgical decision-making, we performed a blinded study, in porcine models, wherein surgeons had to identify a hidden 57Co-source using either palpation or Click-On radioguidance. Results: When assembled onto a ProGrasp instrument, while preserving grasping function and rotational freedom, the fully functional prototype could be inserted through a 12-mm trocar. In dexterity assessments, the Click-On provided a 40% reduction in movements compared to the DROP-IN, which converted into a reduction in time, path length, and increase in straightness index. Radioguidance also improved decision-making; task-completion rate increased by 60%, procedural time was reduced, and movements became more focused. Conclusion: The Click-On gamma probe provides a step toward full integration of radioguidance in minimal invasive surgery. The value of this concept was underlined by its impact on surgical dexterity and decision-making.

The Click-On gamma probe, a second-generation tethered robotic gamma probe that improves dexterity and surgical decision-making / Azargoshasb, S.; van Alphen, S.; Slof, L. J.; Rosiello, G.; Puliatti, S.; van Leeuwen, S. I.; Houwing, K. M.; Boonekamp, M.; Verhart, J.; Dell'Oglio, P.; van der Hage, J.; van Oosterom, M. N.; van Leeuwen, F. W. B.. - In: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING. - ISSN 1619-7070. - (2021), pp. N/A-N/A. [10.1007/s00259-021-05387-z]

The Click-On gamma probe, a second-generation tethered robotic gamma probe that improves dexterity and surgical decision-making

Puliatti S.;
2021

Abstract

Purpose: Decision-making and dexterity, features that become increasingly relevant in (robot-assisted) minimally invasive surgery, are considered key components in improving the surgical accuracy. Recently, DROP-IN gamma probes were introduced to facilitate radioguided robotic surgery. We now studied if robotic DROP-IN radioguidance can be further improved using tethered Click-On designs that integrate gamma detection onto the robotic instruments themselves. Methods: Using computer-assisted drawing software, 3D printing and precision machining, we created a Click-On probe containing two press-fit connections and an additional grasping moiety for a ProGrasp instrument combined with fiducials that could be video tracked using the Firefly laparoscope. Using a dexterity phantom, the duration of the specific tasks and the path traveled could be compared between use of the Click-On or DROP-IN probe. To study the impact on surgical decision-making, we performed a blinded study, in porcine models, wherein surgeons had to identify a hidden 57Co-source using either palpation or Click-On radioguidance. Results: When assembled onto a ProGrasp instrument, while preserving grasping function and rotational freedom, the fully functional prototype could be inserted through a 12-mm trocar. In dexterity assessments, the Click-On provided a 40% reduction in movements compared to the DROP-IN, which converted into a reduction in time, path length, and increase in straightness index. Radioguidance also improved decision-making; task-completion rate increased by 60%, procedural time was reduced, and movements became more focused. Conclusion: The Click-On gamma probe provides a step toward full integration of radioguidance in minimal invasive surgery. The value of this concept was underlined by its impact on surgical dexterity and decision-making.
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The Click-On gamma probe, a second-generation tethered robotic gamma probe that improves dexterity and surgical decision-making / Azargoshasb, S.; van Alphen, S.; Slof, L. J.; Rosiello, G.; Puliatti, S.; van Leeuwen, S. I.; Houwing, K. M.; Boonekamp, M.; Verhart, J.; Dell'Oglio, P.; van der Hage, J.; van Oosterom, M. N.; van Leeuwen, F. W. B.. - In: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING. - ISSN 1619-7070. - (2021), pp. N/A-N/A. [10.1007/s00259-021-05387-z]
Azargoshasb, S.; van Alphen, S.; Slof, L. J.; Rosiello, G.; Puliatti, S.; van Leeuwen, S. I.; Houwing, K. M.; Boonekamp, M.; Verhart, J.; Dell'Oglio, P.; van der Hage, J.; van Oosterom, M. N.; van Leeuwen, F. W. B.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1249784
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