首例验证混合智能机器人完成经导管三尖瓣置换手术
Robotic transcatheter tricuspid valve replacement with hybrid enhanced intelligence: a new paradigm and first-in-vivo study
- 采用强化学习与人机共驾控制的混合智能系统
- 动物实验显示人机共驾比传统控制更高效稳定
- 集成稳定器与可脱载导管，实现临床级手术方案
经导管三尖瓣置换（TTVR）是治疗三尖瓣反流的最新方法，尚处于临床推广初期。智能机器人系统有望克服操作难度并推动普及，但具备高临床实用性的系统与流程尚未报道。本研究提出一套完整解决方案，包含被动稳定器、机器人驱动装置、可脱载输送导管及瓣膜操控机构。为推进自主化，引入基于强化学习、蒙特卡洛概率图的人机协同增强智能控制策略。在模型和首次动物体内实验中验证了系统设计满足临床需求。实验结果表明，人机共驾控制在操作效率、时间效益、自主性与稳定性方面均优于传统主从控制。本研究首次完整呈现机器人辅助TTVR的实施路径，成功实现混合增强智能在介入机器人中的应用，并提供具有高实用价值的前沿技术方案。
原文摘要 · Abstract (English)
Transcatheter tricuspid valve replacement (TTVR) is the latest treatment for tricuspid regurgitation and is in the early stages of clinical adoption. Intelligent robotic approaches are expected to overcome the challenges of surgical manipulation and widespread dissemination, but systems and protocols with high clinical utility have not yet been reported. In this study, we propose a complete solution that includes a passive stabilizer, robotic drive, detachable delivery catheter and valve manipulation mechanism. Working towards autonomy, a hybrid augmented intelligence approach based on reinforcement learning, Monte Carlo probabilistic maps and human-robot co-piloted control was introduced. Systematic tests in phantom and first-in-vivo animal experiments were performed to verify that the system design met the clinical requirement. Furthermore, the experimental results confirmed the advantages of co-piloted control over conventional master-slave control in terms of time efficiency, control efficiency, autonomy and stability of operation. In conclusion, this study provides a comprehensive pathway for robotic TTVR and, to our knowledge, completes the first animal study that not only successfully demonstrates the application of hybrid enhanced intelligence in interventional robotics, but also provides a solution with high application value for a cutting-edge procedure.
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