足踝手术支架在骨科手术机器人辅助手术中的有效性与安全性研究

背景:骨科手术机器人Ti-Robot(由北京积水潭医院与北京天智航医疗科技股份有限公司等单位合作研发)已在国内骨科手术治疗中得到越来越普遍的应用,作为划时代的创新技术,医护人员在使用Ti-Robot的过程中需要逐步掌握。经过一段时间的使用和观察,并结合足踝外科的术中护理需要,自主研制开发了一种足踝手术支架在术中辅助手术。目的:分析足踝手术支架在术中辅助Ti-Robot进行手术的应用效果,与常规手术方式进行有效性和安全性的对比研究。方法:回顾性分析2018年4月至2019年4月完成的Ti-Robot足踝手术30例,其中常规手术方式的15例为对照组,使用足踝手术支架辅助手术的15例为研究组。术中分别记录患者体位固定、患者示踪器固定、机器人执行和定位所用时间,以及术中采集影像资料时C型臂X线机透视调整的次数。结果:术中两组患者的体位固定、患者示踪器固定及机器人执行引导和定位所用时间比较,差异均有统计学意义(P<0.01);两组C型臂X线机透视调整的次数比较,差异无统计学意义(P>0.05)。足踝手术支架使肢体固定更稳定牢靠,手术入路方式的选择更为自由,安全性更高。结论:足踝手术支架作为Ti-Robot在足踝外科手术的必要辅助配件,其应用显著提高手术效率,并减少患者创伤,提升术中护理的医患满意度,但仍存在不足之处,需要进一步改进。

Analysis of effectiveness and safety of foot and ankle bracket in robot assisted orthopedic surgery

Background:Ti-Robot,an orthopedic robot,was cooperatively developed by Beijing Jishuitan Hospital and TINAVI company,and has been widely applied in orthopedic surgeries in China.However,as for a new technique,there is still a long process for medical staff to skillfully operate Ti-Robot intraoperatively.After a period of use and observation,we developed a foot and ankle bracket special for robot assisted surgeries based on foot and ankle surgery's intraoperative nursing require?ments.Objective:To analyze the clinical effect of foot and ankle bracket in surgery by comparison of efficacy and safety with conventional Ti-Robot surgery.Methods:Data of 30 patients undergoing robot assisted foot and ankle surgeries was retrospec?tively analyzed and divided into study group(n=15)with foot and ankle bracket used in surgery and control group(n=15)with?out bracket from April 2018 to April 2019.Time of patient positioning,patient tracker fixing and robot executing during sur?gery were recorded,and also the frequency of C-arm's position adjustment in every case.Results:The time of patient position?ing,patient tracker fixing and robot executing during surgery was significantly less in the study group than in the control group(P<0.01),but there was no difference in the frequency of C-arm's positioning adjustment between the two groups.The applica?tion of foot and ankle bracket made the limbs fixed more stable and provided a larger range of surgical approach options so that better safety was achieved.Conclusions:As a necessary accessory of Ti-Robot in foot and ankle surgeries,the application of foot and ankle bracket increases surgical efficiency significantly,meanwhile decreases injuries of patients,and improves satisfaction of surgeons and patients during intraoperative nursing,however,it also has shortcomings and requires further improvement.