A Cadaveric Feasibility Study of an Automatic Multi-Degrees of Freedom Surgical Robot for Percutaneous Scaphoid Guide Pin Insertion.

Abstract

Background: Percutaneous fixation of scaphoid fractures need accurate guide pin insertion. The emergence of computer-assisted navigation and robotic surgery may provide a promising solution to this problem. Methods: This study presents the development of an automatic multi-degrees of freedom (DOF) surgical robot with computer-assisted navigation system, focusing on percutaneous scaphoid guide pin insertion. Using this device, along with a 3D fluoroscopy unit, we have conducted an experimental study on 10 cadavers for percutaneous scaphoid guide pin insertion to verify the feasibility and reliability of the system. Results: The mean operative duration was 29.1 (SD 4.3) minutes. The cadavers required no more than two attempts to achieve desired wire placement, with the mean positioning-error being 2.0 (SD 0.3) mm and the mean angle-deviation 3.6 (SD 0.7)°. Throughout the study, a mean of 2.2 full-cycle fluoroscopy attempts was required for each cadaver during surgery, and no preoperative CT scan was needed. Conclusions: The outcomes show that using the automatic surgical robot to perform the percutaneous scaphoid guide pin insertion is feasible and desired results can be achieved.