An Active Handheld Micromanipulator

描述(申请人提供)：高度精确的定位是显微外科手术性能的基础。尤其是玻璃体视网膜显微外科在定位精度方面是要求最高的专业之一，而且由于人们对视网膜微血管介入治疗的兴趣日益增加，这一点可能会变得更加苛刻。在处理脆弱的组织时，同样重要的是对外力的精确控制。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。根据这项R01拨款，最初的研究期致力于全手持微操作器的基本开发，该微操作器通过感知自身的移动并偏转其工具尖端来抵消震动，从而执行主动震动补偿。一个完整的工作原型已经建立和测试，震颤补偿已经演示；现在已经为实现该设备在位置和力控制方面的更大潜力奠定了基础，这可能会为许多重大的临床好处开辟道路：减少并发症，改善整体结果，并可能实现新类型的手术。这项研究旨在优化美光公司使用的新型震颤补偿过滤器的参数，并在体外猪身体眼视网膜静脉插管、鸡绒毛膜尿囊膜(CAM)模型和生物实验室细胞微操作中验证其改进的性能。使用Micron的半自动微操作的改进方法将被开发出来，并在体外图案化激光光凝和小鸡CAM中与人类用户进行验证。然后将开发Micron的力控制方法，并在体外和小鸡CAM中与人类用户进行膜剥离和视网膜血管插管任务的验证。主动颤动补偿将主要在插管、图案化激光光凝的扫描技术以及膜剥离和血管插管的力控制方面进行测试。

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.