智能开颅手术机器人系统在开颅手术中应用的实验研究

Objective: To explore the accuracy, efficiency and safety of robot-assisted craniotomy system named Cranibot. Methods: The robot system called Cranibot was developed by Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital and Institute of Intelligent Robotics, Beijing Institute of Technology and then employed to carry out randomized controlled experiments on 3 kinds of subjects including 8 3D-printing PVC (polyvinyl chloride) skull models, 5 cadaveric pig heads and 5 living Bama miniature pigs. Both left and right sides were symmetrically selected in each subject to perform craniotomy, and on each side 4 holes were drilled to form a square bone flap. One part of the skull on one side was randomly categorized into the experimental group in which craniotomy was performed by robot system, and its symmetrical part of skull on the other side belonged to the control group in which craniotomy was performed by the same neurosurgeon team. We observed and measured the drilling position error, time spent on craniotomy and incidence of tissue injury in the two groups. Results: In skull model experiments, the average position error and time spent on craniotomy of "robot" group were 1.87±0.66 mm and 6.64±1.15 min, and those of "surgeon" group were 3.14±0.73 mm and 8.06±1.10 min respectively. The differences were statistically significant (both P<0.05). In experiments on cadaveric pig heads, the average position error and time spent on craniotomy of "robot" group were 3.13±0.35 mm and 7.79±1.21 min, and those of "surgeon" group were 3.83±0.42 mm and 9.05±1.15 min respectively. The differences were statistically significant (both P<0.05). In experiments on living Bama miniature pigs, the average position error and time spent on craniotomy of "robot" group were 3.26±0.51 mm and 11.83±0.92 min, and those of "surgeon" group were 4.39±0.75 mm and 26.10±1.62 min respectively. The differences were statistically significant (both P<0.05). The total incidence of tissue injury was 5.6% (2/36) in "robot" groups and 16.7% (6/36) in "surgeon" groups respectively, which had no statistical difference (P>0.05). Conclusion: The robot-assisted craniotomy system named Cranibot could improve the accuracy and efficiency of craniotomy, while its safety requires further research with large sample size.