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Virtual modeling of robot-assisted manipulations in abdominal surgery

World Journal of Gastrointestinal Surgery 2012年第6期4卷 141-145页

作者： Stanislav V Berelavichus Grigory G Karmazanovsky Vadim S Shirokov valeriy a kubyshkin Andrey G Kriger Evgeny V Kondratyev Olga P Zakharova Surgery Department of Vishnevsky Institute of Surgery B.Serpukhovskaya Street27Moscow 117997Russia Radiology Department of Vishnevsky Institute of Surgery B.Serpukhovskaya Street27Moscow 117997Russia

AIM:To determine the effectiveness of using multidetector computed tomography(MDCT)data in preoperative planning of robot-assisted ***:Fourteen patients indicated for surgery underwent MDCT using 64 and 256-slice *** the examination,a specially constructed navigation net was placed on the patient’s anterior abdominal *** of MDCT data was performed on a Brilliance Workspace 4(Philips).Virtual vectors that imitate robotic and assistant ports were placed on the anterior abdominal wall of the 3D model of the patient,considering the individual anatomy of the patient and the technical capabilities of robotic *** for location of the ports were directed by projection on the roentgen-positive tags of the navigation ***:There were no complications observed during surgery or in the post-operative *** were able to reduce robotic arm interference during *** surgical area was optimal for robotic and assistant manipulators without any need for reinstallation of the ***:This method allows modeling of the main steps in robot-assisted intervention,optimizing operation of the manipulator and lowering the risk of injuries to internal organs.

关键词： Virtual modeling Robotic surgery Multidetector computed tomography Abdominal surgery Virtual surgery

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CT判定胰头癌可切除的准确性研究

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世界核心医学期刊文摘（胃肠病学分册） 2005年第12期1卷 6-7页

作者： Karmazanovsky G. Fedorov V. kubyshkin V. Kot- chatkov A. 郝筱倩 Radiology Department A. V. Vishnevsky Institute of Surgery RAMSc Bol. Serpukhovskaya Street 27 115093 Moscow Russian Federation

Background: Pancreatic cancer is a devastating disease whose early detection remains difficult. There is no 100% reliable imaging test to diagnose and stage pancreatic cancer. We assessed the surgical value of contrast- enhanced spiral computed tomography (CT) in predicting the resectability and survival rates of patients who had pancreatic head cancer. Methods: Eighty- nine patients who had pancreatic head cancer were investigated with spiral CT. Based on the preoperative CT results, we assigned patients to one of three CT groups based on resectability. Results: A correlation between classification of CT resectability and intraoperative finding was found in 83% of patients. The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of spiral CT in identifying predictive unresectability were 79% , 82% , 91% , 62% , and 81% , respectively. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT in diagnosis of vascular invasion were 94% , 84.2% , 94% , 84% , and 91.3% , respectively. Conclusions: The use of CT in the evaluation of pancreatic tumors provides valuable preoperative assessment of surgical resectability and should be performed for clinical examination. Classifying *** by tumor resectability on CT helps to estimate more precisely the tumor stage and to prognosticate survival rates of these patients.

关键词：胰头癌 CT 可切除性阳性预测率肿瘤分期影像学检查造影剂早期诊断特异性

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