Objective: To report a transoral freehand technique using continuous image guidance to biopsy a clival lesion.
Methods: The patient was placed in a Mayfield head rest. Patient data were registered using preacquired magnetic resonance and computed tomography images, and then, under continuous image guidance, a bone biopsy instrument was advanced freehand through a transoral route into the clival lesion.
Results: Bone biopsy instrumentation was successfully placed into the clival lesion. Biopsy forceps were placed through the working channel of the biopsy instrumentation and specimen was successfully retrieved from the clival mass. The patient tolerated the procedure well and the only complaint was dysphagia, which resolved in several days postoperatively.
Conclusion: The transoral freehand technique with stereotactic navigation was found to be a simple, safe, fast, and effective way to biopsy a clival lesion.
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http://dx.doi.org/10.1055/s-0028-1115322 | DOI Listing |
Int J Comput Assist Radiol Surg
July 2024
Department of Electrical and Computer Engineering, The University of British Columbia, 5500-2332 Main Mall, Vancouver, BC, V6T 1Z4, Canada.
Purpose: Transoral robotic surgery (TORS) is a challenging procedure due to its small workspace and complex anatomy. Ultrasound (US) image guidance has the potential to improve surgical outcomes, but an appropriate method for US probe manipulation has not been defined. This study evaluates using an additional robotic (4th) arm on the da Vinci Surgical System to perform extracorporeal US scanning for image guidance in TORS.
View Article and Find Full Text PDFInt J Comput Assist Radiol Surg
June 2023
Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, BC, Canada.
Purpose: Trans-oral robotic surgery (TORS) using the da Vinci surgical robot is a new minimally-invasive surgery method to treat oropharyngeal tumors, but it is a challenging operation. Augmented reality (AR) based on intra-operative ultrasound (US) has the potential to enhance the visualization of the anatomy and cancerous tumors to provide additional tools for decision-making in surgery.
Methods: We propose a US-guided AR system for TORS, with the transducer placed on the neck for a transcervical view.
Orthop Surg
July 2021
Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.
Objectives: This study aims to explore a novel intraoperative trajectory-determined strategy of grouped patient-specific drill templates (PDTs) for transoral C pedicle screw insertion (C TOPI) for atlantoaxial dislocation (AAD) with incomplete reduction and to evaluate its efficiency and accuracy.
Methods: Ten cadaveric C specimens were scanned by computed tomography (CT) and randomly divided into two groups (the PDT and freehand groups). A novel intraoperative trajectory-determined strategy of grouped PDTs was created for AAD with incomplete reduction.
J Orthop Surg Res
May 2019
Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, 1063 Shatai Nan Road, Baiyun District, Guangzhou, Guangdong, China.
Background: The transoral atlantoaxial reduction plate (TARP) is an effective advance in the treatment of atlantoaxial dislocation (AAD) and can enable the performance of anterior atlantoaxial release, reduction, decompression, and internal fixation in a one-stage operation. However, accurate transoral C2 pedicle insertion (C2TOPI) remains a challenge. The aim of this study is to develop a grouped patient-specific drill template (PDT) specifically for AAD with complete reduction and, furthermore, to compare its efficacy and accuracy in facilitating C2TOPI.
View Article and Find Full Text PDFJ Craniovertebr Junction Spine
January 2017
Department of Neurosurgery, Kırıkkale University Medical School, Kırıkkale, Turkey.
Study Design: Atlas fractures are evaluated according to the fracture type and ligamentous injury. External immobilization may result in fracture nonunion.
Objective: The ideal treatment method for non-stabilized atlas fractures is limited fixation without restricting the range of motion of the atlantoaxial and atlantooccipital joints.
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