A Comparative Study Of Robot-assisted Frameless Stereotactic Biopsy And Conventional Frame-based Stereotactic Biopsy

Objective: To evaluate the safety,positioning accuracy and diagnostic yield of the robot-assisted frameless stereotactic biopsy and provide the theory basis for the further clinical application.Methods: we retrospectively analyzed the data of nearly 45 patients who underwent stereotactic biopsy from September 2015 to February 2017.The patients were divided into two different groups according to the different surgical procedures: the robot-assisted surgery group and the conventional frame-based surgery group.Operation time,diagnostic yield,incidence and severity of operative adverse events,post-operative hospitalization and other aspects of the difference between the two groups were contrasted.In addition,a phantom trail using a human skull model was applied to simulate the biopsy procedure under the assistant of surgical robot.Displacement of the robot-assisted target was determined to assess the accuracy of needle positioning and the stability of robotic handling.Results: There were 11 cases in robot-assisted surgery group and 34 cases in conventional frame-based surgery group.The average operation time was 38.7 min in the robotic-assisted operation group compared to the 46.5 min in the conventional frame-based group with a statistically comparative difference(P<0.05).9 cases in former group acquired specific pathological results,the diagnostic yield was 82% compared to the 91% in latter group with 31 positive pathological findings(P>0.05).The gap between the two groups was no statistical significance in operative adverse events rates(P>0.05).The identical result was revealed in post-operative hospitalization(P>0.05),robot-assisted surgery group was 4.9 days on average,compared with another group of 6.5 days.The mean deviation distance of robot-assisted surgery target was about 1.41 ± 0.28 mm,and there was no significant difference(P>0.05)between the mean migration distance and the variance analysis in the three rounds of surgeons with different experiences manifested the strong stability of robotic handling.Conclusions: Compared with the traditional stereotactic biopsy,Remebot robot-assisted stereotactic biopsy is relatively a safe and effective means of biopsy.However,due to the deviation to the target,it is necessary to further evaluate the effect of the application of the robot in the stereotactic surgeries indispensable to ultra-precision.