arXiv:2507.13654cs.RO2025-07

对比两种机器人手术操控模式,发现内部操控更精准。

Control Modes of Teleoperated Surgical Robotic System's Tools in Ophthalmic Surgery

  • 区分内部与外部操控模式,模拟眼内手术操作
  • 内部模式在多数任务中表现更优,高缩放比降低误差
  • 适合提升手术精度,尤其对新手医生有帮助

为微创手术设计的遥操作手术机器人系统通过专用控制台输入设备实现两种不同操控模式:(1) 内部操控模式,模拟外科医生手持器械远端在患者体内操作;(2) 外部操控模式,模拟手持器械近端在体外操作。本研究旨在比较这两种操作模式在不同缩放比例下,于模拟玻璃体视网膜手术环境中的外科医生表现。使用眼内机器人介入手术系统(IRISS)控制台,结合虚拟现实头显呈现显微镜视角的眼内环境,5名经验丰富的玻璃体视网膜外科医生与5名无手术经验者完成四项基本操作任务:触碰并复位、抓取与释放、注射、环形追踪。结果显示,内部操控模式在多个任务和指标上优于外部操控模式。较高的缩放比例总体表现更好,尤其显著降低了轨迹误差和组织损伤。该结果表明,大缩放比例有助于更精确控制,是精细操作的优选方案。但完成时间并未在所有条件下一致缩短,提示外科医生需根据手术需求权衡速度与精度。优化操控动态与人机界面,有望减少并发症,提升操作灵巧性,并使高精度手术可及更多执业者。

原文摘要 · Abstract (English)

The introduction of a teleoperated surgical robotic system designed for minimally invasive procedures enables the emulation of two distinct control modes through a dedicated input device of the surgical console: (1) Inside Control Mode, which emulates tool manipulation near the distal end as if the surgeon was holding the tip of the instrument inside the patient's body; (2) Outside Control Mode, which emulates manipulation near the proximal end as if the surgeon was holding the tool externally. The aim of this research is to compare the surgeon's performance on these two modes of operation along with various scaling factors in a simulated vitreoretinal surgical setting. The console of Intraocular Robotic Interventional Surgical System (IRISS) was utilized but the surgical robot itself and the human eye anatomy was simulated by a virtual environment projected microscope view of an intraocular setup to a VR headset. Five experienced vitreoretinal surgeons and five subjects with no surgical experience used the system to perform four fundamental tool/tissue tasks common to vitreoretinal surgery: touch and reset; grasp and drop; inject; circular tracking. Results indicate that Inside Control outperforms Outside Control across multiple tasks and metrics. Higher scaling factors generally performed better, particularly for reducing trajectory errors and tissue damage. This improvement suggests that larger scaling factors enable more precise control, making them the preferred option for fine manipulation. However, completion time was not consistently reduced across all conditions, indicating that surgeons need to balance speed and accuracy based on surgical requirements. By optimizing control dynamics and user interface, robotic teleoperation has the potential to reduce complications, enhance dexterity, and expand the accessibility of high precision procedures to a broader range of practitioners.

手术机器人遥操作眼科手术人机交互

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