机器人辅助实质器官手术的止血切割器械设计  

Bloodless Cutting Device Design for Robot-Assisted Solid Organ Surgery

作　　者：李建民[1,2] 庞兴旺 孔康[1,2] 刘全达 Li Jianmin;Pang Xingwang;Kong Kang;Liu Quanda(Key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education,Tianjin University,Tianjin 300354,China;School of Mechanical Engineering,Tianjin University,Tianjin 300354,China;Chinese People’s Liberation Army Rocket Army Characteristic Medical Center,Beijing 100088,China)

机构地区：[1]天津大学机构理论与装备设计教育部重点实验室,天津300354 [2]天津大学机械工程学院,天津300354 [3]中国人民解放军火箭军特色医学中心,北京100088

出　　处：《天津大学学报（自然科学与工程技术版）》2022年第3期230-238,共9页Journal of Tianjin University：Science and Technology

基　　金：国家重点研发计划资助项目(2019YFC0118003);国家自然科学基金资助项目(51875394,51520105006).

摘　　要：由于实质器官内血管密布,利用特定能量将该类器官所需切割部位周围组织凝固是当前避免术中严重出血的重要途经.为实现灵活精准的凝固操作,将机器人技术与对组织的能量作用原理相结合,设计了一种可在微创条件下向实质器官实施能量作用的新型机器人灵巧手术器械.该器械末端设计为若干操作针形式,并按正负极需求进行合理布局,使其可在组织内部形成能量回路,进而实现对组织的凝固操作.为提升操作的灵活性,在器械末端增加了偏转关节,结合器械本身自转及机器人从操作手的运动,可实现使操作针始终沿与组织表面垂直方向刺入的目标.操作针刺入并在能量发生器释放能量的同时,机器人能够控制操作针沿刺入方向做自动往复直线运动,以提升对组织的凝固效果并避免结痂.最后,利用性能实验和离体组织实验对该装置进行了验证,结果显示,器械的高频漏电流范围为5.47~8.31 mA;由专家对机器人下离体猪肝脏的模拟手术实验结果评估显示,机器人操作下的止血切割器械可有效实现对实质器官的凝固处理,验证了所设计手术器械的有效性.Tissue coagulation around the organ cutting site is the most effective way to avoid bleeding problems in surgery due to dense blood vessels in the solid organ.In order to achieve flexible and accurate tissue coagulation operation,a new robotic dexterous surgical device was designed,which can implement energy action on the solid or-gan under a minimally invasive surgical condition by combining robot technology and principle of energy action on tissues.The end of the device is designed as a number of operating needles,and reasonable layout is made according to positive and negative electrode requirements,so that the energy loop can be formed in tissues to realize the coagulation operation of the tissue.A deflection joint is added at the end of the device to improve operational flexibility.Combined with device rotation and robot’s slave manipulator motion,the goal of vertical penetration of the needle into the tissue surface can be realized.When needles stab into the tissue and energy generator releases energy,the robot can control the operating needle to do automatic reciprocating linear motion along the penetration direction to improve the coagulation effect of tissue and avoid scab.Finally,the device was verified by performance experimentand ex vivo experiment.Results showed that high-frequency leakage current of the device in various modes is about 5.47-8.31 mA.Results evaluation of simulated operation of pig liver in ex vivo experiment by experts showed that bloodless cutting device operated by the robot could effectively coagulate solid organs,which verified the effective-ness of the designed surgical device.

关 键 词：实质器官手术 微创外科手术机器人 止血切割器械 自动往复运动 

分 类 号：TP242.3[自动化与计算机技术—检测技术与自动化装置]