A Microsurgical Assistant System

显微手术辅助系统

• 批准号: 7656592
• 负责人: RUSSELL H TAYLOR
• 金额: $ 117.08万
• 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/7656592
• 关键词: Address; Aging; Animal Model; Area; Auditory; Beds; Biomedical Engineering; Blindness; Cadaver; Cannulations; Cicatrix; Clinical; Complication; Computer Assisted; Computer Interface; Coupling; Data; Development; Diabetic Retinopathy; Discipline; Disease; Engineering; Epidemic; Epiretinal Membrane; Excision; Eye; Family; Fatigue; Feedback; Fiber; Fiber Optics; Goals; Hand; Human; Image; Imagery; Individual; Lead; Lifting; Light; Macular Hole; Maps; Marriage; Measures; Membrane; Methods; Microscope; Microscopy; Microsurgery; Motion; Motor; Movement; Obesity; Operative Surgical Procedures; Ophthalmology; Pathology; Patients; Performance; Phase; Physiological; Population; Positioning Attribute; Prevalence; Procedures; Qualifying; 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; clinical care; clinical practice; design; disability; ergonomics; image processing; improved; information processing; instrument; instrumentation; intraoperative imaging; macula; neurosurgery; new technology; novel; novel therapeutic intervention; optical fiber; public health relevance; 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）：这种生物工程研究合作伙伴关系（BRP）将重点关注约翰·霍普金斯大学和卡内基 - 梅隆大学的高素质工程师，科学家和微观外表的努力，以开发技术和系统，以解决当前的微疗法实践中的基本限制，以我们的重点为我们的小型手术实践。玻璃体视网膜手术是技术上最苛刻的眼科学科，可以解决需求不断增长的领域中普遍威胁视力的条件。随着我们人口的衰老，威胁视力的流行将继续升级。目前，视网膜手术是在具有自由手仪器的操作显微镜下进行的。局限性包括有限的视觉分辨率和生理手震颤。外科医生还因为缺乏触觉反馈，接近感和视网膜生理参数的实时感知而挣扎。通过将术前图像与术中视图整合在一起，可以提高手术技术和效率。外科医生在当前实践中的人体工程学差会导致外科医生疲劳和潜在的残疾。所有这些因素都导致工作时间延长，随之而来的轻毒性和比需要的并发症率更高。我们计划中的方法的中心是与立体视觉子系统和新型传感器，仪器和机器人设备的家族相连的“外科工作站”系统。这些组件的能力分别解决了当前实践的重要局限性；它们共同提供了模块化，协同和可扩展的系统，使计算机间隔的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。我们的具体目的是1）开发能够解决图像处理和信息融合，感应和操纵的基本限制的技术； 2）将这些组件集成到模块化扩展系统中，以显着增强外科医生执行显微外科任务的能力； 3）评估我们的系统能够改善对现实幻影，尸体和与三个测试床应用相关的现实幻影，尸体和动物模型的外科医生性能的能力。我们选择了三种常见危险条件的手术治疗，以为我们的研究提供特定的重点：视网膜表面的病理学，内部限制膜的病理和视网膜静脉闭塞。我们建议开发两者的特定功能解决与这些程序相关的具体挑战，并且适用于玻璃体视网膜手术所需的其他技术和疾病。他们的整合将验证我们的整体系统方法，并为眼科应用和其他微外科学科（如神经外科手术或微血管手术）提供进一步发展的基础。 公共卫生相关性：这种生物工程研究伙伴关系（BRP）涉及当前微型外科实践中的基本局限性，重点是玻璃体视网膜手术，这是技术上最苛刻的眼科学科。这些能力直接解决了与三种最常见的视力丧失原因相关的挑战，随着我们人群的衰老，它们变得越来越普遍。此外，这些功能广泛适用于其他微型外科问题，该系统将在眼科和其他微外科学科中进一步进步。