An Active Handheld Micromanipulator

主动手持式微操纵器

• 批准号: 8963976
• 负责人: Cameron N Riviere
• 金额: $ 35.48万
• 依托单位: CARNEGIE-MELLON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-01-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8963976
• 关键词: Address; Area; Back; Cannulations; Collaborations; Custom; Development; Devices; Eye; Face; Feedback; Financial compensation; Freedom; Hand; Hemorrhage; Histology; Intervention; Life; Light; Manuals; Membrane; Micromanipulation; Microscope; Microsurgery; Motion; Movement; Needles; Operative Surgical Procedures; Optics; Oryctolagus cuniculus; Otolaryngology; Outcome; Patients; Penetration; Perception; Performance; Positioning Attribute; Postoperative Period; Procedures; Public Health; Research; Research Personnel; Retina; Retinal; Retinal Hemorrhage; Retinal Perforations; Robotics; Staging; Structure; Surgeon; Surgical Instruments; Surveys; System; Tactile; Techniques; Technology; Testing; Time; Tissues; Tremor; Vision; Visual; Work; base; device Artificial lens; improved; in vivo; in vivo Model; instrument; interest; lens; medical specialties; micromanipulator; monocular; neurosurgery; novel; operation; prevent; public health relevance; retina blood vessel structure; tool; virtual

 DESCRIPTION (provided by applicant): Highly accurate control of movement 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 and hemorrhage. As a result, surveys taken to identify directions for improvement in ophthalmic procedures have indicated that both positioning accuracy and tactile (or force) perception have high importance. In order to address the need for enhanced control of movement and force in vitreoretinal microsurgery while also maintaining the natural feel, ease of use, and direct patient contact of handheld surgical instruments, our group has developed an active handheld micromanipulator known as Micron. Micron is a fully handheld system that performs active compensation of hand tremor and other erroneous motion. We have developed novel patient-specific vision-guided position-input "virtual fixtures" (like a virtual stencil) that can be used with Micron for enhanced accuracy. We have also demonstrated force control of Micron. To date, however, tests of Micron (like most of the field of vitreoretinal surgical robotics) have usually been ex vivo and greatly simplified, e.g., using retina "open-sky" rather than an eyeball. One of the main reasons for this is the great difficulty of quantitative stereo in the nonlinear optics of the eye. We address this herein with a novel monocular structured-light approach to depth sensing. At the present stage of development of Micron, the time has now come for clinically useful interventions under realistic conditions. In this project we focus on accomplishing two which have good prospects of maximizing the benefits of Micron, and then demonstrating them in vivo. Therefore, the specific aims of this proposal are as follows: 1. To develop a complete retinal vessel cannulation system and technique using Micron that is realizable in an intact eye in vivo. This procedure will utilizea position-input virtual fixture based on microscope video and structured light projected from the tool tip. Motion scaling will help guide the surgeon to the target vessel, and avoidance zones will help prevent entry into subretinal areas. Force control will help the surgeon to avoid damaging surrounding tissue while targeting the desired vessel with a microfabricated needle. 2. To develop a complete membrane peeling system and technique using Micron that is realizable in an intact eye in vivo. This virtual fixture will enhance control of position, force, and peeling velocity. 3. To demonstrate retinal vessel cannulation and membrane peeling using Micron in a rabbit model in vivo. Performance will be evaluated in terms of tremor amplitude, applied force, and operation time, and amount of intraoperative bleeding. Postoperative SD-OCT and histology will be used to assess tissue damage.

 描述（由申请人提供）：高度精确的运动控制是显微手术性能的基础。特别是玻璃体视网膜显微手术是在定位精度方面要求最高的专业之一，并且由于对视网膜微血管干预的兴趣日益增加，可能会变得更加苛刻。在处理脆弱组织时，同样重要的是精确控制所施加的力。缺乏它会导致并发症，如医源性视网膜破裂和出血。因此，为确定眼科手术的改进方向而进行的调查表明，定位精度和触觉（或力）感知都非常重要。 为了满足玻璃体视网膜显微手术中对运动和力的增强控制的需求，同时保持手持式手术器械的自然感觉，易用性和直接接触患者，我们的团队开发了一种称为Micron的主动手持式显微操作器。Micron是一个完全手持式的系统，可以对手部震颤和其他错误动作进行主动补偿。我们开发了新颖的患者特定的视觉引导位置输入“虚拟夹具”（如虚拟模板），可与Micron一起使用，以提高准确性。我们还展示了Micron的力控制。 然而，迄今为止，Micron的测试（就像玻璃体视网膜手术机器人领域的大多数测试一样）通常是离体的并且大大简化，例如，使用视网膜“开放天空”而不是眼球。造成这种情况的主要原因之一是眼睛非线性光学中定量立体的巨大困难。我们在此提出一个 新颖的单目结构光深度传感方法。在Micron发展的现阶段，现在是在现实条件下进行临床有用干预的时候了。在这个项目中，我们专注于完成两个具有最大化Micron优势的良好前景，然后在体内进行演示。因此，本提案的具体目标如下：1.开发一种完整的视网膜血管插管系统和技术，使用Micron，可在体内完整的眼睛中实现。该过程将利用基于显微镜视频和从工具尖端投射的结构光的位置输入虚拟夹具。运动缩放将有助于引导外科医生到达目标血管，而回避区将 有助于防止进入视网膜下区域。力控制将帮助外科医生在用微制造针瞄准所需血管时避免损伤周围组织。2.开发一个完整的膜剥离系统和技术，使用Micron，可实现在体内完整的眼睛。该虚拟夹具将增强对位置、力和剥离速度的控制。3.使用Micron在兔体内模型中演示视网膜血管插管和膜剥离。将根据震颤幅度、施加的力、手术时间和术中出血量评价性能。术后SD-OCT和组织学将用于评估组织损伤。