An Active Handheld Micromanipulator

描述（由申请人提供）：高度准确的定位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，如在膜剥离过程中医源性视网膜破裂。在R 01资助下的原始研究期间致力于完全手持式显微操作器的基本开发，该显微操作器通过感知自身运动并偏转工具尖端来抵消震颤，从而进行主动震颤补偿。一个完整的工作原型已经建立和测试，震颤补偿已被证明;现在已经奠定了基础，实现该设备的位置和力控制的更充分的潜力，这可能会开辟道路，许多显着的临床效益：减少并发症，改善整体效果，并可能使新类型的程序。本研究旨在优化Micron内使用的新型震颤补偿滤波器的参数，并在猪尸体眼体外视网膜静脉插管和鸡胚绒毛尿囊膜（CAM）模型中的卵内以及生物实验室中的细胞显微操作中验证其与人类用户的改进性能。然后，将开发改进的Micron半自动显微操作方法，并在体外和鸡CAM中与人类用户进行图案化激光光凝验证。然后将开发Micron的力控制方法，并在体外和鸡CAM中的膜剥离和视网膜血管插管任务中与人类用户一起进行验证。主动震颤补偿将主要在插管、图案化激光光凝中的扫描技术以及膜剥离和血管插管中的力控制中进行测试。 公共卫生相关性：该研究旨在开发技术，通过提高显微外科医生和基础研究人员的显微操作能力来改善公共卫生结果。玻璃体视网膜显微手术是该项目的主要手术重点，但开发的技术也适用于耳鼻喉科，神经外科和其他专业。

DESCRIPTION (provided by applicant): Highly accurate positioning 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 during membrane peeling. The original research period under this R01 grant was devoted to the basic development of a fully handheld micromanipulator that performs active tremor compensation by sensing its own movement and deflecting its tool tip to counteract the tremor. A full working prototype has been built and tested, and the tremor compensation has been demonstrated; the ground has now been laid for the realization of the fuller potential of this device for the control of both position and force, which may open the way to numerous significant clinical benefits: reducing complications, improving overall outcomes, and possibly enabling new types of procedures. This research aims to optimize the parameters of the new tremor compensation filter used within Micron, and validate its improved performance with human users in retinal vein cannulation in vitro in porcine cadaver eyes and in ovo in a chick chorioallantoic membrane (CAM) model, and in cell micromanipulation in the biology laboratory. Improved methods for semi automated micromanipulation with Micron will then be developed and validated with human users in patterned laser photocoagulation in vitro and in chick CAM. Methods for force control of Micron will then be developed and validated with human users in membrane peeling and retinal vessel cannulation tasks in vitro and in chick CAM. The active tremor compensation will be tested primarily in cannulation, the scanning technique in patterned laser photocoagulation, and the force control in membrane peeling and vessel cannulation. PUBLIC HEALTH RELEVANCE: This research aims to develop technology that will improve public health outcomes by enhancing the micromanipulation capabilities of microsurgeons and basic researchers. Vitreoretinal microsurgery is the main surgical focus of the project, but the technologies developed are applicable also to otolaryngology, neurosurgery, and other specialties.