基于增强现实的精确截骨手术导航系统

An augmented reality tool allows for visual tracking of real anatomic structures in superposition with volume-rendered computed tomographic or magnetic resonance imaging scans and thus can be used for navigated translocation of important structures during operation. The AR system provides synthetic information, primarily visual, but it is experienced within the context of the real world, as an enhancement of the senses. Another advantage of augmented reality is to project information for the navigation directly into the surgical site. Based on these advantages, AR has become possible to transfer surgical planning to the surgical site with the aid of AR systems and has increasingly proved valuable in various surgical fields. However, the key element to all surgical navigation, including AR, is the correct registration of the image data set to the patient. Precise registration is crucial because it has direct repercussion onto the precision of all subsequent navigation tasks. Based on the precious experiment performed on mandible models, we combined the occlusal splint registration with visual tracking technology to establish a system of augmented reality which can be easily applied in plastic surgery. Then the target registration error that demonstrates accuracy of it will be test before clinical deployment. AR has great potential in future robotic surgery in which the three-dimensional images can be combined with the operative field of vision and the information of the preoperative plan can be preprogrammed using the AR images.And robotic arm can reassure the accuracy and steady of the system.So augmented reality tools like AR Toolkit may be helpful for osteotomy.

本项目结合术中实时成像的增强现实技术和具有力反馈装置的机械手臂，建立一种能够指导颅颌面精确截骨的手术导航系统。增强现实通过透视式头盔可将三维虚拟影像准确叠加并显示到真实场景中，使术前设计的各种信息实时展现在实际手术视野里，实时的指导截骨的定位和方向。但增强图像的显示需要经过配准、定位等步骤完成，而结合颅面手术的特殊性，目前现有的增强现实系统缺乏理想的配准定位方法。因此寻找一种合适的配准方法是其成功运用于颅面手术的关键。加上具有力反馈装置的机械手臂，固定截骨的方向角度，同时放大截骨时的拓空感。本课题建立适用于颅面手术的增强现实系统，结合机械手臂的应用，能够提高颅面截骨手术的精确度和安全性，有望降低颅面截骨手术的难度和危险性。

本项目结合术中实时成像的增强现实技术和具有力反馈装置的机械手臂，建立一种能够指导颅颌面精确截骨的手术导航系统。增强现实通过透视式头盔可将三维虚拟影像准确叠加并显示到真实场景中，使术前设计的各种信息实时展现在实际手术视野里，实时的指导截骨的定位和方向。但增强图像的显示需要经过配准、定位等步骤完成，而结合颅面手术的特殊性，目前现有的增强现实系统缺乏理想的配准定位方法。因此寻找一种合适的配准方法是其成功运用于颅面手术的关键。加上具有力反馈装置的机械手臂，固定截骨的方向角度，同时放大截骨时的拓空感。本课题建立适用于颅面手术的增强现实系统，结合机械手臂的应用，能够提高颅面截骨手术的精确度和安全性，有望降低颅面截骨手术的难度和危险性。.在本次项目的研究中，分别进行了增强现实导航系统的建立和具有力反馈装置的机械手臂的研发，并将二者进行了集成，分别在模型外科和动物外科中进行了验证试验。在模型外科实验中，机械臂组和非机械臂组切除的位置（0.95±0.15mm vs 1.64±0.57mm）和角度（5.34±2.48°vs 10.46±3.46°）有统计学意义（P＜0.01）。在动物实验研究中，增强现实组的位置误差为1.07±0.27mm，角度误差为5.59±3.15°，而传统手术组的位置误差为1.49±0.13mm，角度误差为9.41±2.13°，二者有统计学差异，误差的测定证实了该增强现实系统的精度达到了手术应用的要求，且优于传统手术方法。.本项目拟将增强现实技术与手术机器人技术相结合，研究增强现实虚实融合技术，研发带力反馈的颅颌面整形机器人，开发基于增强现实的颅颌面整形手术辅助机器人系统。实现了增强现实下颌骨快速成型模型的虚实影像配准，完成了该系统的模型设计与力反馈控制和临床试验。以期缩短手术学习周期，减小医务人员手术的操作难度，提高手术成功率并降低手术并发症。填补了国内基于增强现实的颅颌面整形机器人辅助手术的空白。