Development and validation of collaborative robot-assisted cutting method for iliac crest flap raising: Randomized...

Area of Science:

• Oral and Maxillofacial Surgery
• Robotic Surgery
• Biomedical Engineering

Background:

• Current gold standard for computer-assisted jaw reconstruction uses 3D-printed cutting guides for microvascular bone flaps.
• Conventional guides have limitations including invasive fixation, periosteal denudation, extended lead times, and lack of intraoperative flexibility.

Purpose of the Study:

• To investigate the feasibility and accuracy of a robot-assisted cutting method for raising iliac crest flaps.
• To compare robot-assisted cutting against conventional 3D-printed cutting guides in terms of accuracy, duration, workload, and usability.

Main Methods:

• A randomized crossover study involving 40 participants on pelvic models.
• Comparison of conventional 3D-printed cutting guides versus a robot-assisted cutting method.
• Evaluation of osteotomy angle deviation, Hausdorff Distance (HD), Average Hausdorff Distance (AVD), duration, workload, and usability.

Main Results:

• Robot-assisted cutting demonstrated significantly lower mean angular deviation (1.9° ± 1.1°) compared to conventional guides (4.7° ± 2.9°).
• The robot-assisted method achieved a lower mean Hausdorff Distance (1.5 mm ± 0.6 mm) versus conventional guides (2.0 mm ± 0.9 mm).
• No significant difference was found in Average Hausdorff Distance between the two methods (0.8 mm ± 0.5 mm vs. 0.8 mm ± 0.4 mm).

Conclusions:

• Collaborative robot-assisted cutting presents a viable alternative to 3D-printed cutting guides in static experimental settings.
• This robotic approach offers benefits such as reduced invasiveness and increased intraoperative flexibility.
• Future research should validate these findings in dynamic environments and cadaver studies.