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1.
Journal of Central South University(Medical Sciences) ; (12): 716-724, 2023.
Article in English | WPRIM | ID: wpr-982341

ABSTRACT

OBJECTIVES@#Da Vinci robot technology is widely used in clinic,with minimally invasive surgery development. This study aims to explore the possible influence of advanced surgical robotics on the surgery learning curve by comparing the initial clinical learning curves of 2 different surgical techniques: robotic-assisted gastrectomy (RAG) and laparoscopic-assisted gastrectomy (LAG).@*METHODS@#From September 2017 to December 2020, a chief surgeon completed a total of 108 cases of radical gastric cancer from the initial stage, including 27 cases of RAG of the Da Vinci Si robotic system (RAG group) and 81 cases of LAG (LAG group). The lymph node of gastric cancer implemented by the Japanese treatment guidelines of gastric cancer. The surgical results, postoperative complications, oncology results and learning curve were analyzed.@*RESULTS@#There was no significant difference in general data, tumor size, pathological grade and clinical stage between the 2 groups (P>0.05). The incidence of serious complications in the RAG group was lower than the LAG group (P=0.003). The intraoperative blood loss in the RAG group was lower than that in the LAG group (P=0.046). The number of lymph nodes cleaned in the RAG group was more (P=0.003), among which there was obvious advantage in lymph node cleaning in the No.9 group (P=0.038) and 11p group (P=0.015). The operation time of the RAG group was significantly longer than the LAG group (P=0.015). The analysis of learning curve found that the cumulative sum analysis (CUSUM) value of the RAG group decreased from the 10th case, while the CUSUM of the LAG group decreased from the 28th case. The learning curve of the RAG group had fewer closing cases than that of the LAG group. The unique design of the surgical robot might help to improve the surgical efficiency and shorten the surgical learning curve.@*CONCLUSIONS@#Advanced robotics helps experienced surgeons quickly learn to master RAG skills. With the help of robotics, RAG are superior to LAG in No.9 and 11p lymph node dissection and surgical trauma reduction. RAG can clear more lymph nodes than LAG, and has better perioperative effect.


Subject(s)
Humans , Robotics , Robotic Surgical Procedures/methods , Learning Curve , Stomach Neoplasms/pathology , Retrospective Studies , Laparoscopy/methods , Lymph Node Excision/methods , Gastrectomy/methods , Treatment Outcome
2.
Journal of Central South University(Medical Sciences) ; (12): 221-230, 2023.
Article in English | WPRIM | ID: wpr-971389

ABSTRACT

OBJECTIVES@#Surgical robot system has broken the limitation of traditional surgery and shown excellent performance in surgery, and has been widely used in minimally invasive treatment in most areas of surgery. This study aims to verify the basic performance of the domestic surgical robot system and the safety and effectiveness of the integrated bipolar electrocoagulation and ultrasonic knife.@*METHODS@#The basic performance of the domestic surgical robot system was evaluated by completing the square knot and surgical knot, vertical and horizontal perforation and right ring perforation and suture, as well as picking up beans. Compared with laparoscopy, the safety and effectiveness of the domestic surgical robot after integrated interconnection bipolar electrocoagulation and ultrasonic scalpel were evaluated by detecting the vascular closure performance and the degree of histopathological damage in animals.@*RESULTS@#Compared with freehand knotting, domestic robot knotting speed and circumference were slightly worse, but better than laparoscopic knotting. There was no statistical significance in the tension difference of the surgical knots among the 3 methods (P>0.05), but the tension of the square knots made by the freehand and the domestic surgical robot was greater than that of the laparoscopy (P<0.05). The space required for both the left and right forceps heads of knots was smaller than that of laparoscopy (P<0.001), which successfully completed the 4 quadrant suture tasks, and the time of picking up beans was significantly less than that of laparoscopy (P<0.05). There was no significant difference in the temperature of the liver tissue after the bipolar electrocoagulation between the interconnected domestic surgical robot and the laparoscopy (P>0.05), and the acute thermal injury was observed under the light microscope. The temperature of the liver tissue treated by the domestic robotic ultrasound knife was higher than that of the laparoscopic ultrasound knife (P<0.05).@*CONCLUSIONS@#Domestic surgical robots are obviously superior to laparoscopy in suturing, knotting, and moving objects, and domestic surgical robots' interconnect bipolar electrocoagulation and ultrasonic knife have achieved success in animal experiments, and hemostasis is considered to be safe and effective.


Subject(s)
Animals , Robotics , Laparoscopy/methods , Ultrasonography
3.
Chinese Journal of Microsurgery ; (6): 139-146, 2023.
Article in Chinese | WPRIM | ID: wpr-995486

ABSTRACT

Objective:To compair the clinical effect of endoscopic spine surgery with and without assistance of an electromagnetic navigation surgical robot(ENSR) system in the treatment of lumbar disc herniations(LDH).Methods:From March 2021 to December 2021, 73 patients with LDH underwent endoscopic minimally invasive treatment in the Department of Spine Surgery, Limin Hospital of Weihai High District. Thirty-eight patients were treated with endoscopic spine surgery assisted by domestic ENSR system(ENSR group), and 35 patients were treated with endoscopic spine surgery alone(endoscopic group). The patients received follow up regularly by telephone or Wechat. The intraoperative fluoroscopy times, puncture times, upper facet arthroplasty times, operation time, preoperative and postoperative Visual Analogue Scale(VAS), Japanese Orthopaedic Association Scores(JOA), and the MOS item short from health survey(SF-36)were compared between the 2 groups. The early postoperative efficacy was evaluated by modified MacNab criteria at 1 week after surgery. SPSS 26.0 was used to analyse the data. P<0.05 was considered that the difference was statistically significant. Results:The age, gender, body mass index(BMI) and other general data of the 2 groups were basically the same, and there was no statistically significant difference( P>0.05). There was no significant difference in the excellent and good rate of postoperative treatment between ENSR group(97.37%) and endoscopic group(94.29%)( Z=0.90, P>0.05). In terms of operation time, intraoperative fluoroscopy times, puncture times, and plasty times, ENSR group[(67.00±17.00) min, (4±2) times, 1 time, 1 time, respectively] was compared with the endoscopic group[(82.00±16.00] min, (17±6) times, (9±5) times, (5±2) times], and the difference was statistically significant( t=3.87,12.62, 9.87, respectively, P<0.05). There were significant differences in VAS, JOA and SF-36 scores between the 2 groups between before and after surgery( F=106.42, 112.14, 26.88, respectively, P<0.05). There was no significant difference in VAS, JOA and SF-36 scores before and after surgery between the 2 groups( F=0.95, 3.54, 0.97, respectively, P>0.05). Conclusion:The endoscopic spine surgery assisted by the ENSR can achieve satisfactory clinical results and is a safe and effective surgical assistance system. For the endoscopic surgery, assisted by the ENSR has obvious advantages in reducing the times of fluoroscopy, puncture, and facet arthroplasty, and shortening the operation time.

4.
Chinese Journal of Urology ; (12): 1-4, 2022.
Article in Chinese | WPRIM | ID: wpr-933152

ABSTRACT

With the rapid development of digital technologies represented by artificial intelligence, big data, and cloud computing, the concept of intelligent medicine has emerged. As an in-depth integration of the national strategies of " Healthy China" and " Made in China 2025" , intelligent medicine is widely used in the full-course management of the urological diseases, including disease screening, diagnosis, treatment strategy and follow-up. This article aims to review the application progress and prospects of intelligent medicine in urological diseases and provide references for the urologists.

5.
Chinese Journal of Digestive Surgery ; (12): 22-26, 2022.
Article in Chinese | WPRIM | ID: wpr-930901

ABSTRACT

Laparoscopic surgery is a revolution in the fields of surgery in the 21st century. The concept of minimally invasive surgery has been widely accepted. Nowadays, the commercial robot-assisted laparoscopic instrument operating system, commonly known as "surgical robot", does not yet have the attributes of a real robot and still needs further optimization. We are still far from claiming that we are in the "surgical robot era". A new generation of surgical robots with more developed artificial intelligence and simulation functions are worth working on for. "Minimally invasive approach" does not necessarily mean "minimally invasive surgery". The real benefit of patients is the most important indicator for evaluating minimally invasive surgery. The essence of science is discovery but not technological fashion. In the face of rapid technological development, the Chinese surgeons should remain rational and enterprising.

6.
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery ; (12): 524-528, 2022.
Article in Chinese | WPRIM | ID: wpr-923451

ABSTRACT

@#Objective    To explore the application of Toumai® minimally invasive endoscopic robot in thoracic surgery, and to observe its safety and short-term surgical efficacy. Methods    Three patients were enrolled from October to December 2021, including 1 male (69 years) and 2 females (47 years and 22 years). All 3 patients received surgery with Toumai® endoscopic surgical robot, including radical lung cancer surgery in 2 patients and mediastinal tumor resection in 1 patient. Results    All 3 patients were successfully operated without conversion to thoracotomy, complication or death. For the male lobectomy patient, the total operation time was 120 min, the intraoperative blood loss was 100 mL, the catheter drainage time was 4 days and the hospital stay time was 5 days. For the female lobectomy patient, the total operation time was 103 min, the intraoperative blood loss was 100 mL, the catheter drainage time was 4 days and the hospital stay time was 5 days. For the female mediastinal tumor patient, the total operation time was 81 min, the intraoperative blood loss was 50 mL, the catheter drainage time was 3 days and the hospital stay time was 3 days. Conclusion    The Toumai® minimally invasive endoscopic surgical robot is safe and effective in thoracic surgery. Compared with Da Vinci surgical robot, Toumai® has the same 3D visual field experience and smooth operation.

7.
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery ; (12): 411-416, 2022.
Article in Chinese | WPRIM | ID: wpr-923395

ABSTRACT

@#Nowadays, the development of the medical instrument industry makes rapid changes in clinical practice. Hybridization of latest technology is playing an increasingly important role in the diagnosis and treatment of disease. Especially, the trend of the integration of three-channel hybrid technology in diagnosis and treatment of early lung cancer has become increasingly obvious. This paper will focus on the technical advance of the three-channel multi- mirror robot and its application in the diagnosis and treatment of early lung cancer.

8.
Chinese Journal of Medical Instrumentation ; (6): 254-258, 2022.
Article in Chinese | WPRIM | ID: wpr-928899

ABSTRACT

The high incidence of cardiovascular diseases is a serious threat to human health, and endovascular surgery has become the standard treatment for most interventional cardiovascular diseases. The robotassisted endovascular surgery system further enhances surgeons' ability to perform minimally invasive endovascular procedures in interventional cardiology. This study presents a new robotic technique for coronary intervention from the perspective of clinical application. Aiming at clinical application scenarios, this scheme proposed an intuitive guide wire catheter mechanism design, which accurately and perfectly simulates the doctor's hand movements, realizes the positive and negative direction translation of the guide wire catheter, accurate torque control of the guide wire rotation and locking. The results of animal test showed that the R-OneTM has a high degree of dexterity, accuracy and stability,and meets the clinical needs.


Subject(s)
Animals , Cardiovascular Diseases , Catheterization , Equipment Design , Robotic Surgical Procedures , Robotics
9.
Chinese Journal of Medical Instrumentation ; (6): 91-95, 2022.
Article in Chinese | WPRIM | ID: wpr-928865

ABSTRACT

To provide accurate information for registration and safety evaluation of surgical robot, the pose repeatability measurement method was proposed. According to the terminal instrument of the master-slave surgical robot (such as high-frequency electric knife, ultrasonic knife), a suitable target ball fixture was designed. The node data at 10%, 50% and 100% rated speed were measured respectively. Through data analysis, the pose repeatability property of the tested samples at different speeds was obtained. It has high applicability and repeatability, and can meet the requirements of data traceability and registration testing.


Subject(s)
Equipment Design , Lasers , Robotic Surgical Procedures , Robotics , Surgery, Computer-Assisted
10.
Rev. mex. anestesiol ; 44(3): 215-224, jul.-sep. 2021. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1347743

ABSTRACT

Resumen: La práctica de cirugía robótica es un proceso complejo que implica desarrollo y tecnología no sólo en el campo de la cirugía, sino también en el campo de la anestesiología. Implica un proceso multifactorial, ya que ha generado un cambio drástico multidisciplinario basado en tecnología de punta que pretende ofrecer mejores condiciones durante el manejo perioperatorio en cirugía robótica. La anestesia total intravenosa cumple objetivos específicos en relación a la posición del paciente, relajación cerebral, neuroprotección, hemodinamia, pérdida y recuperación de la conciencia, parálisis neuromuscular, parámetros ventilatorios, etc. Ofrece seguridad y calidad al paciente durante el procedimiento con una mínima interferencia con el monitoreo electrofisiológico y permite modular la profundidad anestésica desde una neurosedación hasta una anestesia general, de acuerdo a las diferentes etapas de la cirugía. Un factor atribuible a la anestesia moderna para el éxito de la cirugía robótica es usar diferentes agentes anestésicos que promuevan inducción, mantenimiento y emersión anestésica más rápida y suave, a fin de reducir el tiempo de recuperación del estado de conciencia, funciones básicas y psicomotoras como la anestesia general multimodal.


Abstract: The practice of robotic surgery is a complex process, involving development and technology; not only in the surgery field but also in the anesthesiology field. It implies a multifactorial process since it has generated a drastic multidisciplinary change based on state-of-the-art technology; which aims to offer better conditions during perioperative management in robotic surgery. Intravenous Total Anesthesia accomplishes specific objectives in relation to patient position, brain relaxation, neuroprotection, hemodynamics, loss and recovery of consciousness, neuromuscular paralysis, ventilatory parameters, providing safety and quality during the procedure; with minimal intervention during electrophysiological monitoring and enabling anesthetic depth to be modulated from neurosedation to general anesthesia, according to the different stages of the surgery. A factor attributable to modern anesthesia for robotic surgery success is to employ different anesthetic agents promoting induction, maintenance of general anesthesia, smother and faster anesthetic emersion, for the purpose of reducing recovery time of the state of consciousness), basic and psychomotor functions; as is the general multimodal anesthesia.

11.
Chinese Journal of Tissue Engineering Research ; (53): 3792-3796, 2020.
Article in Chinese | WPRIM | ID: wpr-847429

ABSTRACT

BACKGROUND: Spinal surgical robots are mainly imported from countries outside China. The overall level of automation is still low. Domestic robot’s core technology still has some difficulties to conquer. Domestic robots are in the ascendant. The cost of spinal surgical robots is too expensive to apply in clinic practice. Our research group has developed Orthobot spinal surgical robot system for spine surgery with Shenzhen Xinjunte Company, which may be of great significance to the development of domestic surgical robots. OBJECTIVE: To explore the safety and effectiveness of the application of Orthobot semi-automatic spine surgery robot system in spine surgery in swine lumbar experimental model by analyzing its feasibility so as to optimize surgical procedures. METHODS: Totally 12 swine lumbar samples (L1-L6) were randomly divided into 2 groups. In the experimental group (6 cases), pedicle screw path was planned under the three-dimensional CT data after matching the pre-operative CT images and intra-operative C-arm film. Orthobot spinal surgical robot system was used to locate the pedicle start point automatically and to drill a hole with Kirschner wire into the pedicle. Pedicle screw path was prepared through the Kirschner wire. In the control group (6 cases), X-ray perspective data of C-arm machine during operation were directly used, and the screw path was planned under the two-dimensional X-ray data. The surgical planning time, Kirschner wire implantation time, X-ray exposure time, and total operation time were recorded for further analysis. The accuracy and the excellent and good rate of pedicle screw implantation were evaluated by CT scan according to Abul-Kasimhierarchy grading system. RESULTS AND CONCLUSION: (1) The planning time and the total operation time of single pedicle screw path preparation were lower in the experimental group than in the control group (P 0.05). (2) Post-operation CT evaluation showed that the excellent and good rate of pedicle screw path preparation was significantly better in the experimental group 96.7% (58/60) than in the control group 85.0% (51/60) (P < 0.05). (3) Results suggested that compared with intraoperative C-arm, the application of Orthobot semi-automatic spine surgery robot system combined with preoperative CT and intraoperative C-arm has high accuracy, safeness and effectiveness. However, the registration and matching time of the system is increased and the total operation time is long.

12.
Frontiers of Medicine ; (4): 404-416, 2020.
Article in English | WPRIM | ID: wpr-827856

ABSTRACT

A number of developed countries are rapidly turning into super-aged societies. Consequently, the demand for reduced surgical invasiveness and enhanced efficiency in the medical field has increased due to the need to reduce the physical burden on older patients and shorten their recovery period. Intelligent surgical robot systems offer high precision, high safety, and reduced invasiveness. This paper presents a review of current intelligent surgical robot systems. The history of robots and three types of intelligent surgical robots are discussed. The problems with current surgical robot systems are then analyzed. Several aspects that should be considered in designing new surgical systems are discussed in detail. The paper ends with a summary of the work and a discussion of future prospects for surgical robot development.

13.
Journal of Medical Biomechanics ; (6): E040-E046, 2019.
Article in Chinese | WPRIM | ID: wpr-802503

ABSTRACT

Objective The current manipulator with double parallel quadrilateral mechanism should be connected in series with a flexible degree of freedom (DOF) mechanism, which increases the volume of the manipulator, decreases the motion flexibility and creates the interference between the mechanical arms that hold the mirror and the device. Aimed at solving this problem, a novel mechanical arm was put forward to enhance the motion flexibility and reduce the volume of the manipulator. Methods The mechanical arm was designed by using the mechanism of five-link, slider and slide rail lower pair and wire transmission to realize the telescopic movement of the end effector. The kinematics model of the manipulator was established, and the MATLAB was used as the simulation tool to verify the correctness of the D-H parameters under the specific zero joint angle, and the motion equation of the manipulator was solved. Meanwhile, the three-dimensional workspace of the end effector was obtained by using Monte Carlo algorithm, and the preoperative plan of animal experiment for 3 arms was performed. Finally, cholecystectomy and other operations were acted in pigs, to verify the rationality and maneuverability of the design of double 5-link 2-DOF manipulator. Results The working space of Monte Carlo algorithm under MATLAB environment was -650.4 mm<x<649 mm, 163.8 mm<y<1 202 mm and -254.6 mm<z<829.8 mm. Sixteen cases of pig cholecystectomy were successfully completed, with an average operation time of 51 minutes. Conclusions The novel double 5-link 2-DOF manipulator could successfully complete cholecystectomy and other operations in pigs, which had no other symptoms after the operation. There was no interference between the mechanical arms, which fully verified the feasibility of the design scheme of the robot manipulator for minimally invasive surgery.

14.
Chinese Journal of Practical Surgery ; (12): 840-843, 2019.
Article in Chinese | WPRIM | ID: wpr-816472

ABSTRACT

OBJECTIVE: To evaluate the safety and feasibility of the domestic surgical robot in clinical applications.METHODS: From March 2014 to January 2019, 103 domestic robot-assisted laparoscopic surgeries were performed in Department of General Surgery, Third Xiangya Hospital of Central South University. The clinical features, operation and postoperative results were collected and analyzed. The patients were followed up for 1 month. RESULTS: Among 103 cases, 2 cases(2%) trasfered to open surgery. Two patients(2%) required intraoperative blood transfusion and no postoperative blood transfusion. Intraoperative complications occurred in 2 cases(2%) which were bladder injury and ureteral injury respectively. Postoperative complications occurred in 2 cases(2%) which were anastomotic leakage and pelvic infection. There was no reoperation during hospitalization. All patients were discharged smoothly. There were no re-admissions and deaths within 30 days after surgery. CONCLUSION: Domestic surgical robots are safe and feasible in clinical applications,which needs further verified by multicenter, randomized controlled trials.

15.
Chinese Journal of Traumatology ; (6): 88-92, 2019.
Article in English | WPRIM | ID: wpr-771628

ABSTRACT

This paper systematically reviewed and analyzed the recent publications of robotic-assisted surgeries in the field of tissue repair and reconstruction. Surgical robots can elevate skin flap more accurately and shorten the time of tissue harvest. In addition, robotic-assisted surgery has the advantage of minimal tissue trauma and thus forms minimal scar. The utilization of surgical robots reduces the occurrence of complications after oral radical tumor resection while achieving cosmetic sutures. Robotic-assisted radical mastectomy could radically remove invasive breast cancer lesions and achieve breast reconstruction in the first stage through the small incisions in the operation areas. Surgical robots enable precise microvascular anastomosis and reduce tissue edema in the surgical field. Robotic-assisted technology can help appropriately locate the target tissues at different angles during sinus and skull base surgeries and accurately place tissues during urethroplasty. The robotic-assisted technology provides a new platform for surgical innovation in the field of tissue repair and reconstruction. However, the uncertainty in the survival rate after tumor radical surgery, the increase of operating time, and the high costs are barriers for its clinical application in tissue repair and reconstructive surgery. Nevertheless, robotic-assisted technology has already demonstrated an impact on the field of tissue repair and reconstruction in a meaningful way.


Subject(s)
Humans , Breast Neoplasms , General Surgery , Cicatrix , Minimally Invasive Surgical Procedures , Methods , Mouth Neoplasms , General Surgery , Operative Time , Plastic Surgery Procedures , Methods , Robotic Surgical Procedures , Methods , Skull Base , General Surgery , Surgical Flaps , Tissue and Organ Harvesting , Urethra , General Surgery
16.
Medisan ; 22(4)abr. 2018. ilus
Article in Spanish | LILACS | ID: biblio-894715

ABSTRACT

Se efectuó una revisión bibliográfica para determinar el impacto de la mecatrónica en el sector de la salud. Se valoró el desarrollo de esta desde la visión de diferentes investigadores, lo cual ha permitido su inserción en dicho sector. También se comprobó que la robótica y el procesamiento digital de imágenes y señales tienen mayor incidencia en la medicina. Asimismo, se hizo un análisis de la mecatrónica aplicada a esta ciencia, el cual demostró que las áreas quirúrgica y terapéutica son las más favorecidas y se nutren de técnicas innovadoras, que resultan más fiables y menos invasivas para el paciente


A literature review was carried out to determine the impact of mechatronic in the health sector. Its development was evaluated from the point of view of different investigators, which has allowed its insertion in this sector. It was also proven that robotics and digital processing of images and signs have higher incidence in medicine. Also, an analysis of mechatronic applied to this science was carried out, which demonstrated that the surgical and therapeutical areas are the most favored and receive nourishment through innovative techniques that are more reliable and less invasive for the patient


Subject(s)
Humans , Male , Female , Robotics/methods , Electronics, Medical/instrumentation , Electrical Equipment and Supplies , Robotic Surgical Procedures , Health Systems , Electromagnetic Phenomena , Wearable Electronic Devices/statistics & numerical data
17.
China Medical Equipment ; (12): 119-123, 2018.
Article in Chinese | WPRIM | ID: wpr-706559

ABSTRACT

Objective: To research the competitive situation of technical research on the field of surgical robot and analyze direction of technical development of this field.Methods: The data of Derment Innovation(DI)platform were applied,and the patent analysis method was adopted to combined with visual tool to analyze patents of surgical robot field from various aspects such as the number of patent application,technology life cycle,the trend of regional development,competitor and trend of technical development.Results: There were 1491 patent applications in the globally surgical robot field,and technological fields were concentrated in endoscope,surgically mechanical arm,electronic data processing system,intervention,implantation of related equipment,regulatory system,image processing and transmission,stress and torque,etc.United States and China not only were the major technical birthplace but also were the important target markets in surgical robot field.And enterprises were the main research and development institutions in abroad,while colleges and universities were main institutions in China.Conclusion: The field of surgical robotics is in a fast developing period,and endoscope and surgically mechanical arm are the focusing technical development direction and they obtain most attentions.

18.
Chinese Journal of Experimental Ophthalmology ; (12): 804-807, 2018.
Article in Chinese | WPRIM | ID: wpr-699825

ABSTRACT

Surgical robots have the advantages of good flexibility,high precision and stable operation,which is an important way to improve the safety and accuracy of ophthalmic surgical operations.Scholars have carried out preliminary explorations on the application of robots in the anterior and posterior segmental ocualr surgeries and completed the simulation and animal experiments.However,there are still some challenges for the ophthalmic surgical robots to enter the clinical application,including the lack of intelligent decision-making systems,the limited scope of ocular diseases involved in surgical robots,the small number of types of intelligent surgical tools,and the lack of high-precision navigation technologies.This article will systematically review the development status and future challenges of ocular surgical robots.

19.
International Journal of Biomedical Engineering ; (6): 442-445, 2017.
Article in Chinese | WPRIM | ID: wpr-693066

ABSTRACT

Objective To design the control system of a magnetic resonance image (MRI) navigated pneumatic surgical robot. Method The driven system of the robot was constructed by combining with pneumatically driven and ultrasonic motor. The cylinder position control loop was established based on proportion integration differentiation (PID) control. The mathematical model of the pneumatic servo system was established by system identification. The PID parameter tuning and the simulation of the system characteristics were conducted. The stability analysis was conducted using the Nyquist criterion, and the acupuncture accuracy and the magnetic compatibility of the robot were verified. Results The simulation results showed that the maximum steady-state error was about 0.4 mm and the maximum tracking error was less than 2 mm, indicating that the PID control system had high control precision and trajectory tracking ability. The error of the acupuncture accuracy test was 0.72 mm. The results of water-modeling experiments showed that the magnetic resonance images were clear indicating that the influence of the robot on the MRI images was small. Conclusions The results of imulation, acupuncture and water-modeling tests showed that the pneumatic robot system can meet the requirements of brachytherapy surgery.

20.
Journal of Peking University(Health Sciences) ; (6): 274-280, 2017.
Article in Chinese | WPRIM | ID: wpr-512642

ABSTRACT

Objective:To evaluate the security and efficiency of a surgical robotic assisted percutaneous screw fixation for the treatment of pelvic and acetabular fractures.Methods: In the study,12 patients with pelvic and acetabular fractures who were treated in Beijing Jishuitan Hospital from January to April in 2016 were involved in this research.The research subjects were randomly divided into two groups: the experimental group and the control group.Robotic-assisted percutaneous sacroiliac screw internal fixations were performed under the guidance of fluoroscopy navigation in the experimental group;in the control group,doctors operated manually guided by fluoroscopy.Statistical analysis was performed on the total operation time,the intraoperative fluoroscopy time,the adjustment numbers of intraoperative guide wires,the excellent rate of screw placement and the incidence of adverse events in order to evaluate the security and efficiency of a surgical robotic assisted percutaneous screw fixation for the treatment of pelvic and acetabular fractures.Results: Eleven screws were placed in 7 patients from the experimental group,while 7 screws were placed in 5 patients from the control group in total.All the screw placement positions were satisfactory according to postoperative CT images.The excellent rates of screw placement position were 100% in both groups.However,the P value was 0.016 based on the comparison between the screws' distribution in the two groups which meant that the screw distribution of the experimental group was better than that of the control group.The average fluoroscopy time needed for screw insertion was (7.36±2.63) s in the experimental group while (41.80±13.99) s in the control group (P<0.001).This suggested that the difference between the two groups had statistical significances.Intra-operative fluoroscopy time of the experimental group was significantly smaller than that of the control group.The number of the average screw adjustment was (0.36±0.48) times in the experimental group while (9.00±3.06) times in the control group (P=0.003).This suggested that the difference of the number of the guide needle adjustment between the two groups had statistical significances,and the number of the experimental group was smaller than that of the control group.The average operation time was (43.86±49.06) min in the experimental group while only (29.00±12.14) min were needed in the control group (P=0.528).This suggested that the difference between the two groups had no statistical significance.That is,the total operation time of the two groups was equal.All the screws were in satisfactory positions according to validation results of CT scans.No complications such as screw breaking out the bone cortex and entering into the knee joint cavity,wound infection occurred.Conclusion: Surgical robots are suitable for robot-assisted percutaneous screw fixation in pelvic and acetabular fractures.Robot-assisted treatment of pelvic and acetabular fractures has significant advantages over manual operations including high accuracy,small perspective radiation,safety and efficiency.

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