眼科手术机器人的研究进展  

Research progress of the robot-assisted ophthalmology surgery

作　　者：苏铃雅 陈亦棋 沈丽君 Su Lingya , Chen Yiqi, Shen Lijun(Eye Hospital of Wenzhou Medical University, Zhejiang Eye Hospital, Hangzhou 310000, China)

机构地区：[1]温州医科大学附属眼视光医院浙江省眼科医院,310000 [2]杭州市红十字会医院

出　　处：《中华实验眼科杂志》2018年第4期311-316,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目（81700884、51175013）;浙江省医药卫生科技计划项目（WKJ2010.2-018、WKJ-ZJ.1726）;浙江省教育厅科技计划项目（Y201431237）;温州医科大学眼视光学院重大科研项目（YNZD201003）

摘　　要：手术机器人具有高精度、高灵活度、高重复性等优点并与微创手术相融合，解决了传统微创手术的弊端，逐渐进入医学各个领域。国外学者对医疗手术机器人有广泛的研究，达芬奇手术机器人是目前临床应用最广泛、最为成熟的手术机器人系统。中国的手术机器人虽然起步较晚，但也成功自主研发了角膜移植手术机器人、妙手A、玻璃体视网膜显微手术机器人等一系列医疗手术机器人系统。目前，医疗手术机器人广泛应用于临床各个领域，同时应用于眼科。运用机器人行眼科手术有减少术者的生理颤抖、提高手术的稳定性与精确性、缩短学习曲线等优点。目前，达芬奇手术机器人能完美地完成角膜裂伤缝合、角膜全层移植、羊膜移植、翼状胬肉切除等眼表手术；中国自行研制的辅助角膜移植显微手术机器人也可以完成角膜的钻切和缝合。由于达芬奇手术机器人存在一定的局限性，并不能良好地运用于玻璃体视网膜等复杂的眼内手术。Handheld（手持式）、steady—hand（稳定手）、master-slave（主从式）以及在此基础上研发的各类运用于眼内手术机器人已经成功完成离体猪眼内玻璃体切割、视网膜异物移除、视网膜血管鞘膜剥除、视网膜血管穿刺以及在活体兔眼内完成视网膜激光光凝等眼内的操作，为今后手术机器人辅助眼内手术提供了可能。今后仍需不断地研发各式医疗手术机器人及提升其性能，从而可以更好地应用于临床。Surgical robots have the advantages of high precision, high flexibility, high repeatability, and merging with minimally invasive surgery to solve the shortcomings of traditional minimally invasive surgery, and gradually into all fields of medicine. Foreign scholars have extensive research on medical surgical robots. Currently, Da Vinci surgical robots are the most widely used and most mature surgical robot system. Although our scholars started later,they also successfully developed a corneal transplant robot,MiaoShou-A robot,robotic vitreoretinal microsurgery system and so on. At present, Robot-assisted surgery are widely used in various medical fields, which has also been used in ophthalmology. Robot-assisted surgery can reduce the physiological tremor of the surgeon;improve surgical stability and accuracy; shorten the learning curve and so on. At present, Da Vinci surgical robots can perfectly complete the ocular surface surgery such as suturing of the corneal laceration, corneal whole-layer transplantation, amniotic membrane transplantation and pterygium excision. The corneal transplantation microsurgery robot developed by our country can also complete corneal looping incision and suturing of the corneal. As Da Vinci surgical robots have some limitations and can＇t be well used in complex intraocular surgery such as vitreoretinal surgery. Handheld robot system, steady-hand robot system, master-slave robot system and various kinds of robots based on these systems are used in intraocular surgery. The pars plana vitrectomy （PPV） , retinal foreign body Removal, retinal vascular sheath sclerosis,retinal vascular cannulation had successfully performed in harvested porcine eyes and endolaser for retinal photocoagulation was done in Irish rabbit. It offers the possibility for future intraocular surgery with robot-assisted. At the same time,wider application research of robotic surgery and improvement of a robotic system should be continued.

关 键 词：机器人 眼科 研究进展 

分 类 号：R779.6[医药卫生—眼科] TP242[医药卫生—临床医学]