A novel concept for smart trepanation

The Journal of Craniofacial Surgery
Axel FollmannKlaus Radermacher

Abstract

Trepanation of the skull is a common procedure in craniofacial and neurosurgical interventions, allowing access to the innermost cranial structures. Despite a careful advancement, injury of the dura mater represents a frequent complication during these cranial openings. The technology of computer-assisted surgery offers different support systems such as navigated tools and surgical robots. This article presents a novel technical approach toward an image- and sensor-based synergistic control of the cutting depth of a manually guided soft-tissue-preserving saw. Feasibility studies in a laboratory setup modeling relevant skull tissue parameters demonstrate that errors due to computed tomography or magnetic resonance image segmentation and registration, optical tracking, and mechanical tolerances of up to 2.5 mm, imminent to many computer-assisted surgery systems, can be compensated for by the cutting tool characteristics without damaging the dura. In conclusion, the feasibility of a computer-controlled trepanation system providing a safer and efficient trepanation has been demonstrated. Injuries of the dura mater can be avoided, and the bone cutting gap can be reduced to 0.5 mm with potential benefits for the reintegration of the ...Continue Reading

References

Jan 4, 1998·Journal of Biomechanical Engineering·B R Donnelly, J Medige
Feb 17, 2000·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·M D Cusimano, A S Suhardja
Jun 1, 2000·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·G Savard, R Manchanda
Sep 10, 2003·Journal of Neurosurgery·Ken R Winston, Marjorie C Wang
Oct 22, 2009·Journal of Korean Neurosurgical Society·Duck-Ho GohJaechan Park

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Citations

Mar 5, 2019·International Journal of Computer Assisted Radiology and Surgery·Philipp SchleerKlaus Radermacher
Jun 15, 2014·Annals of Biomedical Engineering·Christopher J Payne, Guang-Zhong Yang

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