Learning Needle Placement in Soft Tissue With Robot-assisted Navigation.

Abstract

The aim of this phantom study was to evaluate the learning curves of novices practicing how to place a cone-beam computed tomography (CBCT)-guided needle using a novel robotic assistance system (RAS). Ten participants performed 18 punctures each with random trajectories in a phantom setting, supported by a RAS over 3 days. Precision, duration of the total intervention, duration of the needle placement, autonomy, and confidence of the participants were measured, displaying possible learning curves. No statistically significant differences were observed in terms of needle tip deviation during the trial days (mean deviation day 1: 2.82 mm; day 3: 3.07 mm; p=0.7056). During the trial days, the duration of the total intervention (mean duration: day 1: 11:22 min; day 3: 07:39 min; p<0.0001) and the duration of the needle placement decreased (mean duration: day 1: 03:17 min; day 3: 02:11 min; p<0.0001). In addition, autonomy (mean percentage of achievable points: day 1: 94%; day 3: 99%; p<0.0001) and confidence of the participants (mean percentage of achievable points: day 1: 78%; day 3: 91%; p<0.0001) increased significantly during the trial days. The participants were already able to carry out the intervention precisely using the RAS on the first day of the trial. Throughout the trial, the participants' performance improved in terms of duration and confidence.