新型机器人解剖器可精准进入肺动脉细分支，提升慢性肺栓塞手术安全性。
Multi-function Robotized Surgical Dissector for Endoscopic Pulmonary Thromboendarterectomy: Preclinical Study and Evaluation
- 基于同心推拉结构设计，实现3.5毫米细径和双段弯曲灵活性。
- 末端工具定位精度达2毫米，在开放环控制下完成精细剥离操作。
- 适用于需要微创、高精度的肺动脉血栓内膜剥脱术，适合外科医生使用。
慢性严重肺血栓栓塞患者需行肺动脉内膜剥脱术（PTE）以清除肺动脉（PA）内的血栓和内膜。传统手术中，医生手持镊子和剥离器在狭窄分支中操作，但现有器械刚性且直，难以深入细小迂曲的肺动脉分支。为此，本文提出一种基于同心推拉机器人（CPPR）结构的新型机器人化剥离器，可深入细长分支。该器械直径仅3.5毫米，具有中空薄壁结构，中央通道容纳冲洗液、末端工具及内窥镜信号线。通过优化的运动学模型，实现60毫米长度末端工具在开环控制下的2毫米定位精度。结合内窥镜，传统PTE有望升级为内窥镜辅助式手术。实验验证了其刚度、运动精度与操控性；离体猪肺模拟手术进一步证明其优异的操作性能和临床潜力。
原文摘要 · Abstract (English)
Patients suffering chronic severe pulmonary thromboembolism need Pulmonary Thromboendarterectomy (PTE) to remove the thromb and intima located inside pulmonary artery (PA). During the surgery, a surgeon holds tweezers and a dissector to delicately strip the blockage, but available tools for this surgery are rigid and straight, lacking distal dexterity to access into thin branches of PA. Therefore, this work presents a novel robotized dissector based on concentric push/pull robot (CPPR) structure, enabling entering deep thin branch of tortuous PA. Compared with conventional rigid dissectors, our design characterizes slenderness and dual-segment-bending dexterity. Owing to the hollow and thin-walled structure of the CPPR-based dissector as it has a slender body of 3.5mm in diameter, the central lumen accommodates two channels for irrigation and tip tool, and space for endoscopic camera's signal wire. To provide accurate surgical manipulation, optimization-based kinematics model was established, realizing a 2mm accuracy in positioning the tip tool (60mm length) under open-loop control strategy. As such, with the endoscopic camera, traditional PTE is possible to be upgraded as endoscopic PTE. Basic physic performance of the robotized dissector including stiffness, motion accuracy and maneuverability was evaluated through experiments. Surgery simulation on ex vivo porcine lung also demonstrates its dexterity and notable advantages in PTE.
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