Robotic assistance for improving surgeries and therapies

该提案的目的是改进现有技术，开发机器人辅助微创手术和治疗的新技术，通过使手术和治疗更有效，创伤更小，住院时间更短，从而减轻加拿大医疗保健系统的负担。在机器人辅助的软组织手术中，重要的是将关于机器人/患者接触力的触觉反馈（触觉）传递到外科医生的手，以便能够更好地控制力并防止组织损伤。建议的研究集中在开发一个令人满意的解决方案，在当前的机器人辅助手术和神经外科系统的触觉反馈的问题的各个方面。具体而言，我们计划针对触觉技术的瓶颈，解决当前手术系统的电气或机械缺陷（工具灵活性，通信延迟，机器人关节的反冲和摩擦等）所造成的限制。在外科手术系统的性能和特性方面以及在使用该系统可以执行的外科手术检查和操作任务的程度方面。虽然微创方法对患者和医疗保健系统的好处是显而易见的，但我们将通过解决机器人辅助手术的困难和培训该领域的HQP来放大它们。此外，该研究计划开发新技术，使外科医生能够使用机器人辅助手术系统对跳动的心脏进行心内手术。目前的做法是停止心脏，因为心脏运动在手术期间对外科医生非常干扰。为了使心脏跳动手术成为可能，关键的想法是控制一个手术机器人，使它不断地跟随心脏的运动-跳动的心脏将似乎稳定的外科医生。拟议的研究将首先着眼于三维超声图像内心脏组织结构的实时跟踪。其结果是，在空间中的心脏目标的跟踪轨迹，将用于同步手术机器人与心脏运动。这项研究的意义在于，与心脏停搏手术不同，心脏不停跳手术不需要体外循环。

The purpose of this proposal is to improve the existing technology and develop new technologies for robot-assisted minimally invasive surgery and therapy that will reduce the burden on Canada's healthcare system by making surgeries and therapies more efficient and less traumatic and the hospital stays shorter. In robot-assisted soft-tissue surgeries, it is important to deliver haptic feedback (sensation of touch) about robot/patient contact forces to the surgeon's hand in order to enable better control over the forces and to prevent tissue damage. The proposed research focuses on various aspects of developing a satisfactory solution to the problem of lack of haptic feedback in current robot-assisted surgical and telesurgical systems. Specifically, focusing on the haptics technology bottlenecks, we plan to address the limitations caused by the electrical or mechanical imperfections of current surgical systems (tool flexibility, communication delay, robot joint's backlash and friction, etc.) both in terms of the surgical system's performance and characteristics and in terms of how well surgical examination and manipulation tasks can be performed using the system. While the benefits of minimally invasive methods to patients and the healthcare system are clear, we will magnify them by addressing the difficulties of robot-assisted surgery and by training HQP in the area. In addition, the research plans to develop new technologies that would enable a surgeon to use a robot-assisted surgical system for intracardiac surgery on the beating heart. The current practice is to stop the heart as heart motions are highly disturbing to the surgeon during the operation. For beating heart surgery to become possible, the key idea is to control a surgical robot such that it continuously follows the heart movements -- the beating heart will then seem steady to the surgeon. The proposed research will first look at real-time tracking of heart tissue structures within three-dimensional ultrasound images. The result, the tracked trajectory of a cardiac target in space, will be used to synchronize the surgical robot with the heart motions. The significance of the research is in that, unlike arrested-heart surgery, beating heart surgery will not involve cardiopulmonary bypass.