Study Of The Robot Surgery Approach Of Brachial Plexus Transaxillary Based On CT Image

Objective:Through the measurement and three-dimensional reconstruction of the CT images of normal adult scanned from the armpit to cervical vertebra 7, research into the robot surgery approach of brachial plexus transaxillary and related anatomic data, provide anatomical basis for the further implementation of the robot surgery.Methods:Three-dimensional reconstruct and measure the CT image of the 80 cases adult patients in our hospital(40 cases(40 male and female) that was continuous scanned from the armpit to cervical vertebra 7. The mean age of patients in the group was 57.52 years(20-91 years), there were not patients who had defects or damage of bone, soft tissue in the neck and shoulder, there was no surgical history of neck and shoulder. Select the 9 level of CT images by the bony structure :cervical vertebral 7,thoracic vertebral 1, middle of clavicle, upper the coronoid process, under the coronoid process, glenoid cavity, under the glenoid cavity, the approach in the axilla. Measure the irregular sectional area of the surrounding soft tissue clearance of brachial plexus in corresponding images by the 3D-doctor software, measure the biggest circle sectional area of the surrounding soft tissue clearance of brachial plexus in the selected images by the Hinet PACS5.0 software. Measure the angle of the surrounding soft tissue clearance of brachial plexus from the armpit to cervical vertebra 7 in the coronary images by the Hinet PACS5.0 software. Combine with the visible human project(VHP) analysis of the surrounding soft tissue adjacent to the brachial plexus.Statistical analysis of the data measured by the Statistical Programme for Social Science, P value is less than 0.05 were statistically significant.Results:1. The biggest circle sectional area of brachial plexus area : 586.36±32.12(192.00-1053.00)mm2,the irregular sectional area:793±45.54(205.00-1873.00)mm2, the space volume of the soft tissue adjacent to the brachial plexus is large enough to hold the robot instrument(maximum cross-sectional area was 78.54), the Angle of the surrounding soft tissue clearance of brachial plexus : 152.67±1.94°(148.00°-156.40°).2. There was statistical significance between men and women under the biggest circle sectional area of Cervical vertebral 7,glenoid cavity, under the glenoid cavity and the approach in the axilla(T test value are: 0.030, 0.030, 0.027), the sectional area of male group was bigger than female group, there was statistical differences during different level of images under the biggest circle sectional area in the male group, female group and mixed group(F value: 73.218, 25.563, 90.049); there was no statistical difference between men and women under the Angle of the surrounding soft tissue clearance of brachial plexus(T value: 0.317), of the measurement data matching T test shows that there was no statistical difference between the left and right side under the Angle of the surrounding soft tissue clearance of brachial plexus((T value: 0.915)).Conclusions:Robotic devices that 10 mm in diameter were able to reach the brachial plexus transaxillary, the operating space can be maintained by the special equipment; robot surgery of brachial plexus transaxillary was a anatomical feasibility.