Enabling Technology for Safe Robot-assisted Surgical Micromanipulation

安全机器人辅助手术显微操作的实现技术

• 批准号: 10366680
• 负责人: PETER LOUIS GEHLBACH
• 金额: $ 44.51万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-03-15 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10366680
• 关键词: Address; Affect; Algorithms; Animal Model; Apoptosis; Area; Behavior; Bilateral; Blindness; Blood coagulation; Cannulas; Cannulations; Clinical; Clinical Treatment; Coagulation Process; Cognitive; Discipline; Disease; Eye; Eye Movements; Eye diseases; Family suidae; Fatigue; Feedback; Goals; Grant; Hand; Hemorrhage; Human; Hybrids; Infusion procedures; Injury; Manuals; Measures; Micromanipulation; Microsurgery; Motion; Natural regeneration; Needles; Neural Retina; Neurons; Obstruction; Operative Surgical Procedures; Ophthalmology; Otolaryngology; Perception; Performance; Perfusion; Persons; Pharmaceutical Preparations; Physiological; Positioning Attribute; Procedures; Psyche structure; Puncture procedure; Readiness; Reproducibility; Research; Retina; Retinal Diseases; Retinal Vein Occlusion; Robot; Robotics; Safety; Sclera; Sensory; Sensory Thresholds; Stress; Structure of central vein of the retina; Surgeon; System; Tactile; Techniques; Technology; Therapeutic Agents; Thrombus; Time; Tissues; Translations; Tremor; Validation; Veins; Vision; Visualization; Work; adaptive learning; base; experience; in vivo; in vivo Model; innovation; instrument; machine learning method; multisensory; neurosurgery; novel; pre-clinical; prevent; real time monitoring; retina blood vessel structure; robot assistance; robot control; robotic system; success; theories; tool; virtual

Project Summary / Abstract The goal of this grant is to develop enabling technology to address fundamental limitations in microsurgery with a specific focus on developing coordinated bilateral assistance for the vitreoretinal surgeon. Retinal vein occlusion (RVO) is the second-most-prevalent vision threatening disease of retinal blood vessels, with no consistently successful clinical treatments to directly resolve the occlusion. A strategic approach, that is particularly amenable to robotic assistance, is to cannulate the occluded retinal vein with a micro-cannula and to inject a clot-dissolving agent. Due to human physiological limitations (tremor, tactile perception, visualization, stress, cognitive requirements, incomplete sensory information, etc.), as well as retinal fragility and the inability to regenerate retinal tissue, various robotic systems have been developed that target select aspects of retinal vein cannulation (RVC). However, even with all present and emerging technological advances, a number of imminently solvable challenges remain as barriers to consistently successful treatment. We propose a bilateral robotic system with real-time multisensory feedback that assesses multiple points of instrument contact located both inside and outside of the eye. Our bilateral system will enhance retina and sclera safety, increase the rate of RVC success, diminish forces on the cannula and vein, reduce the human mental and physical requirements, and allow the surgeon enhanced motion precision to enable more advanced surgical procedures benefitted by bilateral manipulation. To prove the hypothesis that bilateral robot-assisted retinal cannulation is possible and safe, we propose the following specific aims: (1) Demonstrate coordinated position/force hybrid control algorithms for enabling real- time sensorimotor capabilities at sclerotomy for safe bilateral robot-assisted vitreoretinal microsurgery: real-time sensorimotor capabilities at the sclerotomy will be uniquely used to control the robots through a machine learning method that adaptively learns a nonlinear mapping from user behavior to sclera-force/position and predicts unsafe motions; (2) Demonstrate position/force-input control algorithms for enabling real-time sensorimotor capabilities at the tool-tip for safe bilateral robot-assisted vein cannulation: real-time tool-tip-to-tissue interaction force sensing and non-linear robot control algorithms based on observing user behavior will be used to control the tool-tip position and force and to prevent entry into subretinal areas during RVC; (3) Demonstrate and evaluate bilateral RVC using SHER in animal model in vivo: real-time, position/force hybrid control algorithms based on dual-point (tool-shaft and tip) information fusion will provide sensorimotor guidance of surgical maneuvers during RVC. Statistically significant results in vivo, in clinically realistic conditions will demonstrate the feasibility of our approach. This highly innovative system with expanded coordinated bimanual capabilities will allow us to further increase the safety and reliability of RVC and move the technology to preclinical readiness.

项目摘要 /摘要 这笔赠款的目的是开发使技术能够解决微型外科的基本限制 特别着重于为玻璃体外科医生提供协调的双边援助。视网膜静脉 闭塞（RVO）是视网膜血管威胁疾病的第二大视力，没有 一贯成功的临床治疗方法直接解决阻塞。一种战略方法，即 特别适合机器人援助，是用微扫描插入遮挡的视网膜静脉，然后 注入凝块溶解剂。由于人类的生理局限性（震颤，触觉感知，可视化， 压力，认知要求，不完整的感觉信息等）以及视网膜脆弱性和无能为力 为了再生视网膜组织，已经开发了各种机器人系统，以选择视网膜的精选方面 静脉插管（RVC）。但是，即使所有现在和新兴的技术进步，许多 即将解决的挑战仍然是始终如一地成功治疗的障碍。我们提出了双边 具有实时多感官反馈的机器人系统，评估了多个仪器接触点 眼睛内外。我们的双边系统将提高视网膜和巩膜安全，提高速率 RVC成功，减少套管和静脉的力量，减少人类的心理和身体要求， 并允许外科医生增强运动精度，以使更先进的手术程序受益 双边操作。 为了证明双边机器人辅助的视网膜插管是可能且安全的假设，我们提出 以下特定目的：（1）展示了协调的位置/力杂种控制算法，以实现实现 安全双边机器人辅助玻璃体术显微外科手术的硬化术的时间感觉运动功能：实时 硬化切开术的感觉运动功能将独特地用于通过机器学习来控制机器人 适应性地学习从用户行为到巩膜/位置的非线性映射的方法 不安全的动议； （2）展示用于实时感觉运动的位置/力输入控制算法 工具尖上的功能，用于安全双边机器人辅助静脉插管：实时工具 - 脚尖到组织互动 基于观察用户行为的力传感和非线性机器人控制算法将用于控制 工具尖端的位置和力量，以防止在RVC期间进入视网膜下区域； （3）演示和 在体内使用动物模型中使用SHER评估双边RVC：实时，位置/力杂交控制算法 基于双点（工具轴和尖端）信息融合将提供手术指导 RVC期间的演习。体内具有统计学意义的结果，在临床上现实的条件下将证明 我们方法的可行性。这个高度创新的系统，具有扩展的协调双人功能 将使我们能够进一步提高RVC的安全性和可靠性，并将技术转移到临床前准备。