基于颗粒干扰的新型腹腔镜手术辅助装置的设计与开发

Chenan Andy Huang, Sang-Eun Song
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摘要

腹腔镜手术具有明显的高学习曲线,阻碍了典型的培训方法。由于开放手术中不存在的独特挑战(铰链效应、小视野(FoV)、缺乏深度感知和小工作空间),外科住院医生可能会推迟参加腹腔镜手术,直到住院医生后期。完成高度专业化培训的时间很短,这可能会导致毕业生觉得自己对独立实践准备不足。此外,延迟引入可能会使受训者接触不到200例腹腔镜病例。因此,外科住院医师需要在不影响患者安全的情况下增加他们的病例量和培训窗口。该项目旨在开发和测试一个概念验证原型,该原型使用颗粒干扰技术来控制移动腹腔镜工具所需的力。通过增加工具阻力,该设备有助于防止意外伤害附近重要的解剖结构,如泌尿道、血管系统和/或肠道。提高腹腔镜手术的安全性将使住院医生更早地开始他们的培训,获得曝光和信心。一种调整工具阻力的装置对经验丰富的外科医生也有好处——手术需要不断调整工具和张力,导致疲劳。增加工具的阻力可以帮助外科医生在需要持续张力的情况下,也可以防止突然移动。该研究装置使用SolidWorks CAD软件进行原型制作,然后使用腹腔镜盒训练器进行3D打印和评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Design And Development of a Novel Assistive Device for Laparoscopic Surgery Using Granular Jamming
Laparoscopic surgery has a notably high learning curve, hindering typical approaches to training. Due to unique challenges that are not present in open surgery (the hinge effect, small field of view (FoV), lack of depth perception, and small workspace), a surgical resident may be delayed in participating in laparoscopic surgery until later in residency. Having a narrow window to complete highly specialized training can lead to graduates feeling under-prepared for solo practice. Additionally, delayed introduction may expose trainees to fewer than 200 laparoscopic cases. Therefore, there is a need for surgical residents to increase both their caseload and training window without compromising patient safety. This project aims to develop and test a proof-of-concept prototype that uses granular jamming technology to controllably vary the force required to move a laparoscopic tool. By increasing tool resistance, the device helps prevents accidental injury to important nearby anatomical structures such as urinary tract, vasculature, and/or bowel. Increasing the safety of laparoscopic surgery would allow residents to begin their training earlier, gaining exposure and confidence. A device to adjust tool resistance has benefits to the experienced surgeon as well – surgeries require continuous tool adjustment and tension, resulting in fatigue. Increasing tool resistance can assist surgeons in situations requiring continuous tension and can also provide safety against sudden movements. This investigational device was prototyped using SolidWorks CAD software, then 3D printed and assessed with a laparoscopic box trainer.
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