【摘要】 目的探讨第六代无框架立体定向手术机器人(Remote Medical Robot,Remebot)的临床应用价值。方法回顾性分析65例应用Remebot实施无框架脑立体定向手术的病例资料,其中脑深部核团毁损术47例(包括肌张力障碍26例、癫疒间15例、帕金森病6例),脑内病变活检17例,颅咽管瘤腔内Ommaya囊植入术1例。结果 65例病人均成功完成无框架定位手术,定位操作均一次性完成,无严重手术并发症,平均用时(25±5)min,定位精度(0.63±0.11)mm。17例脑内病变活检,均获得明确病理诊断:星形细胞瘤8例,淋巴瘤4例,炎性病变3例,转移癌2例。26例肌张力障碍病人行内囊前肢毁损17例,苍白球腹内侧核(GPi)毁损9例;15例癫疒间病人,行海马、杏仁核核团毁损;6例帕金森病行GPi毁损术。1例颅咽管瘤腔内Ommaya囊植入,术后症状明显改善。手术有效率93.75%(45/48)。结论 Remebot设计结构合理,集成操作,实用性强,定位精确且操作方便,手术安全可行,具有广阔的应用前景。更多还原

【Abstract】 Objective To investigate th e clinical application value of the sixth generation Remote Medical Robot(Remebot).Methods The clinical data of 65 patients undergoing Remebot frameless stereotactic operation were analyzed retrospectively. The deep brain nucleus lesion was seen in 47 cases, including dystonia in 26, epilepsy in 15 and Parkinson’s disease in 6. Brain biopsy was performed in 17 cases and Ommaya reservoir was implanted into the craniopharyngioma in 1. Results The surgical procedures were successful in all the cases without serious operation-related complications. Positioning operations were all completed once, the average operation time was 25 ± 5 min, and the average accuracy was 0.63 ± 0.11 mm. Seventeen cases of brain lesions were diagnosed by brain biopsy: astrocytoma in 8, lymphoma in 4, inflammatory lesions in 3 and brain metastases in 2. In 26 cases of dystonia patients,anterior limb stereotactic lesioning of the internal capsule was induced in 17 cases, and lesioning of the globus pallidus internus(GPi)in 9. Hippocampus and amygdala nucleus lesioning was performed in 15 patients with epilepsy. Lesioning of the GPi was carried out in6 patients with Parkinson’s disease. The symptoms of patient with craniopharyngioma were obviously improved after Ommaya reservoir implantation. And the surgical success rate was 93.75%(45/48). Conclusions The design of Remebot surgical robot is reasonable, the operation is practical and convenient with accurate positioning. The operation is safe and feasible, and has wide application prospect.更多还原