Enabling Technology for Safe Robot-assisted Surgical Micromanipulation

安全机器人辅助手术显微操作的实现技术

• 批准号: 10366680
• 负责人: PETER LOUIS GEHLBACH
• 金额: $ 44.51万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-03-15 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10366680
• 关键词: Address; Affect; Algorithms; Animal Model; Apoptosis; Area; Behavior; Bilateral; Blindness; Blood coagulation; Cannulas; Cannulations; Clinical; Clinical Treatment; Coagulation Process; Cognitive; Discipline; Disease; Eye; Eye Movements; Eye diseases; Family suidae; Fatigue; Feedback; Goals; Grant; Hand; Hemorrhage; Human; Hybrids; Infusion procedures; Injury; Manuals; Measures; Micromanipulation; Microsurgery; Motion; Natural regeneration; Needles; Neural Retina; Neurons; Obstruction; Operative Surgical Procedures; Ophthalmology; Otolaryngology; Perception; Performance; Perfusion; Persons; Pharmaceutical Preparations; Physiological; Positioning Attribute; Procedures; Psyche structure; Puncture procedure; Readiness; Reproducibility; Research; Retina; Retinal Diseases; Retinal Vein Occlusion; Robot; Robotics; Safety; Sclera; Sensory; Sensory Thresholds; Stress; Structure of central vein of the retina; Surgeon; System; Tactile; Techniques; Technology; Therapeutic Agents; Thrombus; Time; Tissues; Translations; Tremor; Validation; Veins; Vision; Visualization; Work; adaptive learning; base; experience; in vivo; in vivo Model; innovation; instrument; machine learning method; multisensory; neurosurgery; novel; pre-clinical; prevent; real time monitoring; retina blood vessel structure; robot assistance; robot control; robotic system; success; theories; tool; virtual

Project Summary / Abstract The goal of this grant is to develop enabling technology to address fundamental limitations in microsurgery with a specific focus on developing coordinated bilateral assistance for the vitreoretinal surgeon. Retinal vein occlusion (RVO) is the second-most-prevalent vision threatening disease of retinal blood vessels, with no consistently successful clinical treatments to directly resolve the occlusion. A strategic approach, that is particularly amenable to robotic assistance, is to cannulate the occluded retinal vein with a micro-cannula and to inject a clot-dissolving agent. Due to human physiological limitations (tremor, tactile perception, visualization, stress, cognitive requirements, incomplete sensory information, etc.), as well as retinal fragility and the inability to regenerate retinal tissue, various robotic systems have been developed that target select aspects of retinal vein cannulation (RVC). However, even with all present and emerging technological advances, a number of imminently solvable challenges remain as barriers to consistently successful treatment. We propose a bilateral robotic system with real-time multisensory feedback that assesses multiple points of instrument contact located both inside and outside of the eye. Our bilateral system will enhance retina and sclera safety, increase the rate of RVC success, diminish forces on the cannula and vein, reduce the human mental and physical requirements, and allow the surgeon enhanced motion precision to enable more advanced surgical procedures benefitted by bilateral manipulation. To prove the hypothesis that bilateral robot-assisted retinal cannulation is possible and safe, we propose the following specific aims: (1) Demonstrate coordinated position/force hybrid control algorithms for enabling real- time sensorimotor capabilities at sclerotomy for safe bilateral robot-assisted vitreoretinal microsurgery: real-time sensorimotor capabilities at the sclerotomy will be uniquely used to control the robots through a machine learning method that adaptively learns a nonlinear mapping from user behavior to sclera-force/position and predicts unsafe motions; (2) Demonstrate position/force-input control algorithms for enabling real-time sensorimotor capabilities at the tool-tip for safe bilateral robot-assisted vein cannulation: real-time tool-tip-to-tissue interaction force sensing and non-linear robot control algorithms based on observing user behavior will be used to control the tool-tip position and force and to prevent entry into subretinal areas during RVC; (3) Demonstrate and evaluate bilateral RVC using SHER in animal model in vivo: real-time, position/force hybrid control algorithms based on dual-point (tool-shaft and tip) information fusion will provide sensorimotor guidance of surgical maneuvers during RVC. Statistically significant results in vivo, in clinically realistic conditions will demonstrate the feasibility of our approach. This highly innovative system with expanded coordinated bimanual capabilities will allow us to further increase the safety and reliability of RVC and move the technology to preclinical readiness.

项目摘要/摘要 这笔赠款的目标是开发使能技术，以解决显微外科手术中的根本限制。 特别侧重于为玻璃体视网膜外科医生开发协调的双边援助。视网膜静脉 视网膜血管阻塞(RVO)是视网膜血管疾病中第二常见的威胁视力的疾病。 临床治疗持续成功，直接解决了咬合问题。一种战略方法，也就是 特别适合机器人辅助的是用微导管插管阻塞的视网膜静脉，并 注射一种溶解血栓的药剂。由于人类生理上的限制(震颤、触觉、视觉、 压力、认知要求、感觉信息不完整等)，以及视网膜脆弱和无力 为了再生视网膜组织，已经开发了各种机器人系统，以视网膜的特定方面为目标 静脉插管(RVC)。然而，即使有了所有现在和正在出现的技术进步，一些 迫在眉睫的可解决挑战仍然是持续成功治疗的障碍。我们提出了双边协议 具有实时多传感器反馈的机器人系统，可评估定位的多个仪器接触点 眼睛里面和外面都有。我们的双边系统将增强视网膜和巩膜的安全性，提高 减少对插管和静脉的作用力，减少人类的精神和身体需求， 并允许外科医生增强运动精度，以使更先进的手术程序受益于 双边操纵。 为了证明双边机器人辅助视网膜插管是可能和安全的这一假设，我们提出了 具体目标如下：(1)演示协调位置/力混合控制算法，以实现实时控制 用于安全的双眼机器人辅助玻璃体视网膜显微手术的巩膜切开术的时间感觉运动能力：实时 巩膜切开术中的感觉运动能力将独特地用于通过机器学习来控制机器人 一种自适应地学习从用户行为到巩膜力/位置的非线性映射并预测 不安全的运动；(2)演示启用实时传感器电机的位置/力输入控制算法 用于安全的双边机器人辅助静脉插管的工具尖端的能力：实时的工具尖端到组织的交互 将使用力传感和基于观察用户行为的非线性机器人控制算法来控制 在RVC手术中，刀尖的位置和力，防止进入视网膜下区域；(3)演示和 在活体动物模型中应用SHER评价双侧RVC：实时、位置/力混合控制算法 基于刀轴和刀尖双点(刀轴和刀尖)的信息融合将为外科手术提供感知运动指导。 RVC过程中的机动动作。在活体、临床现实条件下具有统计学意义的结果将证明 我们方法的可行性。这一高度创新的系统具有扩展的协调双工能力 这将使我们能够进一步提高RVC的安全性和可靠性，并将该技术推向临床前准备状态。