Optical navigation robot-assisted puncture system for accurate lung nodule biopsy: an animal study

作者：Li, Jing; Sun, Liyilei; Liu, Jun; Peng, Qian; Xu, Rongde; Cui, Wei; Deng, Yi; Xie, Weiguo; Huang, Bingding^*; Chen, Jingjing^*

来源：QUANTITATIVE IMAGING IN MEDICINE AND SURGERY, 2023, 13(12): 7789-7801.

DOI：10.21037/qims-23-576

• Percutaneous lung biopsy (PLB)
• computed tomography (CT)
• computed tomography-guided biopsy (CT-guided biopsy)
• optical navigation robot-assisted puncture system

Background: As lung cancer is one of the most significant factors seriously endangering human health, a robot-assisted puncture system with high accuracy and safety is urgently needed. The purpose of this investigation was to compare the safety and effectiveness of such a robot-assisted system to the conventional computed tomography (CT)-guided manual method for percutaneous lung biopsies (PLBs) in pigs.Methods: An optical navigation robot-assisted puncture system was developed and compared to the traditional CT-guided PLB using simulated lesions in experimental animals. A total of 30 pulmonary nodules were successfully created in 5 pigs (Wuzhishan pig, 1 male and 4 females). Of these, 15 were punctured by the optical navigation robot-assisted puncture system (robotic group), and 15 were manually punctured under CT guidance (manual group). The biopsy success rate, operation time, first needle tip-target point deviation, and needle adjustment times were compared between groups. Postoperative CT scans were performed to identify complications.Results: The single puncture success rate was higher in the robotic group (13/15; 86.7%) than in the manual group (8/15; 53.3%). The first puncture was closer to the target lesion (1.8 +/- 1.7 mm), and the operation time was shorter (7.1 +/- 3.7 minutes) in the robotic group than in the manual group (4.4 +/- 2.8 mm and 12.9 +/- 7.6 minutes, respectively). The angle deviation was smaller in the robotic group (3.26(degrees) +/- 2.48(degrees)) than in the manual group (7.71(degrees) +/- 3.86(degrees)). The robotic group displayed significant advantages (P<0.05). The primary complication in both groups was slight bleeding, with an incidence of 26.7% in the robotic group and 40.0% in the manual group. There was 1 case of pneumothorax in the manual group, and there were no deaths due to complications in either group.Conclusions: An optical navigation robot-assisted system for PLBs guided by CT images was developed and demonstrated. The experimental results indicate that the proposed system is accurate, efficient, and safe in pigs.

• 单位
  南方医科大学; 1; 广东省人民医院