A new bone-cutting approach for minimally invasive surgery

Jeffrey Minnaard; Roeland P. Kleipool; Wim Baars; Jenny Dankelman; Sjoerd Stufkens; Tim Horeman

doi:https://doi.org/10.1016/j.medengphy.2020.11.011

A new bone-cutting approach for minimally invasive surgery

Jeffrey Minnaard, Roeland P. Kleipool, Wim Baars, Jenny Dankelman, Sjoerd Stufkens, Tim Horeman

Research output: Contribution to journal › Article › Academic › peer-review

3 Citations (Scopus)

Abstract

Aims: Resection of bone is performed in over 75% of all orthopaedic procedures and the electrically powered oscillating saw is commonly used to cut bone. Drawbacks are relatively large incisions and tissue damage due to overshooting often occur. Therefore, the goal of this study is to develop an improved bone-cutting system that has minimally invasive characteristics. Methods: A new reusable sawing system was designed that can be used in Minimally Invasive Surgery (MIS) consisting of a steerable wire passer and a tissue saving wire saw guide. The system was tested during surgery on a human cadaveric tibia and calcaneus. Results: A MIS steerable compliant Nitinol needle was built and successfully used in a cadaveric surgery to position the cutting wire around a tibia and calcaneus. A wire saw operating system was built that was successfully used to cut the tibia and calcaneus. Conclusion: A MIS bone-cutting system was successfully designed, manufactured and used in a cadaver study showing that safe minimally invasive bone-cutting is feasible for two bone types with minimal damage to the surrounding tissue. Design optimization is needed to stabilize the compliant Nitinol needle during wire saw positioning and to allow cutting of bones with smaller diameters.

Original language	English
Pages (from-to)	56-62
Number of pages	7
Journal	Medical engineering & physics
Volume	87
DOIs	https://doi.org/10.1016/j.medengphy.2020.11.011
Publication status	Published - 1 Jan 2021

Keywords

Advanced MIS surgery
Bone-cutting
Compliant instruments
Minimally invasive orthopedics
Nitinol
Steering needle
Wire saw

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https://doi.org/10.1016/j.medengphy.2020.11.011

Cite this

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title = "A new bone-cutting approach for minimally invasive surgery",

abstract = "Aims: Resection of bone is performed in over 75% of all orthopaedic procedures and the electrically powered oscillating saw is commonly used to cut bone. Drawbacks are relatively large incisions and tissue damage due to overshooting often occur. Therefore, the goal of this study is to develop an improved bone-cutting system that has minimally invasive characteristics. Methods: A new reusable sawing system was designed that can be used in Minimally Invasive Surgery (MIS) consisting of a steerable wire passer and a tissue saving wire saw guide. The system was tested during surgery on a human cadaveric tibia and calcaneus. Results: A MIS steerable compliant Nitinol needle was built and successfully used in a cadaveric surgery to position the cutting wire around a tibia and calcaneus. A wire saw operating system was built that was successfully used to cut the tibia and calcaneus. Conclusion: A MIS bone-cutting system was successfully designed, manufactured and used in a cadaver study showing that safe minimally invasive bone-cutting is feasible for two bone types with minimal damage to the surrounding tissue. Design optimization is needed to stabilize the compliant Nitinol needle during wire saw positioning and to allow cutting of bones with smaller diameters.",

keywords = "Advanced MIS surgery, Bone-cutting, Compliant instruments, Minimally invasive orthopedics, Nitinol, Steering needle, Wire saw",

author = "Jeffrey Minnaard and Kleipool, {Roeland P.} and Wim Baars and Jenny Dankelman and Sjoerd Stufkens and Tim Horeman",

note = "Funding Information: J Minnaard, RP Kleipool, W Baars, J Dankelman, SAS Stufkens and T Horeman have no conflicts of interest or financial ties to disclose. For cadaver studies our institutional ethical review board does not require an approval request according to the Medical Research Involving Human Subjects Act. Work on human beings that is submitted to Medical Engineering & Physics should comply with the principles laid down in the Declaration of Helsinki; Recommendations guiding physicians in biomedical research involving human subjects. Adopted by the 18th World Medical Assembly, Helsinki, Finland, June 1964, amended by the 29th World Medical Assembly, Tokyo, Japan, October 1975, the 35th World Medical Assembly, Venice, Italy, October 1983, and the 41st World Medical Assembly, Hong Kong, September 1989. You should include information as to whether the work has been approved by the appropriate ethical committees related to the institution(s) in which it was performed and that subjects gave informed consent to the work. Not Applicable. Publisher Copyright: {\textcopyright} 2020 IPEM Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

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doi = "https://doi.org/10.1016/j.medengphy.2020.11.011",

language = "English",

volume = "87",

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journal = "Medical engineering & physics",

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T1 - A new bone-cutting approach for minimally invasive surgery

AU - Minnaard, Jeffrey

AU - Kleipool, Roeland P.

AU - Baars, Wim

AU - Dankelman, Jenny

AU - Stufkens, Sjoerd

AU - Horeman, Tim

N1 - Funding Information: J Minnaard, RP Kleipool, W Baars, J Dankelman, SAS Stufkens and T Horeman have no conflicts of interest or financial ties to disclose. For cadaver studies our institutional ethical review board does not require an approval request according to the Medical Research Involving Human Subjects Act. Work on human beings that is submitted to Medical Engineering & Physics should comply with the principles laid down in the Declaration of Helsinki; Recommendations guiding physicians in biomedical research involving human subjects. Adopted by the 18th World Medical Assembly, Helsinki, Finland, June 1964, amended by the 29th World Medical Assembly, Tokyo, Japan, October 1975, the 35th World Medical Assembly, Venice, Italy, October 1983, and the 41st World Medical Assembly, Hong Kong, September 1989. You should include information as to whether the work has been approved by the appropriate ethical committees related to the institution(s) in which it was performed and that subjects gave informed consent to the work. Not Applicable. Publisher Copyright: © 2020 IPEM Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/1/1

Y1 - 2021/1/1

N2 - Aims: Resection of bone is performed in over 75% of all orthopaedic procedures and the electrically powered oscillating saw is commonly used to cut bone. Drawbacks are relatively large incisions and tissue damage due to overshooting often occur. Therefore, the goal of this study is to develop an improved bone-cutting system that has minimally invasive characteristics. Methods: A new reusable sawing system was designed that can be used in Minimally Invasive Surgery (MIS) consisting of a steerable wire passer and a tissue saving wire saw guide. The system was tested during surgery on a human cadaveric tibia and calcaneus. Results: A MIS steerable compliant Nitinol needle was built and successfully used in a cadaveric surgery to position the cutting wire around a tibia and calcaneus. A wire saw operating system was built that was successfully used to cut the tibia and calcaneus. Conclusion: A MIS bone-cutting system was successfully designed, manufactured and used in a cadaver study showing that safe minimally invasive bone-cutting is feasible for two bone types with minimal damage to the surrounding tissue. Design optimization is needed to stabilize the compliant Nitinol needle during wire saw positioning and to allow cutting of bones with smaller diameters.

AB - Aims: Resection of bone is performed in over 75% of all orthopaedic procedures and the electrically powered oscillating saw is commonly used to cut bone. Drawbacks are relatively large incisions and tissue damage due to overshooting often occur. Therefore, the goal of this study is to develop an improved bone-cutting system that has minimally invasive characteristics. Methods: A new reusable sawing system was designed that can be used in Minimally Invasive Surgery (MIS) consisting of a steerable wire passer and a tissue saving wire saw guide. The system was tested during surgery on a human cadaveric tibia and calcaneus. Results: A MIS steerable compliant Nitinol needle was built and successfully used in a cadaveric surgery to position the cutting wire around a tibia and calcaneus. A wire saw operating system was built that was successfully used to cut the tibia and calcaneus. Conclusion: A MIS bone-cutting system was successfully designed, manufactured and used in a cadaver study showing that safe minimally invasive bone-cutting is feasible for two bone types with minimal damage to the surrounding tissue. Design optimization is needed to stabilize the compliant Nitinol needle during wire saw positioning and to allow cutting of bones with smaller diameters.

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KW - Bone-cutting

KW - Compliant instruments

KW - Minimally invasive orthopedics

KW - Nitinol

KW - Steering needle

KW - Wire saw

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DO - https://doi.org/10.1016/j.medengphy.2020.11.011

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C2 - 33461674

SN - 1350-4533

VL - 87

SP - 56

EP - 62

JO - Medical engineering & physics

JF - Medical engineering & physics

ER -

A new bone-cutting approach for minimally invasive surgery

Abstract

Keywords

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