【正文】 微創(chuàng)外科手術，是得人操作機器人手臂進行手術且簡單自如。配備重定位系統(tǒng)的 6 自由度機械手在手術中的精度可達到高于 2 微米，這個系統(tǒng)通過末端執(zhí)行器的反饋信息而進行力和力矩的調節(jié)，而外科醫(yī)生通過綜合操縱臺對手術的各個操作進行監(jiān)控。據報道：機器人位置控制系統(tǒng)通過對由呼吸運動而使腦部腫瘤位置的隨機變化進行分析，然后給予補償，這樣提高了 CYBERKNIFE 在手術過程中精確度和相對安全程度。所以這里我們要記住一點就是：病人所要的是得到最好的醫(yī)療方法，而不是僅僅是可能是最好的方法這種不確定的說法。 即使這種技術能成功的應用與外科領域，機器人輔助系統(tǒng)也將不會完全取代和制約外科醫(yī)生；它們使得外科手術有了重大的改觀，機器人系統(tǒng)使得各種有效的輔助設備得到綜合的應用，使得在手術環(huán)境中各種儀器和諧統(tǒng)一的配合對病人實施手術操作，這一切對于病人的手術后效果都是大大有 利的。s routine, however, must be done accurately, reproducibly, and cost effectively. Numerous aspects of the neurosurgeon39。m peak to peak at the handheld instrument tip. Robots developed for instrument positioning 。s hand and finger movements are scaled down kinematically in terms of displacement, velocity, and acceleration or force. Force Control Force control is critical when performing tasks such as brain retraction. Continuous contact must be maintained without damaging the retracted tissue. 31,.61 Robotic retraction may present a superior alternative to human retraction by minimizing the forces exerted on tissues. Force control is even more important when it es to handling a delicate and fragile object: promise has to be made between a firm grip to prevent fall of the object and softness to prevent from crushing it, as for a light plastic glass filled with water. RobotAssisted Surgical Applications Robots are currently being employed in a wide ar ray of surgical subspecialties. Included are laparoscopy, orthopedics, craniofacial and maxillofacial surgery, microsurgery, radiosurgery, cardiaothoracic surgery, and neurosurgery. Laparoscopy LARS is a robotic system designed to assist surgeons in laparoscopic procedures with tasks such as camera holding and enhanced precision control of Other systems are also available in which surgical vision is robotically Laparoscopic procedures in which robot assistance has been reported include cholecystectomies, hernia repairs, gastric procedures, and A miniature robot capable of propelling itself in a semiautonomous fashion along the lumen of the colon is described for use in colonoscopies. The robot is able to both visualize the colon and perform tissue In prostate cancer, the use of robotics in laparoscopic radical prostatectomies has been reported .42 Laparoscopic radical prostatectomy is among the latest technical innovations in prostate cancer surgery. A voicecontrolled surgical robot from Computer Motion, the AESOP,is capable of holding the laparoscope with 7 df. Exchanging a human assistant with a robot permits a less crowded operative environment and provides a clear view of the operative field. To date, more than 500 laparoscopic radical prostatectomies have been successfully pleted using AESOP. Orthopedics Several robots have been designed for use in orthopedic surgery. These include the ROBOTRACK,52 CRIGOS,12 and ROBODOC enables the surgeon to plan the procedure preoperatively using puterbased imaging. Intraoperatively, the robotic arm, wielding a highspeed drill, creates a canal within the femur in which the implant is placed. Existing robotassisted orthopedic applications include knee arthroplasty,25,53,60 total hip arthroplasty,6 revision of total hip arthroplasties,6,76 repair of hip fractures,13 and pedicle screw insertion during spine procedures) The use of robots in orthopedics is very well established. ROBODOC has been used in over 900 cases,6 and ROBOTRACK has been used in over 200 Microsurgery Robots hold enormous potential for improving the field of microsurgery. The robot39。 they will help them to achieve their transmutation toward a higher being capable of harmoniously melting the human body holistic approach and the robotic synthesizing and bine enormous capacities, all for the good of the patien. 。m. The system scales movements and senses forces applied to the instruments. The surgeon controls the robot from an integrated Other models are also available that reportedly offer steadyhand control during various microsurgical procedures. Radiosurgery The CYBERKNIFE robotic system2 allows a linear accelerator to be arbitrarily positioned in a 6 df orientation. Imageguided robotic radiosurgery utilizing a Fanuc manipulator has also been Robotic motion pensation for respiratory movement of extracranial tumor targets is reported in the Cyberknife2 to offer significant improvements in the associated safety Conclusion Globalization, as mondialization, has advantages and drawbacks. This applies to various fields, including health care and, more precisely, surgery. The financial constraints are putting pressure on the management of health problems t