Cheung, S;
Rahman, R;
Bicknell, C;
Stoyanov, D;
Chang, P-L;
Li, M;
Rolls, A;
... Riga, C; + view all
(2020)
Comparison of manual versus robot-assisted contralateral gate cannulation in patients undergoing endovascular aneurysm repair.
International Journal of Computer Assisted Radiology and Surgery
, 15
(12)
pp. 2071-2078.
10.1007/s11548-020-02247-3.
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Abstract
PURPOSE: Robotic endovascular technology may offer advantages over conventional manual catheter techniques. Our aim was to compare the endovascular catheter path-length (PL) for robotic versus manual contralateral gate cannulation during endovascular aneurysm repair (EVAR), using video motion analysis (VMA). METHODS: This was a multicentre retrospective cohort study with fluoroscopic video recordings of 24 EVAR cases (14 robotic, 10 manual) performed by experienced operators (> 50 procedures), obtained from four leading European centres. Groups were comparable with no statistically significant differences in aneurysm size (p = 0.47) or vessel tortuosity (p = 0.68). Two trained assessors used VMA to calculate the catheter PL during contralateral gate cannulation for robotic versus manual approaches. RESULTS: There was a high degree of inter-observer reliability (Cronbach’s α > 0.99) for VMA. Median robotic PL was 35.7 cm [interquartile range, IQR (30.8–51.0)] versus 74.1 cm [IQR (44.3–170.4)] for manual cannulation, p = 0.019. Robotic cases had a median cannulation time of 5.33 min [IQR (4.58–6.49)] versus 1.24 min [IQR (1.13–1.35)] in manual cases (p = 0.0083). Generated efficiency ratios (PL/aorto-iliac centrelines) was 1.6 (1.2–2.1) in robotic cases versus 2.6 (1.7–7.0) in manual, p = 0.031. CONCLUSION: Robot-assisted contralateral gate cannulation in EVAR leads to decreased navigation path lengths and increased economy of movement compared with manual catheter techniques. The benefit could be maximised by prioritising robotic catheter shaping over habituated reliance on guidewire manipulation. Robotic technology has the potential to reduce the endovascular footprint during manipulations even for experienced operators with the added advantage of zero radiation exposure.
| Type: | Article |
|---|---|
| Title: | Comparison of manual versus robot-assisted contralateral gate cannulation in patients undergoing endovascular aneurysm repair |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s11548-020-02247-3 |
| Publisher version: | https://doi.org/10.1007/s11548-020-02247-3 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Endovascular, innovation, aneurysm, robotics |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Computer Science |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10140856 |
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