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International Journal of Computer Assisted Radiology and Surgery

Erschienen in:

17.10.2020 | Original Article

Comparison of manual versus robot-assisted contralateral gate cannulation in patients undergoing endovascular aneurysm repair

verfasst von: Sheena Cheung, Rafid Rahman, Colin Bicknell, Danail Stoyanov, Ping-Lin Chang, Mimi Li, Alexander Rolls, Liesbeth Desender, Isabelle Van Herzeele, Mohamad Hamady, Celia Riga

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 12/2020

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Abstract

Purpose

Robotic endovascular technology may offer advantages over conventional manual catheter techniques. Our aim was to compare the endovascular catheter path-length (PL) for robotic versus manual contralateral gate cannulation during endovascular aneurysm repair (EVAR), using video motion analysis (VMA).

Methods

This was a multicentre retrospective cohort study with fluoroscopic video recordings of 24 EVAR cases (14 robotic, 10 manual) performed by experienced operators (> 50 procedures), obtained from four leading European centres. Groups were comparable with no statistically significant differences in aneurysm size (p = 0.47) or vessel tortuosity (p = 0.68). Two trained assessors used VMA to calculate the catheter PL during contralateral gate cannulation for robotic versus manual approaches.

Results

There was a high degree of inter-observer reliability (Cronbach’s α > 0.99) for VMA. Median robotic PL was 35.7 cm [interquartile range, IQR (30.8–51.0)] versus 74.1 cm [IQR (44.3–170.4)] for manual cannulation, p = 0.019. Robotic cases had a median cannulation time of 5.33 min [IQR (4.58–6.49)] versus 1.24 min [IQR (1.13–1.35)] in manual cases (p = 0.0083). Generated efficiency ratios (PL/aorto-iliac centrelines) was 1.6 (1.2–2.1) in robotic cases versus 2.6 (1.7–7.0) in manual, p = 0.031.

Conclusion

Robot-assisted contralateral gate cannulation in EVAR leads to decreased navigation path lengths and increased economy of movement compared with manual catheter techniques. The benefit could be maximised by prioritising robotic catheter shaping over habituated reliance on guidewire manipulation. Robotic technology has the potential to reduce the endovascular footprint during manipulations even for experienced operators with the added advantage of zero radiation exposure.

Vorheriger Artikel Vision-based hand–eye calibration for robot-assisted minimally invasive surgery

Nächster Artikel Bidirectional long short-term memory for surgical skill classification of temporally segmented tasks

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Titel: Comparison of manual versus robot-assisted contralateral gate cannulation in patients undergoing endovascular aneurysm repair
verfasst von: Sheena Cheung
Rafid Rahman
Colin Bicknell
Danail Stoyanov
Ping-Lin Chang
Mimi Li
Alexander Rolls
Liesbeth Desender
Isabelle Van Herzeele
Mohamad Hamady
Celia Riga
Publikationsdatum: 17.10.2020
Verlag: Springer International Publishing
Erschienen in: International Journal of Computer Assisted Radiology and Surgery / Ausgabe 12/2020
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-020-02247-3

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Abstract

Purpose

Methods

Results

Conclusion

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