腓骨修复颌骨重建手术辅助机器人系统实验验证
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摘要
本文设计一种腓骨修复颌骨重建手术机器人系统,以辅助医生定位把持游离骨块,实现骨块的空间精确定位和姿态调整。该手术辅助机器人系统主要包括三臂机器人、光学定位仪、定位支架与定位探针、机器人工作站、力觉交互设备以及手术设计系统。在机器人系统辅助下,分别以实际患者的头颅模型和山羊作为实验对象进行颌骨重建手术,验证机器人系统的精度。试验表明该机器人系统能够完成下颌骨重建手术中游离骨块的植入、定位及稳固把持,可辅助医生提高手术精度和质量。目前,该机器人系统仍处于试验阶段,距离临床应用还有诸多难点需要突破。
In this paper, an assisted robotic system for mandibular reconstruction with fibula was designed to assist doctors to locate and hold the free bone, in order to achieve precise spatial positioning and orientation adjustment of the bone. The assisted robotic system mainly includes a three-arm robot, an optical locator, a positioning bracket, a positioning probe, a robot workstation, a force sensing interactive device and a surgical design system. With the assistance of the robotic system,mandibular reconstruction surgery was performed using the skull model of the actual patient and the goat as the experimental subjects, and the accuracy of the robotic system was verified. The results showed that the robotic system can complete the implantation, localization and stable control of the free bone in the mandibular reconstruction surgery, and could assist doctors to improve the surgical accuracy and quality. The robotic system is still in the experimental stage currently, and there are still many difficulties to be overcome in clinical application.
In this paper, an assisted robotic system for mandibular reconstruction with fibula was designed to assist doctors to locate and hold the free bone, in order to achieve precise spatial positioning and orientation adjustment of the bone. The assisted robotic system mainly includes a three-arm robot, an optical locator, a positioning bracket, a positioning probe, a robot workstation, a force sensing interactive device and a surgical design system. With the assistance of the robotic system,mandibular reconstruction surgery was performed using the skull model of the actual patient and the goat as the experimental subjects, and the accuracy of the robotic system was verified. The results showed that the robotic system can complete the implantation, localization and stable control of the free bone in the mandibular reconstruction surgery, and could assist doctors to improve the surgical accuracy and quality. The robotic system is still in the experimental stage currently, and there are still many difficulties to be overcome in clinical application.
引文
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[12]刘航航,罗恩.手术机器人在颅颌面非肿瘤性疾病治疗中的应用[J].国际口腔医学杂志,2018,45(1):85-90.
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[14]Schauer D,Hein A,Lueth TC.RoboPoint-An autoclavable interactive miniature robot for surgery and interventional radiology[A].Lemke HU,Vannier MW,Inamura K,et al.eds.CARS 2003.Computer Assisted Radiology and Surgery.Proceedings of the 17th International Congress and Exhibition[C].London:Elsevier,2003:555-560.
[15]Engel D,Raczkowsky J,Worn H.A safe robot system for craniofacial surgery[A].Proceedings 2001 ICRA.IEEE International Conference on Robotics and Automation[C],IEEE,2001:2020-2024.
[16]朱建华,郭传瑸.手术机器人系统在颅颌面外科中的应用及发展[J].华西口腔医学杂志,2016,34(5):534-538.
[17]郭传瑸.颅颌面外科医疗机器人的研发与应用任重道远[J]中华口腔医学杂志,2018,53(8):505-507.
[2]廖贵清,苏宇雄.下颌骨缺损的修复重建[J].广东牙病防治,2008,16(3):99-102.
[3]马成,黄旋平.下颌骨缺损重建的应用与进展[J].中国组织工程研究,2017,21(28):4550-4555.
[4]H?lzle F,Kesting MR,H?lzle G,et al.Clinical outcome and patient satisfaction after mandibular reconstruction with free fibula flaps[J].Int J Oral Maxillofac Surg,2007,36(9):802-806.
[5]袁仕廷,任仪鹏,庞恋苏,等.计算机辅助技术应用下颌骨缺损修复术后对颞下颌关节间隙的评估[J].口腔颌面修复学杂志,2018,19(1):5-9.
[6]张维军,徐进,张勇,等.光学导航引导的手术机器人系统设计[J].中国医疗设备,2017,32(11):28-31.
[7]冯杭,王丽,邢乐君,等.一种用于口腔和牙科治疗的机器人系统设计[J].中国医疗设备,2017,32(4):30-32.
[8]段星光,郭传瑸,陈超.颅颌面外科辅助手术机器人系统[J].机器人技术与应用,2011,(4):38-42.
[9]林志伟.颅颌面外科手术设计系统关键问题的研究和实现[D]北京:清华大学,2012.
[10]郭玉兴,郭传殡.经口入路机器人手术在咽旁颞下区肿瘤外科中的应用进展[J].中华耳鼻咽喉头颈外科杂志,2014,49(1):83-85
[11]Zhu JH,Wang J,Wang YG,et al.Performance of robotic assistance for skull base biopsy:a phantom study[J].J Neurol Surg B Skull Base,2017,78(5):385-392.
[12]刘航航,罗恩.手术机器人在颅颌面非肿瘤性疾病治疗中的应用[J].国际口腔医学杂志,2018,45(1):85-90.
[13]Lueth TC,Hein A,Albrecht J,et al.A surgical robotic system for maxillofacial surgery[A].Proceedings of the 24th Annual Conference of the IEEE Industrial Electronics Society[C]IEEE,1998:2470-2475.
[14]Schauer D,Hein A,Lueth TC.RoboPoint-An autoclavable interactive miniature robot for surgery and interventional radiology[A].Lemke HU,Vannier MW,Inamura K,et al.eds.CARS 2003.Computer Assisted Radiology and Surgery.Proceedings of the 17th International Congress and Exhibition[C].London:Elsevier,2003:555-560.
[15]Engel D,Raczkowsky J,Worn H.A safe robot system for craniofacial surgery[A].Proceedings 2001 ICRA.IEEE International Conference on Robotics and Automation[C],IEEE,2001:2020-2024.
[16]朱建华,郭传瑸.手术机器人系统在颅颌面外科中的应用及发展[J].华西口腔医学杂志,2016,34(5):534-538.
[17]郭传瑸.颅颌面外科医疗机器人的研发与应用任重道远[J]中华口腔医学杂志,2018,53(8):505-507.