一个基于PC的骨科手术模拟系统

为了更好地推广手术模拟系统，介绍了基于PC的骨科手术模拟系统的实现及应用.系统使医生能从特定患者的CT图像重构出三维表面模型，并使用了面向术式的手术模拟交互，改善了三维交互。通过手术模拟，医生在实际手术前可以选择合适的手术方案，从而降低手术风险。     

机器人技术在中医正骨手术中的应用研究

本文介绍了一套自行开发的机器人辅助正骨医疗手术平台系统．系统由计算机辅助 手术规划软件和正骨机器人两大部分组成，其中计算机辅助手术规划软件可以采集患者骨折 处的X光图像，机器人则在医生的控制下完成拉伸牵引、旋转、模拟手法复位等动作，使患 者骨折处闭合复位．本系统能够代替医生在X光辐射环境下进行正骨手术，避免射线对医生 身体的损伤，同时提高了手术效率、手术精度和安全性．系统已成功地应用于临床．     

外科医生模拟整容实验

英国的研究人员合作开发了一个网格应用程序,这个程序可以在手术前模拟出手术可能的结果,这样就能帮助医生更好地施行面部整容手术。另一个在德国进行的实验如果成功,那么未来医生做手术的方式就将彻底改变。这个计划由莱比锡大学医学院口腔颌面部的医生TomasHierl领导,他们不需要购买昂贵的服务器就可以运行复杂的医学模拟应用程序。NEC为他们提供了一台计算机和到远程的网格计算平台的安全连接,正是这个平台为他们提供了高性能的计算能力。该系统通过收集医生输入病人的扫描数据创建一个模型,然后在模型上模拟各种外科手术过程可能带来…     

面向术式的模拟手术交互

由于髋关节模拟手术按特定的术式进行,交互操作只能按照规定的顺序进行,这种交互的复杂性与使用何种交互设备无关。该文提出面向术式的模拟手术交互,使用了术式导航,帮助医生较快地完成模拟手术,容易获得满意的手术效果。     

基于MRI的开颅手术仿真系统设计

目前临床的医学可视化工具不能准确模拟开颅手术过程,也难以获得颅脑开窗后的仿真影像来评估手术方案对颅内组织的影响。为此,设计一种面向外科手术医生的开颅手术仿真系统。相对于传统医学可视化工具针对医学影像数据进行一次性建模的方式,该系统在三维数据重建前完成关键组织区域的提取和划分,以提升分割效果的区分度,同时采用松耦合结构方便后续功能扩展。系统基于病人术前的MRI数据,自动化地提取出关键组织区域并混合绘制为多解剖结构的手术模型。手术模型可模拟开窗区域规划、手术入路、虚拟切割等开颅手术过程,并对不同解剖结构的面绘制及体绘制模型分别应用切割隐函数,以生成开窗后大脑皮层及浅表静脉等关键区域影像。实现结果表明,该系统允许医生尝试不同的手术方案,能仿真关键问题并评估方案优劣,达到减少手术风险、熟练手术步骤、提高手术精确度的目的。     

髋关节模拟手术中有限元分析方法的应用

介绍了小儿髋关节计算机模拟手术中有限元分析方法的具体应用，有限元分析方法有助于医生在手术前确定最佳方案，从而降低手术风险。     

虚拟脊柱手术系统的设计

脊柱手术因其复杂性所以治疗困难.为了使医生可以方便地对患者的病患部位进行观察分析、制定手术方案并随时进行手术模拟,使用虚拟现实技术,利用CT断层图像DICOM格式的原始数字图像数据,提出了使用ITK,VTK等开发工具设计虚拟手术系统平台的思想.对原始数据进行预处理和图像分割获取三维重建的数据信息,进而快速地建立几何形态精准、解剖形态完整的高精度脊柱骨三维有限元模V,最终帮助医生在三维环境下进行多方位多角度观察分析和交互操作,确定及时、准确的诊断和手术方案.     

基于虚拟现实的计算机辅助立体定向神经外科手术系统

介绍了一个计算机辅助立体定向神经外科手术系统,该系统基于实时可视化绘制、机器人和虚拟现实技术,辅助医生完成立体定向神经外科手术,系统首先利用患者脑部的扫描数据重构并绘制出患者脑部的三维组织结构,为医生调整和确定手术规划提供参照。系统采用了标记点的校准方法,在手术前和手术中分别进行脑部模型和患者的坐标校准。通过机械臂的导航,使机械壁达到了手术规划规定的位置和姿态,医生利用安装在机械臂上的手术器械完成     

虚拟手术系统技术现状

虚拟手术是近年来在国际上发展迅速的一个领域。通过利用虚拟现实技术,医生们可以模拟在由患者的CT或MRI数据所构建的病灶处三维图像上进行手术操作,对于确定病灶位置,制定最佳手术方案和保证手术成功都具有十分重要的意义。该文分别对虚拟手术技术中的图像分割技术、人体器官三维重建技术以及软组织变形技术等几个主要方面研究做出了介绍,并分析了其技术需求及技术关键相关问题,为进一步进行虚拟手术系统的研究工作打下了一定基础。     

基于力反馈的脊柱外科机器人系统的设计与实现

本文针对脊柱椎管狭窄症减压手术中椎管壁磨削不安全这一问题，介绍一种基于力反馈控制策略的脊柱外科机器人系统，包括监控磨削过程的检测子系统、完成磨削手术操作的运动驱动子系统和再现磨削信息状况的控制显示子系统。利用脊柱磨削手术过程中磨削力的变化特点，提出基于力反馈的脊柱外科机器人控制策略，辅助医生实现安全的脊柱手术操作。最后通过仿真实验和模拟骨实验，验证了此基于力反馈控制策略的脊柱外科机器人系统的可行性。     

虚拟显微白内障手术系统人机交互接口设计

基于虚拟现实技术的显微白内障手术仿真训练系统对显微环境下眼科手术操作培 训具有重要的意义。为此,设计并搭建了一套具有高度沉浸感的虚拟显微白内障手术训练系统 的软硬件环境。硬件部分系统以 HTC Vive,Geomagic Touch X 为硬件基础,设计手术器械转换 接口以搭建高保真手术操作环境;软件部分采用基于位置动力学方法(position-based dynamics) 模拟手术过程中眼角膜软组织的变形、穿刺及缝合操作,并采用 GPU 并行计算对手术仿真过程 进行加速。最后,实验结果表明该系统可以实现自然的显微眼科手术人机交互环境,使年轻医 师获得高沉浸感的真实手术训练体验,从而达到一定的培训效果。     

下颌骨骨折虚拟手术培训系统研究

针对下颌骨骨折手术操作技能要求高的特点,使用Unity3D和HTC VIVE进行用于培训和术前模拟的虚拟手术系统的开发。将虚拟手术系统分为三维模型模块、光照系统模块、交互系统模块和手术室瞬间移动模块,对下颌骨骨折手术的场景、交互和手术过程进行模拟。结果表明此虚拟手术系统具有良好的真实感、沉浸感和交互性,能有效引导操作者完成手术流程,达成进行手术训练、模拟的目的。     

Visuohaptic Simulation of Bone Surgery for Training and Evaluation

Visual and haptic simulation of bone surgery can support and extend current surgical training techniques. The authors present a system for simulating surgeries involving bone manipulation, such as temporal bone surgery and mandibular surgery, and discuss the automatic computation of surgical performance metrics. Experimental results confirm the system's construct validity     

Teamwork enables remote surgical control and a new model for a surgical system emerges

Technology has revolutionised surgery in minimising anatomical invasiveness and increasing the range of surgical interventions available. However, modern remote and robot assisted surgery places unorthodox demands on surgeons and on all those involved in surgical operations in the operating theatre/room. This system of work is of vital importance to surgical success. However, research for developing surgical technique focuses mainly on the surgeon’s interface with the operative site, neglecting the operating room system supporting that technique. Furthermore, there is yet no agreement on the framework for regularly organising this vital system and for optimising its design for interprofessional work. By expanding on the conventional human–machine interface, we develop a model depicting the surgeon controlling surgical action through the media and technology of the operating room system. We show how the operating room team mediate the control of the surgical operation. By viewing control and communication in the operating room as a property of a distributed or joint cognitive system, we emphasise the potential for the team, their media and technology to either impair or enhance surgical performance.     

膝关节镜手术仿真训练系统设计

利用虚拟现实技术建立的手术仿真训练系统,可以大大减少内窥镜等疑难手术的培训时间并节约昂贵的动物实验费用.为满足膝关节镜手术训练的需要,针对虚拟手术仿真的技术特点,提出了关于虚拟现实技术的膝关节镜手术仿真训练系统的设计,主要对系统体系结构、软件结构、功能模块和系统界面的设计和技术实现进行了研究,最终实现了一个支持双手操作的手术仿真训练系统.实践证明,系统能逼真地模拟手术的流程,取得了良好的训练效果.     

Computer-based virtual reality simulator for phacoemulsification cataract surgery training

Recent research in virtual reality indicates that computer-based simulators are an effective technology to use for surgeons learning to improve their surgical skills in a controlled environment. This article presents the development of a virtual reality simulator for phacoemulsification cataract surgery training, which is the most common surgical technique currently being used to remove cataracts from the patient’s eyes. The procedure requires emulsifying the cloudy natural lens of the eye and restoring vision by implanting an artificial lens through a small incision. The four main procedures of cataract surgery, namely corneal incision, capsulorhexis, phacoemulsification, and intraocular lens implantation, are incorporated in the simulator for virtual surgical training by implementing several surgical techniques. The surgical activity that are applied on the anatomy of the human eye, such as incision, grasping, tearing, emulsification, rotation, and implantation, are simulated in the system by using different types of mesh modifications. A virtual reality surgical simulator is developed, and the main procedures of phacoemulsification cataract surgery are successfully simulated in the system. The simulation results of the training system show that the developed simulator is capable of generating a virtual surgical environment with faithful force feedback for medical residents and trainees to conduct their training lessons via the computer using a pair of force-feedback haptic devices. In addition, the successful simulation of the mesh modifications on the human eyeball with visual realism and faithful force feedback throughout the surgical operation shows that the developed simulator is able to serve as a virtual surgical platform for surgeons to train their surgical skills.     

Surgical tool motion during conventional freehand and robot-assisted microsurgery conducted using neuroArm

Surgical tool motion during microsurgery could arguably reflect surgical performance. This paper reports on how the motion of a surgical tool correlates or differs between conventional freehand surgery and robot-assisted surgery. In this pilot study, components of the position and orientation as well as the linear and angular velocities of a surgical tool, over the same period of operation, are compared during the two scenarios. For freehand surgery, a bipolar forceps is retrofitted with a tracking system to measure translational and rotational components of the tool motion. In robot-assisted surgery, the position and orientation components are obtained using kinematics of the neuroArm image-guided robotic system. A cross correlation analysis was used to investigate correlation between each pair of displacement or velocity components from freehand and robot-assisted scenarios to indicate how strongly or weakly two sets of data are linked together. The absolute maximum value of the cross correlation coefficient is calculated for each pair of components to quantitatively investigate the correlation between two sets of data. Results showed that the positional and rotational components, reflecting the surgical workspace, in both scenarios are correlated. However, for the cases studied, surgical tool rate of motion differs between the two scenarios. Results are important as they can be utilized to design robot-assisted neurosurgical systems that reflect characteristics of freehand surgery gained by surgeons through years of training, knowledge, and experience.     

Cadaver study for spinal fusion surgery using an image-guided surgical robot system

We present a novel surgical robotic system for spinal fusion that includes a computer-based planning algorithm, O-type bi-planar fluoroscopy, and a surgical robot. The planning system determines a surgical path based on fluoroscopy images or a 3D image reconstructed using pre-operative CT data. The robot guides the surgical path that the surgeon generates with the planning system. In this cadaver study, we tested the performance of the robotic system in the treatment of eight lumbar vertebrae by comparing CT images recorded before and after surgery.     

Collaborative surgical simulation over the Internet

Co-Surgeon is an Internet-based tele-simulation surgery system. The system combines 3D surgery simulation with CSCW technology to enable surgeons to collaboratively simulate alternative treatment plans over the Internet. It enables multiple users in remote locations to manipulate 3D anatomical models and to simulate surgical operations while sharing a view of the simulation. In addition, the system can store the simulated procedure so that offline users can later replay it and participate asynchronously. Co-Surgeon can also manage the procedures, facilitating the use of the simulation capability and widening the system's application in surgical education and reference. This article describes Co-Surgeon's design and implementation, and reports results from laboratory tests of a prototype system     

Surgical robotics: Reviewing the past,analysing the present,imagining the future

This paper presents an overview of the surgical robotics field, highlighting significant milestones and grouping the various propositions into cohorts. The review does not aim to be exhaustive but rather to highlight how surgical robotics is acting as an enabling technology for minimally invasive surgery. As such, there is a focus on robotic surgical solutions which are commercially available; research efforts which have not gained regulatory approval or entered clinical use are mostly omitted. The practice of robotic surgery is currently largely dominated by the da Vinci system of Intuitive Surgical (Sunnyvale, CA, USA) but other commercial players have now entered the market with surgical robotic products or are appearing in the horizon with medium and long term propositions. Surgical robotics is currently a vibrant research topic and new research directions may lead to the development of very different robotic surgical devices in the future—small, special purpose, lower cost, possibly disposable robots rather than the current large, versatile and capital expensive systems. As the trend towards minimally invasive surgery (MIS) increases, surgery becomes more technically demanding for surgeons and more challenging for medical device technologists and it is clear that surgical robotics has now an established foothold in medicine as an enabling technology of MIS.