From virtual reality simulation to collaborative surgery: Enabling data-driven teleoperated percutaneous nephrolithotomy****

从虚拟现实模拟到协作手术：实现数据驱动的远程操作经皮肾镜取石术****

• 批准号: 536211-2018
• 负责人: Rossa, Carlos
• 金额: $ 1.82万
• 依托单位: University of Ontario Institute of Technology
• 依托单位国家: 加拿大
• 项目类别: Engage Grants Program
• 财政年份: 2018
• 资助国家: 加拿大
• 起止时间: 2018-01-01 至 2019-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=663716
• 关键词: virtual; reality; simulation; collaborative; surgery

Percutaneous nephrolithotomy (PCNL) was quickly established as the leading procedure used for management of urinary calculi for large urinary stones. Despite over 40 years of development, PCNL remains a challenging procedure to learn. Particularly in less experienced hands, PCNL can lead to higher complication rates compared to other endoscopic procedures. Developing adequate expertise to achieve surgical competence is not trivial as it involves training in gaining access to the kidney, but also in stone fragmentation, tool navigation, and stone scavenging. Due to the procedure steep learning curve and inherent complexity, PCNL residents will inevitably perform a certain number of sub-optimal interventions during the training process. ****Marion Surgical has identified the need to improve PCNL training and maintain it as a safe and effective treatment for patients. The company has developed a virtual reality simulator that affords residents the opportunity to train in a systematic environment that does not compromise patient safety. The system reproduces what an operating room would look like, and offers real-time fluoroscopic images of the kidney to the operator, who manipulates a surgical tool using a force-feedback device. The latter emulates the sensation of touch with the human tissue and as in a real-world intervention. ****The purpose of this collaboration is to create a data-driven telerobotic system that co-manipulates the surgical tools in tandem with the surgeon in order to improve clinical outcomes of residents. The project will train two Master students in emerging areas of robot-aided surgey and the outcomes of this project will lead to better clinical outcomes during PCNL. It will allow Marion Surgical to develop some of the first-ever applications of machine learning to the growing area of virtual surgery and make a strong entry into the emerging surgical robotics market. ********

经皮肾镜取石术（PCNL）很快被确立为用于处理大泌尿系结石的主要手术。尽管经过40多年的发展，PCNL仍然是一个具有挑战性的学习过程。特别是对于经验不足的人来说，与其他内窥镜手术相比，PCNL可能会导致更高的并发症发生率。发展足够的专业知识以实现手术能力并不简单，因为它涉及进入肾脏的培训，还涉及结石粉碎，工具导航和结石清除。由于手术陡峭的学习曲线和固有的复杂性，PCNL住院医师在培训过程中将不可避免地执行一定数量的次优干预。*Marion Surgical已确定需要改进PCNL培训，并将其作为患者安全有效的治疗方法。该公司开发了一种虚拟现实模拟器，为居民提供在不影响患者安全的系统环境中进行培训的机会。该系统再现了手术室的样子，并向操作者提供肾脏的实时荧光图像，操作者使用力反馈装置操纵手术工具。后者模仿与人体组织的触摸感觉，并在现实世界的干预。**** 这项合作的目的是创建一个数据驱动的远程机器人系统，与外科医生一起共同操纵手术工具，以改善住院医生的临床结果。该项目将在机器人辅助手术的新兴领域培训两名硕士生，该项目的成果将在PCNL期间带来更好的临床结果。它将使Marion Surgical能够在不断增长的虚拟手术领域开发一些机器学习的首次应用，并有力地进入新兴的手术机器人市场。********