Development of Microsurgery Robotic System and Digitalization of microsurgical tehnique

在本研究中，我们开发了先进的显微外科机器人系统，并利用数字化显微外科技术建立了科学的显微外科技能分析方法。首先，我们设计了一种不干扰显微镜、内窥镜等视觉系统的新型偏移式机械臂。然后，该系统配备了中间工作部件，使系统具有可灭菌性。系统灭菌后，连续操作2h，证明机械手尖端无菌。此外，我们还开发了一种新的主机械手系统，其中包括Ginbaru系统，通过这种主机械手，外科医生可以通过移动手指和手腕来控制机器人。这类似于显微外科手术的情况。在创造了如此先进的机器人系统之后，我们现在正在进行各种实验。利用该系统对外科手术过程进行科学的分析。首先对机器人程序进行了分析。在腹腔镜手术中，更多的机器人手术被认为是20:1或40:1左右，但在显微手术领域，这是5:1到10:1。这种差异可能是由于常规手术的规模不同。显微外科医生在进行精细的手术时不习惯做大的动作。其次，评估初学者对机器人系统微程序的学习曲线。三位从未做过显微外科手术的工科学生使用我们的机器人系统将微型人造血管缝合在一起。经过几次练习，手术时间在1小时内稳定下来，手术准确。这个经过验证的机器人系统可以快速地进行显微外科手术。下一步是显微外科技术的数字化。微血管机器人吻合过程中，计算机控制信号以100Hz的频率批量存储。通过这种方法，我们可以在时间日志中显示X， Y， Z运动距离，手的速度，加速度，角加速度。通过这种方法，我们可以分析每只手的协调性、特定过程中的速度和加速度以及运动范围。利用该技术，我们可以对外科手术技术进行科学的分析。通过将外科大师的手术过程存储并在力反馈大师系统中进行再现，外科医生可以学习外科大师的手速和左-右协调。在钳上放置应变片，分析吻合血管时所用的强度。资深外科医生可以很流畅地控制左手，左手的力量几乎等于右手。但对于经验不足的外科医生来说，L的强度非常高，并且持续应用。这种趋势可以通过实践加以改善。经验丰富的资深外科医生对钳头施加的力度最多在2N左右。本研究证明了显微外科机器人系统将在未来改善外科手术过程，并将这种医学工程方法应用于显微外科技术分析，将改善我们未来的外科教育。少

In this research, we developed and advanced microsurgical Robotic System and produced scientific analysis method of Microsurgical Skill by digitalized microsurgical techniques.First we created new offset type robotic manipulator, which would not interfere with visual system such as microscope or endoscope. Then this system was equipped with intermediate working part, which will make our system sterilizable. After sterilization of the system and continuous 2hour manipulation, the tip of the manipulator was proved to be sterile. Also, we created new master manipulator system, which involves Ginbaru System, and with this master manipulator robot, surgeon could control the robot by moving fingers and wrist. This is similar to the condition of microsurgical procedures.After creating such advanced robotic system, we now proceeding with various experiments.Using such system, surgical procedures were analyzed in scientific manner.First robotic procedure was analyzed. Ideal reduction rate for r … More obotic surgery was believed to be around 20:1 or 40:1 in laparoscopic procedures, but in the field of microsurgery, this was 5:1 to 10:1. The difference is possibly due to difference of scale of routine surgery. Microsurgeons are not used to do massive movements in performing delicate procedures. Second, learning curve of micro procedures by robotic system by the beginners was assessed. Micro artificial vessel was sutured together using our robotic system by three engineer students, who never perform microsurgery. Their procedure time stabilized after several practice within one hour, and procedure was accurate. This proved robotic system allows rapid leering of microsurgical procedures.Next step was digitalization of microsurgical skills. The computer control signals were stored in 100Hz batches during robotic anastomosis of the micro vessels. By this method, we could display X, Y, Z movement distance in time log, velocity of the hand, accelerations, angle acceleration during each procedure. By this method we could analyze coordination of each hand, speed and acceleration during specific procedures and range of motion. Using this technique, we can analyze surgical technique in scientific way By storing master surgeons procedures and reproducing it in the force feedback master system, surgeons will be able to learn master surgeons hand speed and L-R coordination.Putting strain gauge on the forceps, we analyzed strength used during vessel anastomosis. Senior surgeon could control left hand very smoothly and strength in l was almost equal to R hand. But by the less experienced surgeons, strength on L was very high and continuously applied. This trend could be improved by practice. The strength applied to the tip of forceps was around 2N at most by experienced senior surgeons.This research proved microsurgical robotic sys tern improve surgical procedure in the future, and involving such medico- engineering method in analyzing microsurgical skill, will improved our future surgical education. Less