Cold ablation robot‐guided laser osteotomy in hand, wrist and forearm surgery—A feasibility study

Honigmann, Philipp; Hofer, Maximilian; Hirsch, Sibylle; Morawska, Marta; Müller‐Gerbl, Magdalena; Thieringer, Florian M.; Coppo, Enrico

doi:10.1002/rcs.2438

Cited by 8 publications

(3 citation statements)

References 68 publications

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“…Moreover, recent literature has explored novel applications and prospects for robot-guided laser technology. For instance, Honigmann et al conducted a study assessing the potential use of robot-guided laser osteotomies in hand, wrist, and forearm surgery on human cadavers, shedding new light on these applications [ 42 ]. In a separate study, Wojcik et al assessed the feasibility of complex unicortical calvarial harvesting through robot-guided laser osteotomy, expanding the horizons of this technology [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Dimensional Accuracy of Robot-Guided Laser Osteotomy in Reconstruction with Patient-Specific Implants—An Accuracy Study of Digital High-Tech Procedures

Msallem,

Veronesi,

Beyer

et al. 2024

JCM

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Background/Objective: With the rapid advancement in surgical technologies, new workflows for mandibular reconstruction are constantly being evaluated. Cutting guides are extensively employed for defining osteotomy planes but are prone to errors during fabrication and positioning. A virtually defined osteotomy plane and drilling holes in robotic surgery minimize potential sources of error and yield highly accurate outcomes. Methods: Ten mandibular replicas were evaluated after cutting-guided saw osteotomy and robot-guided laser osteotomy following reconstruction with patient-specific implants. The descriptive data analysis summarizes the mean, standard deviation (SD), median, minimum, maximum, and root mean square (RMS) values of the surface comparison for 3D printed models regarding trueness and precision. Results: The saw group had a median trueness RMS value of 2.0 mm (SD ± 1.7) and a precision of 1.6 mm (SD ± 1.4). The laser group had a median trueness RMS value of 1.2 mm (SD ± 1.1) and an equal precision of 1.6 mm (SD ± 1.4). These results indicate that robot-guided laser osteotomies have a comparable accuracy to cutting-guided saw osteotomies, even though there was a lack of statistical significance. Conclusions: Despite the limited sample size, this digital high-tech procedure has been shown to be potentially equivalent to the conventional osteotomy method. Robotic surgery and laser osteotomy offers enormous advantages, as they enable the seamless integration of precise virtual preoperative planning and exact execution in the human body, eliminating the need for surgical guides in the future.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Dimensional Accuracy of Robot-Guided Laser Osteotomy in Reconstruction with Patient-Specific Implants—An Accuracy Study of Digital High-Tech Procedures

Msallem,

Veronesi,

Beyer

et al. 2024

JCM

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“…The laser power levels and appropriate air-water coolant are essential during laser-assisted osteotomy to prevent thermal damage in surrounding tissues. Lasers with high absorption coefficients for water and hydroxyapatite such as titanium:sapphire (800 nm), erbium, chromium:yttrium, scandium, gallium, garnet (Er, Cr:YSGG, 2780 nm), erbium:yttrium, aluminum, garnet (Er:YAG, 2940 nm), and carbon dioxide (CO 2 , 9600 nm) lasers provide optimal precision and depth control [17,32,37,[41][42][43][44][45][46]. Further, utilizing the newer femtosecond lasers capable of ultrashort pulses with high incident energy and an optimal transmission period shorter than the thermal tissue relaxation times would achieve ideal surgical outcomes.…”

Section: Utility Of Hard-tissue Lasersmentioning

confidence: 99%

Automation in Dentistry with Mechanical Drills and Lasers for Implant Osteotomy: A Narrative-Scoping Review

Ganta,

Mosca,

Varsani

et al. 2023

Dentistry Journal

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The popularity of implants is increasing with the aging population requiring oral–dental rehabilitation. There are several critical steps in the implant workflow, including case selection, implant design, surgical procedure, biological tissue responses, and functional restoration. Among these steps, surgical osteotomy procedures are a crucial determinant of clinical success. This brief review was aimed at outlining the current state of the field in automation-assisted implant surgical osteotomy technologies. A broad search of the literature was performed to identify current literature. The results are outlined in three broad categories: semi-automated static (image-guided) or dynamic (navigation-assisted) systems, and fully-automated robotic systems. As well as the current mechanical rotary approaches, the literature supporting the use of lasers in further refinement of these approaches is reviewed. The advantages and limitations of adopting autonomous technologies in practical clinical dental practices are discussed. In summary, advances in clinical technologies enable improved precision and efficacious clinical outcomes with implant dentistry. Hard-tissue lasers offer further advancements in precision, improved biological responses, and favorable clinical outcomes that require further investigation.

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“…The end effector (EE) is the most flexible component of robotic manipulators, enabling a diverse range of industrial application possibilities which include, but are not limited to, point-to-point (PTP) movements such as stacking [2][3][4], as well as movements along specific paths, such as laser cutting, spraying, etc. [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Sequential Optimal Trajectory Planning Scheme for Robotic Manipulators along Specified Path Based on Direct Collocation Method

Xiong,

Ding,

Chen

et al. 2024

Actuators

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Robotic manipulators play a pivotal role in modern intelligent manufacturing and unmanned production systems, often tasked with executing specific paths accurately. However, the input of the robotic manipulators is trajectory which is a path with time information. The resulting core technology is trajectory planning methods which are broadly classified into two categories: maximum velocity curve (MVC) methods and multiphase direct collocation (MPDC) methods. This paper concentrates on addressing challenges associated with the latter methods. In MPDC methods, the solving efficiency and accuracy are greatly influenced by the number of discretization nodes. When dealing with systems with complex dynamics, such as robotic manipulators, striking a balance between solving time and path discretization errors becomes crucial. We use a mesh refinement (MR) algorithm to find a suitable number of nodes under the premise of ensuring the path discretization error. So, the actual device can effectively implement the planned solutions. Nonetheless, the conventional application of the MR algorithm requires solving the original problem in each iteration; these processes are extremely time-consuming and may fail to solve when dealing with a complex dynamic system. As a result, we propose a sequential optimal trajectory planning scheme to solve the problem efficiently by dividing the original optimal control (OC) problem into two stages: path planning (PP) and trajectory planning (TP). In the PP stage, we employ a DC method based on arc length and an MR algorithm to identify key nodes along the specified path. This aims to minimize the approximation error introduced during discretization. In the TP stage, the identified key nodes serve as boundary conditions for an MPDC method based on time. This facilitates the generation of an optimal trajectory that maximizes motion performance, considering constant velocity in Cartesian space and dynamic constraints while keeping the path discretization error. Simulation and experiment are conducted with a six-axis robotic manipulator, ROCR6, and show significant potential for a wide range of applications in robotics.

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Cold ablation robot‐guided laser osteotomy in hand, wrist and forearm surgery—A feasibility study

Cited by 8 publications

References 68 publications

Evaluation of the Dimensional Accuracy of Robot-Guided Laser Osteotomy in Reconstruction with Patient-Specific Implants—An Accuracy Study of Digital High-Tech Procedures

Evaluation of the Dimensional Accuracy of Robot-Guided Laser Osteotomy in Reconstruction with Patient-Specific Implants—An Accuracy Study of Digital High-Tech Procedures

Automation in Dentistry with Mechanical Drills and Lasers for Implant Osteotomy: A Narrative-Scoping Review

Sequential Optimal Trajectory Planning Scheme for Robotic Manipulators along Specified Path Based on Direct Collocation Method

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