Articulating Rotary Burs for Enhanced Bone Resection: Implications for Arthroscopic, Endoscopic Spinal, and Robotic Surgery

医学 机械人手术 外科 侵入性外科 衔接(社会学) 切除术 扭矩 微创手术 普通外科 外科手术 梅德林 3d打印 手术机器人 机械臂 内镜手术 医学物理学 内窥镜检查 腹腔镜检查 学习曲线
作者
Akshar P Thakkar,Thomas R. Nayak,Peter J. Millett,Sanjeev Bhatia
出处
期刊:Surgical Innovation [SAGE Publishing]
卷期号:: 15533506261452149-15533506261452149
标识
DOI:10.1177/15533506261452149
摘要

Introduction Bone resection in minimally invasive procedures requires precise instrument positioning within constrained joint environments. Conventional straight arthroscopic burs (SABs) offer limited mobility due to geometric and soft tissue restrictions, often necessitating portal adjustments or tissue releases. Articulating rotary burs (ARB) incorporate adjustable articulation angles to enhance mobility and minimize collateral damage. This study aimed to quantitatively evaluate the cutting surface area (CSA) of a SAB and an ARB to compare efficiency in bone resection. Methods A 3D point cloud analysis was performed in SolidWorks (Dassault Systèmes, Vélizy-Villacoublay, France) to compare CSA of a 5.0 mm SAB and a 5.0 mm ARB (Articulator™ Arthroscopic Bur, Joint Preservation Innovations, Naperville, IL), both with ball bur heads. Analyses accounted for continuous rotation about the tool’s long axis. The SAB was compared with the ARB at 0°, 15°, and 30° distal articulation. Surface areas are reported in in 2 with metric equivalents (mm 2 ). An aggregate motion-envelope CSA (0°–30°) was calculated as the sum of articulated positions. Results The CSA of the SAB was 0.081 in 2 (52.3 mm 2 ). The ARB CSA was 0.081 in 2 (52.3 mm 2 ) at 0°, 0.203 in 2 (131.0 mm 2 ) at 15°, and 0.284 in 2 (183.2 mm 2 ) at 30°, totaling 0.568 in 2 (366.5 mm 2 ). Overall, the ARB demonstrated a 601% greater CSA. Conclusion In this geometric modeling study, distal articulation increased accessible CSA across articulated positions. ARBs may expand geometric access in minimally invasive settings; however, translation to surgical performance (eg, resection rate, thermal effects, torque transmission, and safety) requires empirical validation.

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