Autonomous System for Tumor Resection (ASTR) - Dual-Arm Robotic Midline Partial Glossectomy
Autonomous System for Tumor Resection (ASTR) - Dual-Arm Robotic Midline Partial Glossectomy
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DOI：
10.1109/lra.2023.3341773
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发表时间：
2024-02-01
影响因子：
5.2
通讯作者：
Krieger，Axel
中科院分区：
文献类型：
--
作者：
Ge，Jiawei;Kam，Michael;Krieger，Axel
头颈癌是世界上第七大常见癌症，鳞状细胞癌是最常见的组织学亚型。手术切除是许多头颈部鳞状细胞癌患者的主要治疗方式，准确识别肿瘤边界并确保足够的切除边缘对于优化肿瘤结局至关重要。这封信提出了一种创新的自主肿瘤切除系统（ASTR），并进行了可行性研究，通过执行监督自主中线部分舌切除术的假瘤毫米精度。建议ASTR系统包括一个双摄像头视觉系统，电外科仪器，一个新开发的真空抓取仪器，两个6自由度机械手，和一个新的自主控制系统。这封信介绍了一个基于本体的研究框架，用于创建和实施一个复杂的自主手术工作流程，使用舌切除术作为案例研究。本研究使用猪舌组织，并使用彩色墨水和近红外荧光（NIRF）标记物标记以指示假瘤。ASTR主动监测NIRF标记，并从样本中收集空间和颜色数据，从而根据建议的舌切除术工作流程规划和执行机器人轨迹。该系统成功地进行了六个连续的监督自主假瘤切除猪标本。平均表面和深度切除误差分别为和，在6次切除中均未检测到阳性肿瘤边缘。切除的准确性被证明是等同于手动的假瘤舌切除术进行了经验丰富的耳鼻喉科医生。
Head and neck cancers are the seventh most common cancers worldwide, with squamous cell carcinoma being the most prevalent histologic subtype. Surgical resection is a primary treatment modality for many patients with head and neck squamous cell carcinoma, and accurately identifying tumor boundaries and ensuring sufficient resection margins are critical for optimizing oncologic outcomes. This letter presents an innovative autonomous system for tumor resection (ASTR) and conducts a feasibility study by performing supervised autonomous midline partial glossectomy for pseudotumor with millimeter accuracy. The proposed ASTR system consists of a dual-camera vision system, an electrosurgical instrument, a newly developed vacuum grasping instrument, two 6-DOF manipulators, and a novel autonomous control system. The letter introduces an ontology-based research framework for creating and implementing a complex autonomous surgical workflow, using the glossectomy as a case study. Porcine tongue tissues are used in this study, and marked using color inks and near-infrared fluorescent (NIRF) markers to indicate the pseudotumor. ASTR actively monitors the NIRF markers and gathers spatial and color data from the samples, enabling planning and execution of robot trajectories in accordance with the proposed glossectomy workflow. The system successfully performs six consecutive supervised autonomous pseudotumor resections on porcine specimens. The average surface and depth resection errors measureand, respectively, with no positive tumor margins detected in any of the six resections. The resection accuracy is demonstrated to be on par with manual pseudotumor glossectomy performed by an experienced otolaryngologist.