Surgical Robotics: An Introduction

Surgical robots assisting surgeons during operations are being used in selected medical fields like neurosurgery, orthopaedics and endoscopy. In an introductory part, the authors present a workflow for robot assisted surgery, which includes the steps: image data acquisition, image processing, surgical planning and the actual robot assisted intraoperative transposition. Each step of the workflow comprises different computer aided methods and apparatuses, which are presented in this paper. The following part focuses on different mechanical set-ups and various application fields for surgical robots. They include neurosurgery, orthopaedic surgery, radiosurgery and radiotherapy, prostatectomy, endoscopy, laparoscopy, cardiac surgery and craniofacial surgery.     

Effect of automatic image realignment on visuomotor coordination in simulated laparoscopic surgery

During laparoscopic surgery, the surgeon's hand-eye coordination is often disrupted by the incongruent mapping between the orientation of the endoscopic view and the actual operative field. Two experiments were conducted to examine the effect of automatic image realignment on the performance of laparoscopic surgery. The first experiment investigated how visual-motor misalignment impacted laparoscopic surgery performance. Novice subjects were randomly assigned to one of the two paired viewing conditions in a simulated laparoscopic surgery environment: 1) the endoscope was either at the center of the modeled workspace with an optical axis of 90°, or at -45° from the midline of the subjects with an optical axis 45°; 2) the endoscope was either at 0°, or at 180° from the midline of the subjects, both with an optical axis of 45°. Each group of twelve subjects performed a dynamic point-and-touch task under the assigned pair of viewing conditions, each with eight image orientations, in a repeated-measures mixed design. The second experiment examined whether the automatic realigning mechanism that was activated mid-task (such that a congruent mapping between display and control was re-established if the mapping at the beginning of the task had been misaligned) was helpful to improve performance. Twelve novice subjects performed the same task as in the first experiment in a repeated-measures design. Performance was examined under three misaligned visuomotor mappings, each followed by the realigned mapping activated by the automatic realigning mechanism. Results showed that performance was best when the endoscopic image was perfectly aligned with the actual task space (0° image orientation), but degraded progressively as a function of deviation from perfect alignment. Subjects' performance maintained a consistent pattern across 8 image orientations regardless of optical axis orientation and endoscope location. Performance was improved with the automatic realigning mechanism. It is recommended that any solution to restore the visuomotor congruency in laparoscopic surgery should first align the image with the task space. This work has implications for the design of visualization systems in laparoscopic surgery.     

基于核磁图像导航的前列腺针刺手术机器人

在对核磁共振图像(MRI)导航手术机器人设计需求进行分析的基础上,设计出一套可用于完成经会阴前列腺近距离粒子放射治疗手术的机器人系统.该系统具有5个自由度,通过核磁兼容气缸和超声波电机混合驱动,自主实现针体位姿调整和针刺操作.根据机器人系统动力学分析进行了驱动气缸选型.最后通过核磁兼容性实验和针刺精度实验,验证该机器人系统能够满足核磁兼容性要求,针刺精度为0.91mm.     

Influence of Social Support on Adaptation to Surgery.

The authors investigated the influence of patients' social support on subjective and objective stress indicators before, during, and after surgery. The sample consisted of 42 male and 42 female patients. Social support as perceived by the patients was measured by a surgery-specific inventory with the Emotional Support and Informational Support subscales. Perioperative adaptation was assessed by self-reported anxiety, the amount of narcotics needed for anesthesia induction, and the length of the postoperative stay. Results demonstrated that patients who scored high on social support showed less anxiety, received lower doses of narcotics, and had a shorter hospital stay than did patients with low support. However, gender was a moderator of some of these associations. Compared with men, women exhibited more relationships that were in accordance with the hypotheses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

手术仿真中基于质点-弹簧模型的人体组织变形仿真

采用质点一弹簧建模方法提出了人体软组织面模型和体模型系统、程式化的计算模型建立方法。将连续的软组织离散为由弹簧偶尼器及与其连接的质点构成的离散系统，用邻接表来表示离散系统的拓扑结构，即弹簧一质点间的邻接关系，依据该信息，可自动建立方程并计算与每个质点连接的弹簧、阻尼器对质点的粘弹性力的贡献，然后采用4阶Runge-Kutta方法对得到的微分方程组进行数值积分。通过小肠模型(面模型)和规则块状软组织模型(体模型)2个实例介绍了采用所提出的方法实施软组织变形仿真的过程。     

外科手术机器人技术发展现状及关键技术分析

外科诊疗是医疗机器人研究和应用最广泛也是比较成熟的领域,目前研究主要集中在脑神经外科、整形外科、介入式无损检测、角膜移植等领域.为促进我国医疗机器人技术的研究和发展,在充分论述医疗机器人研究意义的基础上,对国内外典型外科手术机器人的研究及应用状况作了详细介绍,并对研究医疗机器人所涉及的手术机器人机构、医学三维图像建模、虚拟手术仿真、遥操作网络传输等关键技术进行了详尽的分析,同时指出了今后的发展方向.     

外科手术机器人技术发展现状及关键技术分析

外科诊疗是医疗机器人研究和应用最广泛也是比较成熟的领域，目前研究主要集中在脑神经外科、整形外科、介入式无损检测、角膜移植等领域．为促进我国医疗机器人技术的研究和发展，在充分论述医疗机器人研究意义的基础上，对国内外典型外科手术机器人的研究及应用状况作了详细介绍，并对研究医疗机器人所涉及的手术机器人机构、医学三维图像建模、虚拟手术仿真、遥操作网络传输等关键技术进行了详尽的分析，同时指出了今后的发展方向．     

基于Internet的机器人遥外科手术的问题及对策

针对基于Internet的机器人遥外科手术面临的时延问题，提出了网络及其通讯协议的发展，如高可靠性通信链路和实时传输协议，是解决时延问题的根本；历史上形成的网络遥操作系统的控制策略，如基于事件的方法和无源性及耗散系统理论，为解决时延问题提供了可借鉴的方法。     

虚拟现实技术及其在现代医学中的应用

虚拟现实是近年来发展起来的一项新的技术,它已经被广泛地应用于许多领域,特别是在医学领域．本文在简述虚拟现实技术的基础上,从虚拟人、辅助诊断和手术、虚拟手术模拟以及虚拟的远程医疗系统四个方面介绍了虚拟现实在医学上的应用．     

侧颅底手术过程中脑及颅神经功能保护

手术是绝大部分侧颅底病变的首选治疗方式。因侧颅底解剖结构复杂,毗邻脑及重要血管神经,手术容易致死或致残,限制了该部位手术的实施。脑、后组颅神经、面神经、听力功能是该部位手术保护的重点,恰当处理功能保留和切除病变的关系、良好的外科操作技能以及合理使用介入、导航等新的辅助技术是侧颅底手术中实现器官功能保护的关键。