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Robotic waterjet wound debridement – Workflow adaption for clinical application and systematic evaluation of a novel technology

Schoeb, Dominik, Stefan and Klodmann, Julian and Schlager, Daniel and Müller, Philippe, F. and Miernik, Arkadiusz and Bahls, Thomas (2018) Robotic waterjet wound debridement – Workflow adaption for clinical application and systematic evaluation of a novel technology. PLoS One, 13, pp. 1-14. Public Library of Science (PLoS). DOI: 10.1371/journal.pone.0204315 ISSN 1932-6203

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Official URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204315

Abstract

Objective We evaluated the clinical potential of a novel robotic system for autonomous performance of waterjet wound debridement. Summary background data Within the last decade, waterjet wound debridement has proven to be a valid alternative to the conventional approach using sharp spoons and scalpel. Methods The DLR MIRO robot using the DLR MICA instrument for robotic surgery was adapted for actuation of an ERBEJET 2 flexible endoscopic waterjet probe. Waterjet debridement of various wound shapes and sizes using a porcine skin model was compared between this novel robotic system and a control group of human medical professionals with regard to wound area cleaned by the waterjet, off-target area, and procedural time. Results After the wound area was registered in the robotic system, it automatically generated a cleaning path and performed debridement based on generated surface model. While the robotic system demonstrated a significant advantage for the covered wound area (p = 0.031), the average off-target area was not significantly different from human controls. Human participants had high variability in cleaning quality across users and trials, while the robotic system provided stable results. Overall procedural time was significantly lower in trials performed by humans. Conclusions Robotic waterjet wound debridement is a promising new technological approach compared to the current clinical standard of interventional wound therapy, providing higher efficiency and quality of wound cleaning compared to human performance. Additional trials on more complicated wound shapes and in vivo tissue are necessary to more thoroughly evaluate the clinical potential of this technology.

Item URL in elib:https://elib.dlr.de/121965/
Document Type:Article
Title:Robotic waterjet wound debridement – Workflow adaption for clinical application and systematic evaluation of a novel technology
Authors:
AuthorsInstitution or Email of AuthorsAuthors ORCID iD
Schoeb, Dominik, StefanDepartment of Urology, Faculty of Medicine and Medical Center—University of Freiburg, University of Freiburg, Freiburg, Germanyhttps://orcid.org/0000-0001-6394-7064
Klodmann, JulianJulian.Klodmann (at) dlr.deUNSPECIFIED
Schlager, DanielDepartment of Urology, Faculty of Medicine and Medical Center—University of Freiburg, University of Freiburg, Freiburg, GermanyUNSPECIFIED
Müller, Philippe, F.Department of Urology, Faculty of Medicine and Medical Center—University of Freiburg, University of Freiburg, Freiburg, GermanyUNSPECIFIED
Miernik, ArkadiuszDepartment of Urology, Faculty of Medicine and Medical Center—University of Freiburg, University of Freiburg, Freiburg, GermanyUNSPECIFIED
Bahls, ThomasThomas.Bahls (at) dlr.dehttps://orcid.org/0000-0002-9935-2676
Date:27 September 2018
Journal or Publication Title:PLoS One
Refereed publication:Yes
Open Access:Yes
Gold Open Access:Yes
In SCOPUS:Yes
In ISI Web of Science:Yes
Volume:13
DOI :10.1371/journal.pone.0204315
Page Range:pp. 1-14
Editors:
EditorsEmail
Blumenberg,, MiroslavNYU Langone Medical Center, UNITED STATES
Publisher:Public Library of Science (PLoS)
ISSN:1932-6203
Status:Published
Keywords:robotic waterjet wound debridement, Surgical and invasive medical procedure, medical robotics
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Space Technology
DLR - Research area:Raumfahrt
DLR - Program:R SY - Technik für Raumfahrtsysteme
DLR - Research theme (Project):R - Vorhaben Medizinische Assistenzsysteme
Location: Oberpfaffenhofen
Institutes and Institutions:Institute of Robotics and Mechatronics (since 2013) > Mechatronic Systems
Deposited By: Bahls, Thomas
Deposited On:29 Nov 2018 15:52
Last Modified:29 Nov 2018 15:52

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