Intra-operative quantification of the surgical gesture in orbital surgery: Application to the proptosis reduction

Autor: Yohan Payan, Vincent Luboz, Franck Boutault, Pascal Swider, Dominique Ambard
Přispěvatelé: Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Centre National de la Recherche Scientifique (CNRS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS), Laboratoire de biomécanique de Toulouse (EA 3697), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Université Joseph Fourier - Grenoble 1 (UJF)-Centre National de la Recherche Scientifique (CNRS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Université Joseph Fourier - Grenoble 1 (UJF)-Centre National de la Recherche Scientifique (CNRS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)
Rok vydání: 2007
Předmět:
medicine.medical_specialty
Intra operative
[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging
Decompression
medicine.medical_treatment
Biophysics
FOS: Physical sciences
Osteotomy
03 medical and health sciences
computer assisted planning
0302 clinical medicine
Proptosis
medicine
Exophthalmos
Humans
Computer Simulation
Orthopedics and Sports Medicine
Displacement (orthopedic surgery)
experimental method
[PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph]
Reduction (orthopedic surgery)
Orthodontics
business.industry
Force gauge
[SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph]
Stiffness
030229 sport sciences
Physics - Medical Physics
Orbital surgery
Biomechanical Phenomena
Surgery
Surgery
Computer-Assisted
030221 ophthalmology & optometry
Medical Physics (physics.med-ph)
medicine.symptom
Finite Element model
business
Algorithms
Zdroj: HAL
Clinical Biomechanics
Clinical Biomechanics, Elsevier, 2007, 22, pp.298-303
ISSN: 0268-0033
1879-1271
DOI: 10.1016/j.clinbiomech.2006.10.008
Popis: Background Proptosis is characterized by a protrusion of the eyeball due to an increase of the orbital tissue volume. To recover a normal eyeball positioning, the most frequent surgical technique consists in the osteotomy of orbital walls combined with a loading on the eyeball to initiate tissue decompression. The first biomechanical models dealing with proptosis reduction, validated in one patient, have been previously proposed by the authors. Methods This paper proposed an experimental method to quantify the intra-operative clinical gesture in proptosis reduction, and the pilot study concerned one clinical case. The eyeball’s backward displacement was measured by an optical 3D localizer and the load applied by the surgeon was simultaneously measured by a custom-made force gauge. Quasi-static stiffness of the intra-orbital content was evaluated. Findings The average values for the whole experiment was 16 N (SD: 3 N) for the force exerted by the surgeon and 9 mm (SD: 4 mm) for the eyeball backward displacement. The averaged quasi-static stiffness of the orbital content was evaluated to 2.4 N/mm (SD: 1.2) and showed a global decrease of 45% post-operatively. Interpretation The protocol and the associated custom-designed devices allowed loads, induced displacements and macroscopic stiffness of the orbital content to be measured intra-operatively. The clinical relevance has been demonstrated in a pilot study. To our knowledge, no study has been published allowing the clinical gesture in proptosis reduction to be quantified intra-operatively. Associating an enlarged database and validated patient-related predictive models will reinforce the surgical efficiency and patient comfort contributing to diagnosis and intra-operative guidance.
Databáze: OpenAIRE
Externí odkaz: