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Computer and robot assistance in craniotomy/craniectomy procedures is intended to increase precision and efficiency of the removal of calvarial tumours, enabling the preoperative design and manufacturing of the corresponding implant. In the framework of the CRANIO project, an active robotic system was developed to automate the milling processes based on a predefined resection planning. This approach allows for a very efficient milling process, but lacks feedback of the intra-operative process to the surgeon. To better integrate the surgeon into the process, a new teleoperated synergistic architecture was designed. This enables the surgeon to realize changes during the procedure and use their human cognitive capabilities. The preoperative planning information is used as guidance for the user interacting with the system through a master-slave architecture. In this article, the CRANIO system is presented together with this new synergistic approach. Experiments have been performed to evaluate the accuracy of the system in active and synergistic modes for the bone milling procedure. The laboratory studies showed the general feasibility of the new concept for the selected medical procedure and determined the accuracy of the system. Although the integration of the surgeon partially reduces the efficiency of the milling process compared with a purely active (automatic) milling, it provides more feedback and flexibility to the user during the intra-operative procedure. [ABSTRACT FROM AUTHOR]

The goal of the present study was to determine the electrophysiological correlate of the threshold of perception of passive motion (TPPM) in a group of healthy individuals. We expect a different pattern of activation over the frontoparietal network produced by the conscious perception of the passive movement. Ten right-handed male volunteers, between 20 and 30 years of age, were submitted to the threshold of perception of passive motion (TPPM) task in a proprioception testing device (PTD). The device was designed to passively move the arm in internal and external rotations about the shoulder joint. Participants were instructed to press a hand-held switch every time movement of the shoulder was detected. Electromyographic (EMG) and electroencephalographic (EEG) activities were acquired during the task. Passive movement of the shoulder joint was followed by a clear and prolonged decrease in the signal magnitude of the electroencephalogram. The electrophysiological correlate of the TPPM was characterized by the establishment of a frontoparietal network, during the processing of somatosensory information., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Purpose: To quantitatively analyze differences in mechanical properties, needle design including signs of wear, subjective handling and specimen quality of bone biopsy needles., Materials and Methods: In this study 19 different bone biopsy systems (total 38; 2 /type) were examined. With each biopsy needle five consecutive samples were obtained from vertebral bodies of swine. During puncture a force-torques sensor measured the mechanical properties and subjective handling was assessed. Before and after each biopsy the needles were investigated using a profile projector and signs of wear were recorded. Afterwards, a pathologist semi-quantitatively examined the specimen regarding sample quality. The overall evaluation considered mechanical properties, needle wear, subjective handling and sample quality. Differences were assessed for statistical significance using ANOVA and t-test., Results: Needle diameter (p = 0.003) as well as needle design (p = 0.008) affect the mechanical properties significantly. Franseen design is significantly superior to other needle designs. Besides, length reduction recorded by the profile projector, as a quality criterion showed notable distinctions in between the needle designs., Conclusion: Bone biopsy needles vary significantly in performance. Needle design has an important influence on mechanical properties, handling and specimen quality. Detailed knowledge of those parameters would improve selecting the appropriate bone biopsy needle., (© Georg Thieme Verlag KG Stuttgart · New York.)