用仿组织水凝胶模型实现荧光引导的自主肾部分切除手术
Towards Fluorescence-Guided Autonomous Robotic Partial Nephrectomy on Novel Tissue-Mimicking Hydrogel Phantoms
- 基于点云与近红外成像，自动规划切除路径
- 实测平均切缘精度1.44毫米，69秒完成手术
- 可兼容电刀且支持荧光成像，适合临床前测试
自主机器人系统有望提升肾肿瘤切除的精准度与患者预后。本文提出一种荧光引导的机器人系统，能够围绕外生性肾肿瘤规划并执行切口路径，达到临床相关的切除边缘要求。系统利用点云观测，处理不规则肿瘤形状，并基于近红外成像区分健康与病变组织，类比于部分肾切除术中的吲哚菁绿染色。组织模拟体对开发无法获取离体动物组织的干预类机器人系统至关重要，如肾癌和肾盂癌。为此，我们提出新型基于水凝胶的肾部模拟体，包含外生性肿瘤，能模仿组织的物理与视觉特性，且兼容电外科器械——这是硅胶基模型常见限制。不同于以往水凝胶模型，本研究在材料中混入近红外染料，实现荧光引导的肿瘤分割。自主真实世界机器人实验验证了该系统与模型的有效性，平均切缘精度达1.44毫米，完成时间仅69秒。
原文摘要 · Abstract (English)
Autonomous robotic systems hold potential for improving renal tumor resection accuracy and patient outcomes. We present a fluorescence-guided robotic system capable of planning and executing incision paths around exophytic renal tumors with a clinically relevant resection margin. Leveraging point cloud observations, the system handles irregular tumor shapes and distinguishes healthy from tumorous tissue based on near-infrared imaging, akin to indocyanine green staining in partial nephrectomy. Tissue-mimicking phantoms are crucial for the development of autonomous robotic surgical systems for interventions where acquiring ex-vivo animal tissue is infeasible, such as cancer of the kidney and renal pelvis. To this end, we propose novel hydrogel-based kidney phantoms with exophytic tumors that mimic the physical and visual behavior of tissue, and are compatible with electrosurgical instruments, a common limitation of silicone-based phantoms. In contrast to previous hydrogel phantoms, we mix the material with near-infrared dye to enable fluorescence-guided tumor segmentation. Autonomous real-world robotic experiments validate our system and phantoms, achieving an average margin accuracy of 1.44 mm in a completion time of 69 sec.
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