Development of Microsurgery Robotic System

目的：为了提高外科医生在深部手术领域的灵活性和可操作性，我们研制了一种主从式显微外科机器人系统。报告了我们的概念和初步实验结果。方法：该系统有一个主控单元，它在六个自由度(d.o.f.)内传递运动指令。；X、Y、Z、旋转、尖端屈曲和抓握)到两个手臂。奴隶机械手有一个附加了六个直径的悬挂底座。它容纳了一个带有两个机械手(直径5毫米，长18厘米)的电动操作单元。将该样机在浅层和深层手术领域的准确性与常规徒手显微手术进行了比较。在20只Wistar大鼠的深部手术场行部分动脉切断和颈动脉完全端端吻合。在身体上也进行了四种常规外科手术。结果：采用机器人技术后，非优势手在深部指点的准确率明显提高。我们成功地关闭了部分动脉切开术，并在深外科领域完全吻合了大鼠的颈动脉。在最初的10次大鼠实验中，缝合所需的时间显著缩短。机器人器械在身体上的移动也令人满意，但操纵器必须更小，才能适应狭窄的颅内空间。结论：计算机控制的手术操作将是神经外科手术的重要工具，我们的机器人系统的初步实验显示出良好的可操作性。

Objectives : To enhance surgeons' dexterity and maneuverability in the deep surgical field, we developed a master-slave microsurgical robotic system. Our concept and the results of preliminary experiments are reported here. Methods : This system has a master control unit, which conveys motion commands in six degrees of freedom (d.o.f. ; X, Y, Z, rotation, tip flexion, and grasping) to two arms. The slave manipulator has a hanging base with an additional six d.o.f. that holds a motorized operating unit with two manipulators (5 mm in diameter, 18 cm in length). The accuracy of the prototype in shallow and deep surgical fields was compared to routine freehand microsurgery. Closure of a partial arteriotomy and complete end-to-end anastomosis of the carotid artery in the deep operative field was done in 20 Wistar rats. Four routine surgical procedures were also carried out in cadavers. Results : The accuracy of pointing in the deep field with the non-dominant hand was significantly improved through the use of the robotics. We successfully closed the partial arteriotomy and completely anastomosed the rat carotid arteries in the deep surgical field. The time needed for stitching was significantly shortened over the course of the first 10 rat experiments. The robotic instruments also moved satisfactorily in the cadavers, but the manipulators must be smaller to fit in the narrow intracranial space. Conclusion : Computer-controlled surgical manipulation will be an important tool for neurosurgery, and preliminary experiments with our robotic system show promising maneuverability.