实时感知组织变形,提升机器人眼底注射精度
Real-time Deformation-aware Control for Autonomous Robotic Subretinal Injection under iOCT Guidance
- 通过iOCT B⁵扫描实现术中动态三维重建与定位
- 90%成功率生成视网膜下积液,较之前提升55个百分点
- 适合眼科微创手术自动化研究者参考
机器人平台可提供稳定精准的器械定位,显著提升视网膜微手术效果。将其与术中光学相干断层扫描(iOCT)结合,可实现影像引导下的机器人自主干预,完成如向视网膜下腔注射治疗药物等高级操作。然而,器械与组织相互作用引起的组织形变是自主iOCT引导机器人视网膜下注射的主要挑战,影响针尖定位与手术效果。本文提出一种考虑插入过程中组织变形的新方法,通过密集采样的iOCT B⁵扫描实现实时场景分割与3D重建。利用B⁵扫描,实时监测器械相对于内界膜(ILM)与视网膜色素上皮(RPE)之间虚拟目标层的位置。在离体猪眼实验中,该方法实现了插入深度的动态调整,相较于以往自主插入方法,针尖定位精度显著提升。相比此前仅35%的视网膜下积液生成成功率,本方法在实验中可靠地实现了90%的成功率。
原文摘要 · Abstract (English)
Robotic platforms provide consistent and precise tool positioning that significantly enhances retinal microsurgery. Integrating such systems with intraoperative optical coherence tomography (iOCT) enables image-guided robotic interventions, allowing autonomous performance of advanced treatments, such as injecting therapeutic agents into the subretinal space. However, tissue deformations due to tool-tissue interactions constitute a significant challenge in autonomous iOCT-guided robotic subretinal injections. Such interactions impact correct needle positioning and procedure outcomes. This paper presents a novel method for autonomous subretinal injection under iOCT guidance that considers tissue deformations during the insertion procedure. The technique is achieved through real-time segmentation and 3D reconstruction of the surgical scene from densely sampled iOCT B-scans, which we refer to as B${^5}$-scans. Using B${^5}$-scans we monitor the position of the instrument relative to a virtual target layer between the ILM and RPE. Our experiments on ex vivo porcine eyes demonstrate dynamic adjustment of the insertion depth and overall improved accuracy in needle positioning compared to prior autonomous insertion approaches. Compared to a 35% success rate in subretinal bleb generation with previous approaches, our method reliably created subretinal blebs in 90% our experiments.
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