一站对多地5G远程控制骨科机器人手术的临床应用

目的探讨一站对多地(一对多,one to many)5G远程骨科机器人手术的准确性和安全性。方法纳入2019年6至8月北京积水潭医院脊柱外科、山东省烟台山医院骨科、浙江省嘉兴市第二医院骨科、天津市第一中心医院骨科、河北省张家口市第二医院脊柱外科和新疆维吾尔自治区克拉玛依市中心医院骨科应用天玑骨科手术机器人辅助一对多5G远程脊柱内固定手术治疗的患者5例。4例患者为胸腰椎骨折,1例患者为腰椎滑脱。评价指标包括螺钉置入准确性、术中不良事件与术后5 d内并发症发生率、手术时间等。结果共完成2次一对多5G远程骨科机器人手术,包括一站对二地手术和一站对三地手术各1次。5例患者均顺利完成手术,手术时间为(122.0±33.5)min,导针置入时间为(44.0±8.2)min。共置入椎弓根螺钉30枚,螺钉分级为A级29枚、B级1枚。螺钉位置优秀(A级)率为96.7%,螺钉位置可接受(A级+B级)率为100%。螺钉置入实际位置与规划位置的偏差为(0.79±0.52)mm。术中未发生不良事件,术后5 d内未发生并发症。视觉模拟评分法(VAS)评分从术前的(4.6±1.5)分降低到术后的(2.6±0.5)分。结论一对多5G远程骨科机器人手术的准确性高、安全性好,将有助于远程医疗行业加快进入5G时代。5G远程骨科机器人手术的临床应用有望推动高端医用装备技术的发展。

Clinical application of "one to many" 5G remote orthopedic robot-assisted surgery

Objective To investigate the accuracy and safety of clinical application of"one to many"5G remote orthopedic robot-assisted surgery.Methods Between June and August 2019,a total of 5 patients underwent"one to many"5G remote TiRobot orthopedic robot-assisted spinal surgery in Department of Spine Surgery,Beijing Jishuitan Hospital,Department of Orthopedics,Yantaishan Hospital,Department of Orthopedics,Second Hospital of Jiaxing City,Department of Orthopedics,Tianjin First Central Hospital,Department of Spine Surgery,Second Hospital of Zhangjiakou City and Department of Orthopedics,Karamay Central Hospital of Xinjiang.Four patients were diagnosed with thoracolumbar fractures,and one patient was diagnosed with lumbar spondylolisthesis.The main measurements included the accuracy of screw placement,intraoperative adverse events,postoperative complications within 5 days and operation time,etc.Results A total of 2"one to many"5G remote orthopedic robot-assisted surgery were successfully performed,including 1"one-to-two"simultaneous surgery and 1"one-to-three"simultaneous surgery.All 5 patients completed their procedures.The operation time was(122.0±33.5)min.The duration of pedicle guide wire insertion was(44.0±8.2)min.A total of 30 pedicle screws were placed.Twenty-nine screws were classified as Grade A,and one screw was classified as Grade B.The excellent screw position(Grade A)rate was 96.7%,and the acceptable(Grade A+B)rate was 100%.The deviation between the actual position of pedicle screws and the planned position was(0.79±0.52)mm.No adverse events occurred during the procedures.No complication occurred within 5 days after surgery.VAS score decreased from(4.6±1.5)points to(2.6±0.5)points postoperatively.Conclusions"One to many"5G remote orthopedic robot-assisted surgery is accurate and safe.The combination of 5G and robot will accelerate the telemedicine industry into the new era of 5G.The clinical application of 5G remote orthopedic robot-assisted surgery will promote the development and application.