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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5225_Библиотеки_им_академика_М_И_Перельмана.pdf
10 Robotic Navigation: Instrumentation
Step 3: Intraoperative CT.
Step 4: Intraoperative planning of screw trajectories.
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Step 5: Appropriate positioning of monitor in line of sight of ducial.
Step 6: Implant verication.
T. J. C. Pazionis et al.
Step 7: Activate surveillance marker and completion of landmark verication.
10 Robotic Navigation: Instrumentation
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Step 8: Verify all instruments.
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T. J. C. Pazionis et al.
Step 9: Select screw you would like to implant on touch screen.
10 Robotic Navigation: Instrumentation
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Step 10: Step on Pedal—this should be done before each step in the process to
reposition the robotic arm and ensure the trajectory is still as planned.
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T. J. C. Pazionis et al.
Step 11: The burr is then used to select the entry point using robotic navigation
as a guide, followed by the drill to 30mm, tap and then screw insertion. This is done
on power when using Globus compatible screws. After each step, ensure that the
robot is repositioned using the foot pedal and the indicators are “green.”
10 Robotic Navigation: Instrumentation
Step 12: An alternate workow may be used to place cannulated screws. Place a
cannulated tube through the robotic arm in the desired trajectory.
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Step 13: Remove the end effector by unclamping it from the robotic arm.
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T. J. C. Pazionis et al.
Step 14: Place a guidewire through the tube and remove the tube. Probe the channel using the guidewire to ensure optimal placement in bone.
Step 15: Place a cannulated screw by hand over the guidewire.
10 Robotic Navigation: Instrumentation
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Robotic Workow Using Preoperative CT andMazor
(Medtronic) Robot
There are two possible workows—either intraoperative CT and a “scan and plan”
approach or a preoperative CT with a uoroscopic merge.
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T. J. C. Pazionis et al.
Step 1: The preoperative CT workow allows for screw trajectory planning
preoperatively.
Step 2: The Mazor Robot is attached to the patient’s iliac crest as shown.