血管介入机器人的初步临床应用  

Preliminary clinical application of vascular interventional robot

作　　者：徐武夷[1] 卢旺盛[1] 刘达[2] 贾博[1] 惠瑞[1] 刘龙[2] 赵德鹏[2] 王大明[3] 田增民[1] 

机构地区：[1]海军总医院全军神经外科中心,北京100048 [2]北京航空航天大学机器人研究所 [3]卫生部北京医院神经外科

出　　处：《中华外科杂志》2014年第8期593-596,共4页Chinese Journal of Surgery

摘　　要：目的 验证血管介入手术机器人系统应用于临床血管介入手术的可行性与安全性.方法 2013年3月至9月共10例患者行全脑血管造影术,其中男性6例,女性4例;年龄19 -58岁,平均38.4岁.手术由神经外科医师和血管介入机器人共同完成,在人工完成股动脉鞘穿刺后,将造影管固定于机器人,专家在图像导航的引导下操作机器人主端,指令通过网络传输介入导管手术室内的机器人从端,完成全脑血管造影术.记录从股动脉鞘置入后开始至全脑血管选择性造影结束的时间（手术时间）,同时记录医生在X线下暴露工作时间,记录导管运动设定靶点与实际操作机器人达到的位置差别（定位精度）.结果 机器人在25 - 41 min内完成全脑血管造影术,平均完成时间（31 ±5） min,手术过程顺利,无手术并发症.远程定位精度达到（1.03 ±0.23） mm.工作人员在X线下暴露时间为0 min.整个手术过程基本实行了机械化和自动化,无手术并发症.结论 血管介入手术机器人系统基本上达到减少医生接受辐射的初步目的,同时在图像导航加强基础上方便了介入操作,缩短手术时间,为提高手术质量创造了有利条件.Objective To verify the feasibility and safety of the vascular interventional vascular interventional surgical robot system applied to vascular interventional operation.Methods From March to September 2013,10 patients had undergone robot-assisted cerebral angiography.There were 6 male and 4 female patients ; aged from 19 to 58 years,with an average age of 38.4 years.The operation were carried out by neurosurgeons and vascular interventional robot.After successfully implanted of femoral artery sheath by hand,the catheter was fixed on the robot,under the guidance of navigation image the surgeon manipulate the master part and control the slave part of robot by sending command through network transmission,finally finished the whole cerebral angiography.The operation time was recorded from placing the sheath into femoral artery to finishing cerebrovascular selective angiography,simultaneously the time of staff under exposure of X ray was recorded,and the position difference between the setted targets and the actual position（positioning accuracy）.Results It took 25-41 minutes to finish the cerebral angiography,the average time was （31 ±5） minutes,and the robot-assisted angiography went quickly and smoothly without surgical complications.The remote positioning accuracy was （1.03 ± 0.23） mm.The time of staff under exposure of X ray was 0 minute,the entire experimental process was basically implemented mechanization and automation.Conclusion This system basically achieves initial medical purposes,such as reducing the radiation,facilitating interventional procedures on the basis of enhancing the image navigation,shorting the operation time,and improve the quality of operation.

关 键 词：放射学 介入性 外科手术 微创性 机器人 

分 类 号：R651[医药卫生—外科学]