title: Respiratory motion compensation for the robot-guided laser osteotome.
abstract: OBJECTIVE
  The use of a robot-guided laser osteotome for median sternotomy is impeded by prohibiting cutting inaccuracies due to respiration-induced motions of the thorax. With this paper, we advance today's methodologies in sternotomy procedures by introducing the concept of novel 3D functional cuts and a respiratory motion compensation algorithm for the computer-assisted and robot-guided laser osteotome, CARLO®.
  
  
  METHODS
  We present a trajectory planning algorithm for performing 3D functional cuts at a constant cutting velocity. In addition, we propose the use of Gaussian process (GP) prediction in order to anticipate the sternum's pose providing enough time for the CARLO®device to adjust the position of the laser source.
  
  
  RESULTS
  We analysed the performance of the proposed algorithms on a computer-based simulation framework of the CARLO®device. The median position error of the laser focal point has shown to be reduced from 0.22 mm without GP prediction to 0.19 mm with GP prediction.
  
  
  CONCLUSIONS
  The encouraging simulation results support the proposed respiratory motion compensation algorithm for robot-guided laser osteotomy on the thorax. Successful compensation of the respiration-induced motion of the thorax opens doors for robot-guided laser sternotomy and the related novel cutting patterns. These functional cuts hold great potential to significantly improve postoperative sternal stability and therefore reduce pain and recovery time for the patient. By enabling functional cuts, we approach an important threshold moment in the history of osteotomy, creating innovative opportunities which reach far beyond the classic linear cutting patterns.
authors.affiliation: Center for medical Image Analysis & Navigation, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, 4123, Allschwil, Switzerland. alina.giger@unibas.ch.
authors.forename: Alina
authors.initials: A
authors.lastname: Giger
authors.affiliation: Center for medical Image Analysis & Navigation, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, 4123, Allschwil, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Jud
authors.affiliation: Center for medical Image Analysis & Navigation, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 14, 4123, Allschwil, Switzerland.
authors.forename: Philippe C
authors.initials: PC
authors.lastname: Cattin
mesh_terms: D000465:Algorithms; D003198:Computer Simulation; D006801:Humans; D021621:Imaging, Three-Dimensional; D053685:Laser Therapy; D009038:Motion; D010027:Osteotomy / Q000295:instrumentation*; D012119:Respiration; D012371:Robotics / Q000295:instrumentation*; D056346:Sternotomy / Q000379:methods*
keywords: Functional cut; Laser osteotomy; Motion compensation; Motion estimation; Robotic surgery