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Investigation into the Benefits of Tactile Feedback for Laparoscopic, Robotic, and Remote Surgery.

机译：对腹腔镜，机器人和远程手术的触觉反馈的好处进行研究。

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摘要

Minimally invasive surgery (MIS) provides profound and well-known benefits to patients at the cost of increased technical difficulty for surgeons. In all types of minimally invasive surgery, including robotic, laparoscopic, and remote surgery, tactile information is altered, or in the case of robotic procedures, completely absent.;The first version of a tactile feedback system for robotic surgery was completed in 2008. During the course of this research, the feedback system was iteratively redesigned in order to address some of its shortcomings, improve its performance, and to allow the necessary expansion to other applications and in-vivo use.;When the improved tactile feedback system was integrated with a non-robotic laparoscopic grasper, it was found that tactile feedback significantly decreased the grip force of novice subjects during laparoscopic training, but had little impact on experts.;After designing a new water insulation methodology, the system was integrated with the da Vinci surgical robot and used for the first time in a live tissue experiment. This experiment showed that there was a high variability between subjects, and that there was a correlation between the amount of force used and amount of damage observed. Most expert and novice subjects used significantly decreased grasping forces, and had significantly fewer sites of damage when evaluated by a blinded pathologist, but some of this may have been caused by familiarization with the task.;The first prototype remote surgery system with tactile feedback was developed by combining three existing systems: The University of Washington RAVEN-II, the UCLA LapaRobot, and the improved tactile feedback system. In a preliminary investigation of remote surgery over a simulated network with delays of 100 ms and then 1 ms, there were decreases in grasping force for most subjects, and more significant retention when the time delay was minimized.;Together these findings suggest that tactile may be a beneficial addition to minimally invasive surgical systems—especially for cases with heavy cognitive demand, such as training of novice users, challenging control schemes, and when handling delicate tissue—and that efforts should continue to advance the feedback system towards clinical viability.
机译：微创手术（MIS）以增加外科医生的技术难度为代价，为患者提供了深刻而众所周知的好处。在所有类型的微创手术中，包括机器人，腹腔镜手术和远程手术，触觉信息都会改变，或者在机器人程序的情况下完全不存在触觉信息;用于机器人手术的触觉反馈系统的第一版已于2008年完成。在此研究过程中，反复对反馈系统进行了重新设计，以解决其一些缺点，提高其性能并允许将其扩展到其他应用和体内使用。当集成了改进的触觉反馈系统时在使用非机器人腹腔镜抓紧器的情况下，发现触觉反馈显着降低了新手在腹腔镜训练过程中的抓地力，但对专家的影响很小。；在设计了一种新的防水方法之后，该系统与达芬奇集成了起来手术机器人，并首次在活组织实验中使用。该实验表明，受试者之间存在很大的变异性，并且所用力与观察到的损伤量之间存在相关性。当由盲人病理学家评估时，大多数专家和新手受试者使用的抓握力都显着降低，并且受损部位明显减少，但是其中某些原因可能是由于对任务的熟悉而引起的。通过结合三个现有系统开发：华盛顿大学的RAVEN-II，加州大学洛杉矶分校的LapaRobot和改进的触觉反馈系统。在通过模拟网络进行的延迟为100 ms然后为1 ms的远程手术的初步研究中，大多数受试者的抓握力均降低，并且在时间延迟最小化的情况下保留力更显着。这些研究结果表明触觉可能是微创外科手术系统的有益补充（特别是对于具有大量认知需求的病例，例如新手用户的培训，具有挑战性的控制方案以及在处理脆弱组织时），并且应该继续努力，将反馈系统提高到临床可行性。

著录项

  • 作者

    Wottawa, Christopher Robert.;

  • 作者单位

    University of California, Los Angeles.;

  • 授予单位 University of California, Los Angeles.;
  • 学科 Engineering Computer.;Engineering Biomedical.;Engineering Robotics.
  • 学位 Ph.D.
  • 年度 2013
  • 页码 164 p.
  • 总页数 164
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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