术中在线定位高精度自动化腕骨骨折手术机器人关键技术研究

The function of the wrist is very essential to our daily life, but unfortunately the incidence of the wrist fractures was quite high in China, which leads to a rather large amount of the patients in clinical practice. Therefore, the demand for robotic system in orthopedic surgery is recently increasing dramatically. Although robot system for orthopedic surgery has made considerable progress in the last decade, the surgical robots research has not got any breakthrough for wrist fracture surgery, which requires the highest accuracy in the orthopedic surgery field. This project is focused on the surgical robot system specifically for wrist fractures, targeting a system with these characteristics: lean, agile, safe, high stability. Our system will fulfill online surgery study, high-precision positioning, robotic arm's optimal path planning and decision-making capacity. Through studying the surgical procedures and rules of the wrist fractures' surgery, based on three-dimensional images, position and force distribution data acquired from wrist positioning groove, and position and torque data from multi-DOF manipulator and end-actuator, we will design the real-time close-loop feedback control system and multi-modality information fusion system specifically for wrist fractures. We will provide a theoretical basis and practical guidance for the wrist factures' surgery on patients with efficient, reliable, and automated operation. Through this project, we will build a surgical robot suitable for wrist surgery, and verify several theory and approaches, including: new high-precision positioning technology, robot arm and its end-actuator's control. We will further propose new ideas, theory and key technologies for the orthopedic surgical robotics, and expect a significant reduction in work intensity and improvement in the operation efficiency for the surgeons.

腕关节和日常活动息息相关，而腕骨骨折在我国有发病率高且人数多的特点，人们对骨科手术机器人的需求日益增多。骨科手术机器人在近年来虽取得了长足的进步，然而没有在业内公认的精度要求最高的腕骨骨折手术的相关领域有质的突破。本项目以专门针对腕骨骨折的手术机器人为研究对象，以系统结构精简、敏捷、安全、稳定性高为目标，研究具有术中在线高精度定位、最佳路径规划和决策能力的机器人，并通过研究腕骨手术的流程和规律，基于三维影像、腕骨定位槽感知的位置和力分布数据、多自由度机械臂和末端执行器的位置和力矩，设计针对腕骨的多模式信息融合以及实时全闭环控制系统，为腕骨骨折患者的高效、可靠、自动化手术提供理论依据和实践指导。通过本项目，构建出适用于腕骨手术的手术机器人，验证新型高精度定位技术、机械臂及其执行器的控制理论和方法，为骨科手术机器人研究提供新的理念和关键技术，期望大幅度降低医护人员的工作强度和提高手术的效率。

腕关节生理功能重要，与人们日常活动息息相关。在我国，腕骨骨折具有发病率高且人数多等特点，人们对骨科手术机器人的需求日益增多。近年来，虽然骨科手术机器人技术取得长足的进步，然而由于腕骨生理特点复杂，尚未在业内公认的精度要求最高的腕骨骨折手术的相关领域实现技术突破。本项目以针对腕骨骨折的手术机器人作为研究对象，以系统结构精简、敏捷、安全、稳定性高为目标，研究具有术中在线高精度定位、最佳手术路径规划能力的手术机器人。本项目设计并搭建了多自由度手术机械臂以及无创手臂定位托架；针对腕骨骨折手术的特点，设计出具有力反馈的末端手术执行机构，实现自动化的手术穿刺操作；开发了基于医学三维影像的手术导航系统，完成患者腕部三维模型重构、精准手术导航等功能。此外，通过对腕骨骨折手术流程和规律的研究，利用医学三维影像、手术定位槽、多自由度机械臂和末端手术执行机构的位置与力传感信息，设计出针对腕骨手术的多模式信息融合控制策略及实时在线全闭环控制系统，从而实现了精准、高效、可靠的自动化腕骨骨折手术。项目组利用腕骨骨折手术机器人完成了若干模型试验以及10例尸体标本试验，通过试验发现使用腕骨骨折手术机器人可提高手术精度、降低术中辐射量和术中穿刺次数、减少手术持续时间。通过本项目的研究，验证了新型高精度定位技术、机械臂及其执行器的控制理论和方法，为骨科手术机器人研究提供了新的理念和关键技术，可以预见本系统可大幅度降低医护人员的工作强度，并提高手术的效率。