应用于机器人辅助微创外科手术的术前规划方法
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摘要
机器人辅助微创外科手术(RMIS)技术可帮助外科医生有效克服传统微创外科技术的不足,提高外科医生对手术的执行能力,其所带来的良好的临床效果已被广泛接受.对于机器人来说,术前规划工作相对于传统微创外科手术更为复杂,合理的术前规划可以有效避免机器人末端执行器之间的相互干涉,提高机器人辅助微创外科手术的可操作性、可达性和可视性等,这对手术效果至关重要.本文将微创外科手术规划临床经验与机器人操作性能知识相结合,提出了一种基于多目标粒子群优化算法(MOPSO)的术前规划方法,从机器人有效工作空间、碰撞干涉检测、机械臂与器械末端运动灵活性及手眼协调性几个方面入手,对机器人进行综合性的定量评价,并以此为依据通过计算求解得出以合理的患者体表手术切口位置与机器人初始设置位置为主要目标的方案.为验证该方法的有效性,以机器人辅助腹腔镜胆囊切除术为实验范例,应用"MicroHandS"手术机器人系统为实验设备,针对同一名病患,将外科医生的经验方案和由算法计算得出的术前规划方案进行比较分析,其结果证明了该方法的优越性.实验结果表明,由优化算法得到的术前规划方法优势明显,有效地解决了以往仅依靠临床经验进行机器人辅助微创外科手术术前规划所带来的问题,提高了手术的安全性和效率.
Robot-assisted minimally invasive surgery(RMIS)technology helps surgeons to efficiently overcome the shortcomings associated with traditional MIS technology,extends their ability to perform surgical procedures,and has been widely accepted owing to its good clinical results. A proper preoperative planning for RMIS,although more complicated than that of MIS,can effectively prevent interference between robotic end-effectors and enhance the manipulability,reachability,and visibility of RMIS,which is critical to the outcome of surgical procedures. This study aims to propose an optimization algorithm for preoperative planning based on multi-objective particle swarm optimization(MOPSO)to improve the performance of the robot in combination with our clinical experience and knowledge regarding robot manipulability. We found that the port placements on the patient's body and the initial robot settings can be reasonably obtained by quantitatively evaluating multiple metrics,including the effective working space,collision and interference detection,the kinematic dexterity of both the robotic arms and end-effector,and hand-eye coordination. To validate the performance of this method,we conducted a robot-assisted laparoscopic cholecystectomy as a case study and used a MicroHand S surgical robot as our experimental equipment. We then compared and analyzed the solutions recommended by experienced surgeons and that by the algorithm for the same patient. The experimental results demonstrate the superiority of the proposed method,which provides an effective way to help surgeons solve the problems that arise when performing surgeries while depending only on clinical experience.Hence,the proposed method improves the safety and efficiency of surgery.
Robot-assisted minimally invasive surgery(RMIS)technology helps surgeons to efficiently overcome the shortcomings associated with traditional MIS technology,extends their ability to perform surgical procedures,and has been widely accepted owing to its good clinical results. A proper preoperative planning for RMIS,although more complicated than that of MIS,can effectively prevent interference between robotic end-effectors and enhance the manipulability,reachability,and visibility of RMIS,which is critical to the outcome of surgical procedures. This study aims to propose an optimization algorithm for preoperative planning based on multi-objective particle swarm optimization(MOPSO)to improve the performance of the robot in combination with our clinical experience and knowledge regarding robot manipulability. We found that the port placements on the patient's body and the initial robot settings can be reasonably obtained by quantitatively evaluating multiple metrics,including the effective working space,collision and interference detection,the kinematic dexterity of both the robotic arms and end-effector,and hand-eye coordination. To validate the performance of this method,we conducted a robot-assisted laparoscopic cholecystectomy as a case study and used a MicroHand S surgical robot as our experimental equipment. We then compared and analyzed the solutions recommended by experienced surgeons and that by the algorithm for the same patient. The experimental results demonstrate the superiority of the proposed method,which provides an effective way to help surgeons solve the problems that arise when performing surgeries while depending only on clinical experience.Hence,the proposed method improves the safety and efficiency of surgery.
引文
[1]Trejos A L,Patel R V.Port placement for endoscopic cardiac surgery based on robot dexterity optimization[C]//International Conference on Robotics and Automation.Barcelona,Spain,2005:912-917.
[2]Kappert U,Schneider J,Cichon R,et al.Development of robotic enhanced endoscopic surgery for the treatment of coronary artery disease[J].Circulation,2001,104(Suppl 1):102-107.
[3]Loulmet D,Carpentier A,d'Attellis N,et al.Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments[J].The Journal of Thoracic and Cardiovascular Surgery,1999,118(1):4-10.
[4]Cannon J W,Stoll J A,Selha S D,et al.Port placement planning in robot-assisted coronary artery bypass[J].IEEE Transactions on Robotics and Automation,2003,19(5):912-917.
[5]Tabaie H A,Reinbolt J A,Graper W P,et al.Endoscopic coronary artery bypass graft(ECABG)procedure with robotic assistance[J].Journal of Endourology,2004,18(6):572-575.
[6]Cestari A,Buffi N M,Scapaticci E,et al.Simplifying patient positioning and port placement during roboticassisted laparoscopic prostatectomy[J].European Urology,2010,57(3):530-533.
[7]Sun L W,van Meer F,Schmid J,et al.Advanced da Vinci surgical system simulator for surgeon training and operation planning[J].International Journal of Medical Robotics and Computer Assisted Surgery,2007,3(3):245-251.
[8]Hayashibe M,Suzuki N,Hashizume M,et al.Robotic surgery setup simulation with the integration of inversekinematics computation and medical imaging[J].Computer Methods and Programs in Biomedicine,2006,83(1):63-72.
[9]Coste-Manièreè,Adhami L,Severac-Bastide R,et al.Optimized port placement for the totally endoscopic coronary artery bypass grafting using the da Vinci robotic system[J].Experimental RoboticsⅦ,2000,271:199-208.
[10]Yeniaras E,Deng Z G,Syed M A,et al.A novel virtual reality environment for preoperative planning and simulation of image guided intracardiac surgeries with robotic manipulators[J].Studies in Health Technology and Informatics,2011,163:716-722.
[11]Park S,Howe R D,Torchiana D F.Virtual fixtures for robotic cardiac surgery[C]//International Conference on Medical Image Computing and Computer-Assisted Intervention.London,UK,2001:1419-1420.
[12]Li M,Ishii M,Taylor R H.Spatial motion constraints using virtual fixtures generated by anatomy[J].IEEETransactions on Robotics,2007,23(1):4-19.
[13]Ren J,Patel R V,McIsaac K A,et al.Dynamic 3-Dvirtual fixtures for minimally invasive beating heart procedures[J].IEEE Transactions on Medical Imaging,2008,27(8):1061-1070.
[14]Azimian H.Preoperative planning of robotics-assisted minimally invasive cardiac surgery under uncertainty[D].Ontario,Canada:The University of Western Ontario,2012.
[15]Sun L W,Yeung C K.Port placement and pose selection of the da Vinci surgical system for collision-free intervention based on performance optimization[C]//Proceedings of the 2007 IEEE/RSJ International Conference on Intelligent Robots and Systems.San Diego,USA,2007:1951-1956.
[16]Trejos A L,Patel R V,Ross I,et al.Optimizing port placement for robot-assisted minimally invasive cardiac surgery[J].International Journal of Medical Robotics and Computer Assisted Surgery,2007,3(4):355-364.
[17]Azimian H,Patel R V,Naish M D,et al.A framework for preoperative planning of robotics-assisted minimally invasive cardiac surgery(RAMICS)under geometric uncertainty[C]//Proceedings of IEEE International Conference on Robotics and Automation.Shanghai,China,2011:5018-5023.
[18]Azimian H,Patel R V,Naish M D,et al.A semiinfinite programming approach to preoperative planning of robotic cardiac surgery under geometric uncertainty[J].IEEE Journal of Biomedical and Health Informatics,2012,17(1):172-182.
[19]王伟,王伟东,董为,等.基于协作空间与灵巧度的机器人辅助微创手术术前规划算法[J].机器人,2016,38(2):208-216.Wang Wei,Wang Weidong,Dong Wei,et al.A preoperative planning algorithm based on dexterity and collaboration space for the robot-assisted minimally invasive surgery[J].Robot,2016,38(2):208-216(in Chinese).
[20]孔康,王树新,张淮锋,等.紧凑型微创手术机器人的设计与实现[J].天津大学学报:自然科学与工程技术版,2017,50(11):1131-1139.Kong Kang,Wang Shuxin,Zhang Huaifeng,et al.Design and implementation of a compact minimally invasive surgical robot[J].Journal of Tianjin University:Science and Technolgoy,2017,50(11):1131-1139(in Chinese).
[21]Wang W,Li J,Wang S,et al.System design and animal experiment study of a novel minimally invasive surgical robot[J].International Journal of Medical Robotics and Computer Assisted Surgery,2016,12(1):73-84.
[22]Carbone G,Ottaviano E,Ceccarelli M.An Optimum design procedure for both serial and parallel manipulators[J].Journal of Mechanical Engineering Science,2007,221(7):829-843.
[23]Rosen J,Brown J,Chang L,et al.The blue DRAGON-A system for measuring the kinematics and the dynamics of minimally invasive surgical tools inVivo[C]//Proceedings of the 2002 IEEE/ICRA.Washington,DC,USA,2002:11-15.
[24]陈智链,孙汉旭,陈钢,等.基于碰撞干涉空间的空间机械臂碰撞干涉分析方法研究[EB/OL].http://www.paper.edu.cn/releasepaper/content/4625647,中国科技论文在线,2015-01-07.Chen Zhilian,Sun Hanxu,Chen Gang,et al.Collision analysis method for space manipulator based on collision and interference space[EB/OL].http://www.paper.edu.cn/releasepaper/content/4625647,Sciencepaper Online,2015-01-07(in Chinese).
[25]Gosselin C M.Dexterity indices for planar and spatial robotic manipulators[C]//Proceedings of IEEE International Conference on Robotics and Automation.USA,1990:650-655.
[26]Stocco L,Salcudean S E,Sassani F.Fast constrained global minimax optimization of robot parameters[J].Robotica,1998,16(6):595-605.
[27]Liegeois A.Automatic supervisory control of the configuration and behavior of multibody mechanisms[J].IEEETransactions on Systems,Man and Cybernetics,1977,7(12):868-871.
[28]Coello C A C,Pulido G T,Lechuga M S.Handling multiple objectives with particle swarm optimization[J].IEEE Transactions on Evolutionary Computation,2004,8(3):256-279.
[29]Hanna G B,Shimi S,Cuschieri A.Optimal port locations for endoscopic intracorporeal knotting[J].Surgical Endoscopy,1997,11(4):397-401.
[2]Kappert U,Schneider J,Cichon R,et al.Development of robotic enhanced endoscopic surgery for the treatment of coronary artery disease[J].Circulation,2001,104(Suppl 1):102-107.
[3]Loulmet D,Carpentier A,d'Attellis N,et al.Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments[J].The Journal of Thoracic and Cardiovascular Surgery,1999,118(1):4-10.
[4]Cannon J W,Stoll J A,Selha S D,et al.Port placement planning in robot-assisted coronary artery bypass[J].IEEE Transactions on Robotics and Automation,2003,19(5):912-917.
[5]Tabaie H A,Reinbolt J A,Graper W P,et al.Endoscopic coronary artery bypass graft(ECABG)procedure with robotic assistance[J].Journal of Endourology,2004,18(6):572-575.
[6]Cestari A,Buffi N M,Scapaticci E,et al.Simplifying patient positioning and port placement during roboticassisted laparoscopic prostatectomy[J].European Urology,2010,57(3):530-533.
[7]Sun L W,van Meer F,Schmid J,et al.Advanced da Vinci surgical system simulator for surgeon training and operation planning[J].International Journal of Medical Robotics and Computer Assisted Surgery,2007,3(3):245-251.
[8]Hayashibe M,Suzuki N,Hashizume M,et al.Robotic surgery setup simulation with the integration of inversekinematics computation and medical imaging[J].Computer Methods and Programs in Biomedicine,2006,83(1):63-72.
[9]Coste-Manièreè,Adhami L,Severac-Bastide R,et al.Optimized port placement for the totally endoscopic coronary artery bypass grafting using the da Vinci robotic system[J].Experimental RoboticsⅦ,2000,271:199-208.
[10]Yeniaras E,Deng Z G,Syed M A,et al.A novel virtual reality environment for preoperative planning and simulation of image guided intracardiac surgeries with robotic manipulators[J].Studies in Health Technology and Informatics,2011,163:716-722.
[11]Park S,Howe R D,Torchiana D F.Virtual fixtures for robotic cardiac surgery[C]//International Conference on Medical Image Computing and Computer-Assisted Intervention.London,UK,2001:1419-1420.
[12]Li M,Ishii M,Taylor R H.Spatial motion constraints using virtual fixtures generated by anatomy[J].IEEETransactions on Robotics,2007,23(1):4-19.
[13]Ren J,Patel R V,McIsaac K A,et al.Dynamic 3-Dvirtual fixtures for minimally invasive beating heart procedures[J].IEEE Transactions on Medical Imaging,2008,27(8):1061-1070.
[14]Azimian H.Preoperative planning of robotics-assisted minimally invasive cardiac surgery under uncertainty[D].Ontario,Canada:The University of Western Ontario,2012.
[15]Sun L W,Yeung C K.Port placement and pose selection of the da Vinci surgical system for collision-free intervention based on performance optimization[C]//Proceedings of the 2007 IEEE/RSJ International Conference on Intelligent Robots and Systems.San Diego,USA,2007:1951-1956.
[16]Trejos A L,Patel R V,Ross I,et al.Optimizing port placement for robot-assisted minimally invasive cardiac surgery[J].International Journal of Medical Robotics and Computer Assisted Surgery,2007,3(4):355-364.
[17]Azimian H,Patel R V,Naish M D,et al.A framework for preoperative planning of robotics-assisted minimally invasive cardiac surgery(RAMICS)under geometric uncertainty[C]//Proceedings of IEEE International Conference on Robotics and Automation.Shanghai,China,2011:5018-5023.
[18]Azimian H,Patel R V,Naish M D,et al.A semiinfinite programming approach to preoperative planning of robotic cardiac surgery under geometric uncertainty[J].IEEE Journal of Biomedical and Health Informatics,2012,17(1):172-182.
[19]王伟,王伟东,董为,等.基于协作空间与灵巧度的机器人辅助微创手术术前规划算法[J].机器人,2016,38(2):208-216.Wang Wei,Wang Weidong,Dong Wei,et al.A preoperative planning algorithm based on dexterity and collaboration space for the robot-assisted minimally invasive surgery[J].Robot,2016,38(2):208-216(in Chinese).
[20]孔康,王树新,张淮锋,等.紧凑型微创手术机器人的设计与实现[J].天津大学学报:自然科学与工程技术版,2017,50(11):1131-1139.Kong Kang,Wang Shuxin,Zhang Huaifeng,et al.Design and implementation of a compact minimally invasive surgical robot[J].Journal of Tianjin University:Science and Technolgoy,2017,50(11):1131-1139(in Chinese).
[21]Wang W,Li J,Wang S,et al.System design and animal experiment study of a novel minimally invasive surgical robot[J].International Journal of Medical Robotics and Computer Assisted Surgery,2016,12(1):73-84.
[22]Carbone G,Ottaviano E,Ceccarelli M.An Optimum design procedure for both serial and parallel manipulators[J].Journal of Mechanical Engineering Science,2007,221(7):829-843.
[23]Rosen J,Brown J,Chang L,et al.The blue DRAGON-A system for measuring the kinematics and the dynamics of minimally invasive surgical tools inVivo[C]//Proceedings of the 2002 IEEE/ICRA.Washington,DC,USA,2002:11-15.
[24]陈智链,孙汉旭,陈钢,等.基于碰撞干涉空间的空间机械臂碰撞干涉分析方法研究[EB/OL].http://www.paper.edu.cn/releasepaper/content/4625647,中国科技论文在线,2015-01-07.Chen Zhilian,Sun Hanxu,Chen Gang,et al.Collision analysis method for space manipulator based on collision and interference space[EB/OL].http://www.paper.edu.cn/releasepaper/content/4625647,Sciencepaper Online,2015-01-07(in Chinese).
[25]Gosselin C M.Dexterity indices for planar and spatial robotic manipulators[C]//Proceedings of IEEE International Conference on Robotics and Automation.USA,1990:650-655.
[26]Stocco L,Salcudean S E,Sassani F.Fast constrained global minimax optimization of robot parameters[J].Robotica,1998,16(6):595-605.
[27]Liegeois A.Automatic supervisory control of the configuration and behavior of multibody mechanisms[J].IEEETransactions on Systems,Man and Cybernetics,1977,7(12):868-871.
[28]Coello C A C,Pulido G T,Lechuga M S.Handling multiple objectives with particle swarm optimization[J].IEEE Transactions on Evolutionary Computation,2004,8(3):256-279.
[29]Hanna G B,Shimi S,Cuschieri A.Optimal port locations for endoscopic intracorporeal knotting[J].Surgical Endoscopy,1997,11(4):397-401.