機(jī)械設(shè)計(jì)制造及自動(dòng)化專(zhuān)業(yè)外文翻譯--外科手術(shù)機(jī)器人的現(xiàn)狀臨床應(yīng)用和技術(shù)挑戰(zhàn)(文件)
【正文】 dors in several areas have been selected to give the reader an overview of the field. The column labeled “Studies” refers to whether human trials, animal studies, cadaver studies, or other studies have been done. Neurosurgery As mentioned in the historical review, neurosurgery was the first clinical application of robotics and continues to be a topic of current interest. Neurosurgical stereotactic applications require spatial accuracy and precision targeting to reach the anatomy of interest while minimizing collateral damage. This section presents three neurosurgical robotic systems. 1. Minerva from the University of Lausanne in Switzerland 2. NeuroMate from Integrated Surgical Systems in the . 3. An MRI patible robot developed by Dohi and colleagues in Japan Minerva One of the earliest robotic systems developed for precise needle placement was the neurosurgical robot Minerva [13], designed for stereotactic brain biopsy. A special purpose robot was constructed which was designed to work within the CT scanner so that the surgeon could follow the position of the instruments on successive CT scans. NeuroMate The NeuroMate is a sixaxis robot for neurosurgical applications that evolved from work done by Benabid, Lavallee, and colleagues at Grenoble University Hospital in France [9, 14, 25]. The original system was subsequently redesigned to fulfill specific stereotactic requirements and particular attention was paid to safety issues [26]. MRI patible robot ceramics. In phantom tests using watermelons, the robot performed satisfactorily with a positioning error of less than mm from the desired target. The unit was small enough at 491 mm in maximum height to fit inside the MRI gantry of 600 mm in diameter. Orthopedic Orthopedics was also an early adopter of robotics, as the ROBODOC system described next was used to assist surgeons in performing part of a total hip replacement in 1992. Urology One of the pioneering research groups in Medical Robotics is the Mechantronics in Medicine Laboratory at Imperial College in London. Starting in 1988, the group began developing a robotic system named the Probot to aid in transurethral resection of the prostate [18]. Technology Challenges / Research Areas While a number of different clinical areas are being explored as noted in Section 3, the field of medical robotics is still in its infancy and we are just at the beginning of this era. Only a handful of mercial panies exist and the number of medical robots sold each year is very small. Part of the reason for this is that the medical environment is a very plex one and the introduction of new technology is difficult. In addition, the pletion of a medical robotics project requires a partnership between engineers and clinicians which is not easy to establish. Technology challenges and research areas for medical robotics include both the development of system ponents and the development of systems as a whole. In terms of system ponents, research is needed in: 1. system architecture 2. software design 3. mechanical design 4. imaging patible designs 5. user interface 6. safety For medical robotics systems, the development of application testbeds is critical to move the field forward. These testbeds can also serve to improve the dialog between engineers and clinicians. However, at least in the ., it is difficult to get funding to develop these testbeds. Governmental funding agencies such as NIH or NSF will usually not fund such efforts as they are geared more towards basic research rather than applied research and development. Manufacturers are usually not interested because the environment and investment payback for medical robotics is uncertain. The regulatory issues for medical robotics have not been fully explored, although several systems have been FDA approved. These factors remain obstacles to advancing the field. In the following sections, each of the six system ponents listed above are briefly discussed. System Architecture For medical robotics to evolve as its own field and for the cost and difficulty of developing prototype systems to decrease, the establishment of a system architecture would be an enabling step. The systems architecture should emphasize modularity, as noted by Taylor in the design of the SteadyHand robot, which emphasizes modularity in mechanical design, control system electronics, and software [22]. A modular approach has also been emphasized in the Urology Robotics laboratory of Stoianovici [37], where a number of mechanical modules have been developed for precision interventional procedures. Software Design The development of a software environment for medical robotics, possibly including an appropriate real time operating system, is a significant challenge. Many researchers developing medical robotics system base their software development on mercially available software packages that may not be suitable for the surgical environment. However, the low cost and widespread availability of these software packages makes their use attractive and there are steps that can be taken (such as watchdog timers, backup systems, and error recovery procedures)
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