Development of Microsurgery Robotic System

目的：为了提高外科医生在深部手术领域的灵活性和机动性，我们研制了一种主从型显微外科机器人系统。这里报告了我们的概念和初步实验的结果。方法：该系统有一个主控制单元，将六个自由度的运动指令（d.o.f； X， Y， Z，旋转，尖端弯曲和抓握）传递给两个手臂。从机械手有一个悬挂底座，附加6个d.o.f.，用于容纳带有两个机械手（直径5毫米，长度18厘米）的机动操作单元。并与常规徒手显微手术进行了浅、深手术野精度的比较。对20只Wistar大鼠行部分动脉切开术和颈动脉端到端完全吻合术。在尸体上也进行了四次常规外科手术。结果：应用机器人技术后，非优势手的深场指向精度明显提高。我们成功地关闭了部分动脉切开术，并在手术深野处完全吻合了大鼠颈动脉。在前10个大鼠实验过程中，缝合所需的时间明显缩短。机器人仪器在尸体中也能令人满意地移动，但机械臂必须更小，以适应狭窄的颅内空间。结论：计算机控制的手术操作将成为神经外科的重要工具，初步实验表明我们的机器人系统具有良好的可操作性。

Objectives : To enhance surgeons' dexterity and maneuverability in the deep surgical field, we developed a master-slave microsurgical robotic system. Our concept and the results of preliminary experiments are reported here. Methods : This system has a master control unit, which conveys motion commands in six degrees of freedom (d.o.f. ; X, Y, Z, rotation, tip flexion, and grasping) to two arms. The slave manipulator has a hanging base with an additional six d.o.f. that holds a motorized operating unit with two manipulators (5 mm in diameter, 18 cm in length). The accuracy of the prototype in shallow and deep surgical fields was compared to routine freehand microsurgery. Closure of a partial arteriotomy and complete end-to-end anastomosis of the carotid artery in the deep operative field was done in 20 Wistar rats. Four routine surgical procedures were also carried out in cadavers. Results : The accuracy of pointing in the deep field with the non-dominant hand was significantly improved through the use of the robotics. We successfully closed the partial arteriotomy and completely anastomosed the rat carotid arteries in the deep surgical field. The time needed for stitching was significantly shortened over the course of the first 10 rat experiments. The robotic instruments also moved satisfactorily in the cadavers, but the manipulators must be smaller to fit in the narrow intracranial space. Conclusion : Computer-controlled surgical manipulation will be an important tool for neurosurgery, and preliminary experiments with our robotic system show promising maneuverability.