A Microsurgical Assistant System

显微手术辅助系统

• 批准号: 7525891
• 负责人: RUSSELL H TAYLOR
• 金额: $ 118.33万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7525891
• 关键词: Address; Age; Aging; Animal Model; Area; Auditory; Beds; Biomedical Engineering; Blindness; Cadaver; Cannulations; Caring; Cicatrix; Clinical; Complication; Computer Assisted; Computer Interface; Computer information processing; Condition; Coupling; Data; Depth; Development; Diabetic Retinopathy; Discipline; Disease; Engineering; Epidemic; Epiretinal Membrane; Excision; Eye; Family; Fatigue; Feedback; Fiber; Fiber Optics; Goals; Hand; Human; Image; Imagery; Individual; Information Technology; Lead; Lifting; Light; Macular Hole; Maps; Marriage; Measures; Membrane; Methods; Microscope; Microscopy; Microsurgery; Motion; Motor; Movement; Numbers; Obesity; Operative Surgical Procedures; Ophthalmology; Pathology; Patients; Performance; Phase; Physiological; Population; Positioning Attribute; Prevalence; Procedures; Public Health; Purpose; Qualifying; Range; Rate; Research; Research Ethics Committees; Resolution; Retina; Retinal; Retinal Detachment; Retinal Vein Occlusion; Robotics; Safety; Scanning; Scientist; Sensory; Spectrum Analysis; Structure of central vein of the retina; Sum; Surface; Surgeon; System; Tactile; Techniques; Technology; Testing; Time; Tissues; Toxic effect; Tremor; Universities; Update; Video Microscopy; Vision; Visual; Work; base; clinical application; design; disability; ergonomics; image processing; improved; instrument; instrumentation; intraoperative imaging; macula; neurosurgery; new technology; novel; novel therapeutics; optical fiber; research and development; retina blood vessel structure; robotic device; sensor; spectroscopic imaging; tool; virtual

DESCRIPTION (provided by applicant): This Bioengineering Research Partnership (BRP) will focus the efforts of highly qualified engineers, scientists and micro-surgeons from Johns Hopkins University and Carnegie-Mellon University to develop technology and systems addressing fundamental limitations in current microsurgical practice, using vitreoretinal surgery as our focus. Vitreoretinal surgery is the most technically demanding ophthalmologic discipline and addresses prevalent sight-threatening conditions in areas of growing need. With the aging of our population, the prevalence of sight-threatening conditions will continue to escalate. Retinal surgery is currently performed under an operating microscope with free-hand instrumentation. Limitations include limited visual resolution, and physiological hand tremor. The surgeon also struggles with a lack of tactile feedback, proximity sensing, and real-time sensing of physiological parameters of the retina. Surgical technique and efficiency would be enhanced by the integration of preoperative images with the intraoperative view. Poor ergonomics for the surgeon in current practice result in surgeon fatigue and potential disability. All of these factors contribute to extended operating times, attendant light toxicity, and higher than needed complication rates. At the center of our planned approach is a "surgical workstation" system interfaced to a stereo visualization subsystem and a family of novel sensors, instruments, and robotic devices. The capabilities of these components individually address important limitations of current practice; together they provide a modular, synergistic, and extendable system that enables computer-interfaced technology and information processing to work in partnership with surgeons to improve clinical care and enable novel therapeutic approaches. Our specific aims are 1) Develop enabling technology addressing fundamental limitations in image processing and information fusion, sensing, and manipulation; 2) integrate these components into a modular extendable system to significantly enhance surgeons' ability to perform microsurgical tasks; and 3) evaluate our systems' ability to improve surgeon performance of realistic surgical tasks on realistic phantom, cadaver, and animal models associated with three testbed applications. We have chosen surgical treatment of three common sight threatening conditions to provide specific focus for our research: pathology of the retinal surface, pathology of the internal limiting membrane, and retinal vein occlusion. The specific capabilities that we propose to develop both address the specific challenges associated with these procedures and are applicable to other techniques and diseases required of vitreoretinal surgery. Their integration will validate our overall system approach and provide a basis for further development both for ophthalmic applications and other microsurgical disciplines such as neurosurgery or microvascular surgery. PUBLIC HEALTH RELEVANCE: This Bioengineering Research Partnership (BRP) addresses fundamental limitations in current microsurgical practice, focusing on vitreoretinal surgery, which is the most technically demanding ophthalmologic discipline. The capabilities developed directly address challenges associated with surgical treatment of three of the most common causes of vision loss, which are becoming more prevalent with the aging of our population. Further, these capabilities are broadly applicable in other microsurgical problems, and the system will enable further advances both for ophthalmology and for other microsurgical disciplines.

描述（由申请人提供）：该生物工程研究合作伙伴关系（BRP）将集中来自约翰霍普金斯大学和卡内基梅隆大学的高素质工程师、科学家和显微外科医生的努力，开发技术和系统，解决当前显微外科实践的基本局限性，以玻璃体视网膜手术为重点。玻璃体视网膜手术是技术要求最高的眼科学科，可解决需求不断增长的领域中普遍存在的威胁视力的情况。随着人口老龄化，威胁视力的疾病的患病率将继续上升。目前，视网膜手术是在手术显微镜下使用徒手器械进行的。局限性包括有限的视觉分辨率和生理性手部颤抖。外科医生还面临缺乏触觉反馈、接近感应和视网膜生理参数实时感应的问题。通过将术前图像与术中视图相结合，可以提高手术技术和效率。当前实践中外科医生的人体工程学较差会导致外科医生疲劳和潜在的残疾。所有这些因素都会导致手术时间延长、随之而来的光毒性以及高于所需的并发症发生率。我们计划的方法的核心是一个“手术工作站”系统，该系统连接到立体可视化子系统和一系列新型传感器、仪器和机器人设备。这些组件的功能分别解决了当前实践的重要局限性；它们共同提供了一个模块化、协同和可扩展的系统，使计算机接口技术和信息处理能够与外科医生合作，以改善临床护理并实现新颖的治疗方法。我们的具体目标是 1) 开发解决图像处理和信息融合、传感和操作方面基本限制的支持技术； 2）将这些组件集成到模块化可扩展系统中，显着增强外科医生执行显微外科任务的能力； 3) 评估我们的系统在与三个测试台应用相关的真实体模、尸体和动物模型上提高外科医生执行真实手术任务的能力。我们选择了三种常见的威胁视力的疾病的手术治疗，为我们的研究提供具体的重点：视网膜表面的病理学、内界膜的病理学和视网膜静脉阻塞。我们建议开发的具体功能既可以解决与这些手术相关的具体挑战，也适用于玻璃体视网膜手术所需的其他技术和疾病。它们的集成将验证我们的整体系统方法，并为眼科应用和其他显微外科学科（例如神经外科或微血管外科）的进一步发展提供基础。 公共健康相关性：该生物工程研究合作伙伴关系 (BRP) 解决了当前显微外科实践的基本局限性，重点关注玻璃体视网膜手术，这是技术要求最高的眼科学科。所开发的功能直接解决了与视力丧失的三种最常见原因的手术治疗相关的挑战，随着人口老龄化，这些原因变得越来越普遍。此外，这些功能广泛适用于其他显微外科问题，并且该系统将为眼科和其他显微外科学科带来进一步的进步。