Évaluation d'outils d'assistance naviguée et robotisée à la découpe osseuse pour la chirurgie des tumeurs du pelvis
(2010)
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- (en) This thesis originates from the research project "Sarcome" that we conducted in close collaboration with the Department of orthopaedic surgery of the UCL and the Saint-Luc University Hospital (Brussels). This project deals with the surgical treatment of malignant osseous tumors within the pelvis. Nowadays, one of the most satisfactory solutions is a large resection combined with reconstruction by massive allografts (without limb amputation). However, the conventional (freehand) bone-cutting procedure is still inaccurate, particularly because of the complex anatomy of the bony pelvis. The works presented in this thesis deal especially with the evaluation of computer- and robot-assisted devices integrated with the surgical procedure to improve the quality of the bone-cutting gestures. Firstly, we propose a systematic approach to define and to evaluate the quality of a bone-cutting process in accordance with the international ISO1101 standards. This approach is based on a bone-cutting simulator (on a simple osseous geometry) and enabled us to validate the ISO parameter "location" as a new quality standard for bone-cutting in orthopaedic surgery. Secondly, we propose a quantitative study to compare several surgical assistance tools based on their effective performances during cutting. In this thesis, we especially investigated navigated and robot-assisted technologies by implementing them on a pelvic simulator. Bone-cutting accuracy, as measured by the ISO location, is significantly improved when an optical navigation system and an active industrial robot are integrated with the freehand cutting procedure with an oscillating saw. Finally, the navigated cutting procedure was successfully applied to a patient suffering from a malignant osseous tumor within the pelvis. This is the first clinical case in which both tumoral resection and reconstruction by allograft were performed with the aid of a navigation system during the same surgical intervention.
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Cartiaux, O. (2010). Évaluation d’outils d’assistance naviguée et robotisée à la découpe osseuse pour la chirurgie des tumeurs du pelvis. https://hdl.handle.net/2078.5/130012