An Active Handheld Micromanipulator

描述（申请人提供）：高度精确的定位是显微外科手术的基础。特别是玻璃体视网膜显微外科手术是定位精度要求最高的专业之一，由于对视网膜微血管干预的兴趣日益浓厚，这一要求可能会越来越高。在处理脆弱的组织时，精确控制施加力也同样重要。缺乏它会导致并发症，如在膜剥离过程中医源性视网膜断裂。最初的研究阶段是在这个R01拨款下，致力于一个全手持微机械臂的基本发展，它通过感知自身的运动和偏转其刀尖来抵消震颤，从而进行主动震颤补偿。建立了一个完整的工作原型并进行了测试，并演示了震颤补偿；现在已经为实现该设备在控制位置和力量方面的更充分潜力奠定了基础，这可能会为许多重要的临床益处开辟道路：减少并发症，改善总体结果，并可能实现新型手术。本研究旨在优化Micron公司使用的新型震颤补偿滤波器的参数，并在猪尸体眼视网膜静脉体外置管和鸡绒毛膜尿囊膜（CAM）模型的卵细胞中验证其改善的人类用户性能，以及在生物实验室的细胞微操作。Micron半自动显微操作的改进方法将在体外和小鸡CAM中进行图案激光光凝，并在人类用户中进行验证。Micron的力控制方法将在体外和小鸡CAM中开发和验证膜剥离和视网膜血管插管任务的人类用户。主动震颤补偿将主要测试在插管，扫描技术在图像化激光光凝，力控制在膜剥离和血管插管。

DESCRIPTION (provided by applicant): Highly accurate positioning is fundamental to the performance of microsurgery. Vitreoretinal microsurgery in particular is among the most demanding of specialties in terms of positioning accuracy, and is likely to become more so due to the increasing interest in retinal microvascular interventions. Of similar importance when dealing with delicate tissues is precise control of applied force. The lack of it leads to complications such as iatrogenic retinal breaks during membrane peeling. The original research period under this R01 grant was devoted to the basic development of a fully handheld micromanipulator that performs active tremor compensation by sensing its own movement and deflecting its tool tip to counteract the tremor. A full working prototype has been built and tested, and the tremor compensation has been demonstrated; the ground has now been laid for the realization of the fuller potential of this device for the control of both position and force, which may open the way to numerous significant clinical benefits: reducing complications, improving overall outcomes, and possibly enabling new types of procedures. This research aims to optimize the parameters of the new tremor compensation filter used within Micron, and validate its improved performance with human users in retinal vein cannulation in vitro in porcine cadaver eyes and in ovo in a chick chorioallantoic membrane (CAM) model, and in cell micromanipulation in the biology laboratory. Improved methods for semi automated micromanipulation with Micron will then be developed and validated with human users in patterned laser photocoagulation in vitro and in chick CAM. Methods for force control of Micron will then be developed and validated with human users in membrane peeling and retinal vessel cannulation tasks in vitro and in chick CAM. The active tremor compensation will be tested primarily in cannulation, the scanning technique in patterned laser photocoagulation, and the force control in membrane peeling and vessel cannulation. PUBLIC HEALTH RELEVANCE: This research aims to develop technology that will improve public health outcomes by enhancing the micromanipulation capabilities of microsurgeons and basic researchers. Vitreoretinal microsurgery is the main surgical focus of the project, but the technologies developed are applicable also to otolaryngology, neurosurgery, and other specialties.