穿刺手术柔性针路径规划技术现状和展望

微创穿刺手术由于具有创伤小、恢复快等优势,近年来在临床上得到广泛应用,主要用来进行组织活检、局部消融和局部麻醉等操作。 目前穿刺手术使用的手术器械是斜尖柔性针,相比较于刚性针,前者可以避开重要的器官和组织,对患者的损伤较小。 在手术过程中,有效的路径规划算法可以辅助医生提高手术的安全性和准确性,现有的术中路径规划算法的误差在毫米量级,限制了其在临床手术中的应用,亟待探讨解决方法。 为此,梳理了穿刺手术中柔性针的路径规划研究进展,分析了影响路径规划的因素,对穿刺针的路径规划算法进行了详细的介绍,指出了当前需要解决的关键问题,最后从最优路径选择、参数反馈以及术中实时路径规划方法等不同方面出发探讨了柔性针手术穿刺针路径规划的未来发展方向。

Current situation and prospect of flexible needle path planning technology for puncture surgery

Due to its advantages of small trauma and fast recovery, minimally invasive puncture surgery has been widely used in clinicalpractice in recent years, mainly for tissue biopsy, local ablation and local anesthesia. At present, the surgical instruments used inpuncture surgery are oblique pointed flexible needles, which can avoid important organs and tissues and cause less damage to patientsthan rigid needles. In the process of surgery, effective path planning algorithms can assist doctors to improve the safety and accuracy ofsurgery, and the error of existing intraoperative path planning algorithms is in the order of millimeters, which limits its application inclinical surgery, and solutions need to be explored. Therefore, the research progress of flexible needle path planning in puncture surgeryis sorted out, the factors affecting path planning are analyzed, the path planning algorithm of puncture needle is introduced in detail, thekey problems that need to be solved are pointed out, and finally the future development direction of path planning of flexible needlesurgical puncture needle is discussed from different aspects such as optimal path selection, parameter feedback and intraoperative real-time path planning method.