Development/Evaluation of a User Interface for Robotically-Assisted Ureteroscopy

 描述（由申请人提供）：本提案的目标是开发和评价用于机器人辅助输尿管镜检查的直观且符合人体工程学的上级用户界面。使用柔性内窥镜的肾盂的常规输尿管镜检查充满了可视化、辐射暴露和人体工程学挑战。这种微创手术可以清除结石，诊断出血或恶性肿瘤，以及直接活检和破坏恶性肿瘤。对于肿瘤检查，医生必须在荧光透视下操纵输尿管镜通过肾脏中的10至12个肾盏中的每一个，以在肾脏内跟踪输尿管镜尖端。这涉及使用来自荧光透视的2D图像来估计输尿管镜的3D位置。此外，输尿管镜控制需要使用双手，一只手将输尿管镜移入和移出，另一只手旋转和弯曲输尿管镜。因此，非常需要改进柔性输尿管镜的控制和跟踪，以用于这种基本和常见的泌尿外科手术。 在过去的两年中，我们的研究小组已经开发出一种机器人机械系统，解决了这些人体工程学的挑战。该机器人组件还为开发软件和硬件提供了基础，以解决与输尿管镜检查相关的其他挑战。这项建议的目标是开发和评估软件的直观控制的机器人使用负担得起的 硬件接口设备，如操纵杆。该提案的中心假设是，开发具有直观界面和跟踪功能的机器人系统将允许更有效、符合人体工程学和准确的肾脏手术输尿管镜检查。我们将通过以下两个具体目标来解决这一假设：具体目标1：扩展我们现有的机器人辅助输尿管镜用户界面，以提供输尿管镜头端的3D跟踪 并改进操纵杆运动和尖端运动之间的校准。这些改进应允许泌尿科医生容易，有效，准确地控制输尿管镜。具体目标2：使用肾脏模型评价新用户界面的有效性、效率和用户满意度。一旦我们的泌尿外科团队认为界面令人满意，我们将比较泌尿科医生使用我们的机器人系统与传统的手动技术的性能。 我们的长期目标是开发一种硬件和软件系统，使患者和医院工作人员的辐射暴露更低，有效的肿瘤检查，以及在输尿管镜检查过程中为医生提供舒适的人体工程学体验。

 DESCRIPTION (provided by applicant): The goal of this proposal is to develop and evaluate an intuitive and ergonomically superior user interface for robotically-assisted ureteroscopy. Conventional ureteroscopy of the renal pelvis with a flexible endoscope is fraught with visualization, radiation exposure, and ergonomic challenges. This minimally invasive procedure enables stone removal, diagnosis for bleeding or malignancy, as well as direct biopsy and destruction of malignant tumors. For tumor inspection, the physician has to maneuver the ureteroscope through each of the 10 to 12 calyces in the kidney under fluoroscopy to keep track of the ureteroscope tip within the kidney. This involves estimating the 3D position of the ureteroscope using the 2D images from fluoroscopy. Moreover, ureteroscope control requires use of both hands, one to move the ureteroscope in and out and the other to rotate and flex the ureteroscope. Thus, there is great need for improved control and tracking of the flexible ureteroscope for this essential and common urologic procedure. Over the past two years, our research group has developed a robotic mechanical system that addresses some of these ergonomic challenges. This robotic assembly also provides a foundation to develop software and hardware to address the other challenges associated with ureteroscopy. The goal of this proposal is to develop and evaluate software for intuitive control of the robot using an affordable hardware interface device such as a joystick. The central hypothesis of this proposal is that development of a robotic system with an intuitive interface integrated with tracking capability wil allow for more efficient, ergonomic, and accurate ureteroscopy for kidney procedures. We will address this hypothesis through these two specific aims: Specific Aim 1: Extend our existing user interface for robotically assisted ureteroscopy to provide 3D tracking of the ureteroscope tip and improve the calibration between joystick movement and tip motion. These improvements should allow the urologist to easily, efficiently, and accurately control the ureteroscope. Specifi Aim 2: Evaluate the new user interface for effectiveness, efficiency, and user satisfaction using kidney phantoms. Once the interface is considered satisfactory by our urology team, we will compare urologist performance using our robotic system versus the conventional manual technique. Our long-term goal is the development of a hardware and software system that enables lower radiation exposure to the patients and hospital staff, effective tumor inspections, and a comfortable ergonomic experience for the physicians during ureteroscopy.