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______________________腹腔鏡手術(shù)器械運(yùn)動空間測量與計算方法__________________

Measurement and calculation method for motion space of laparoscopic instrument

作者:                             呂坤勇  宋成利  張燕群  葉莎莎  王殊軼                  
單位:                      上海理工大學(xué)醫(yī)療器械與食品學(xué)院(上海200093)        
關(guān)鍵詞:                     腹腔鏡手術(shù);手術(shù)器械;運(yùn)動空間;雙目視覺          
分類號:                      R318;R615        
出版年·卷·期(頁碼):2016·35·2(124-129)
摘要:

目的 腹腔鏡手術(shù)器械的運(yùn)動分析是器械設(shè)計的重要指標(biāo),手術(shù)器械通過切口進(jìn)入腹腔能到達(dá)的空間很大,然而器械實(shí)際操作中的運(yùn)動幅度是有限的。本文測量模擬腹腔鏡手術(shù)時器械的插入深度、偏轉(zhuǎn)角度等參數(shù),獲得器械的實(shí)際運(yùn)動空間。方法 在腹腔鏡手術(shù)訓(xùn)練系統(tǒng)上設(shè)置轉(zhuǎn)移任務(wù)和縫合任務(wù)。采用雙目視覺系統(tǒng)Micron Tracker捕捉每把器械上的標(biāo)記點(diǎn),獲得標(biāo)記點(diǎn)坐標(biāo)以及相應(yīng)的器械尖端坐標(biāo)。通過數(shù)據(jù)處理,建立以操作平臺為基準(zhǔn)的坐標(biāo)系,計算出器械的插入深度、偏轉(zhuǎn)角度,最后獲得器械運(yùn)動空間的數(shù)學(xué)表達(dá)式。結(jié)果 轉(zhuǎn)移任務(wù)中左右器械運(yùn)動空間基本對稱,器械的插入深度約為154~240mm,上下擺動的角度約為29°,左右擺動的角度約為30°。縫合任務(wù)中左右器械運(yùn)動空間差距較大,右器械的擺動角度(上下45°,左右52.2°)明顯比左器械大(上下27.7°,左右34.7°)。縫合任務(wù)中器械的運(yùn)動空間比轉(zhuǎn)移任務(wù)大。結(jié)論 腹腔鏡手術(shù)中器械的實(shí)際運(yùn)動空間比器械所能到達(dá)的空間小。器械的實(shí)際運(yùn)動空間受操作任務(wù)、插入點(diǎn)位置、左-右手等因素影響。本研究可用于傳統(tǒng)腹腔鏡手術(shù)的器械運(yùn)動分析,也可為不同切口下器械的運(yùn)動空間分析提供參考,并為新手術(shù)入路下的器械設(shè)計提供思路。

Objective Motion analysis of laparoscopic instrument is crucial for instrument design. The space that surgical instrument can reach after entering the abdomen via a small incision is large, however, motion space of the instrument during operation is limited. In this paper, range of motion of the instrument was measured, including inserted length and pivoting angle. Methods Two tasks, transferring and suturing, were set up based on laparoscopic surgery training system. A binocular vision system, Micron Tracker, was used to obtain the position of the marker on the instrument and instrument tip during task operation. A new coordinate system was established based on the operation platform. The inserted length and pivoting angle of the instruments were calculated afterwards. Finally, a general formula of instrument motion space was obtained. Results In transferring task, motion space of left and right instruments were almost symmetrical. The inserted length was approximately 154 to 240mm. Up/down pivoting angle was approximately 29 deg. Left/right pivoting angle was approximately 30 deg. In suturing task, there was a big difference of motion space between left and right instruments. Up/down (45 deg) and left/right (52.2 deg) pivoting angles of right instrument were much bigger than those of left instrument (up/down 27.7 deg, left/right 34.7 deg). In addition, instrument motion space in suturing task was larger than that in transferring task. Conclusions Actual motion space of the instrument during operation is smaller than theoretical value. Operation tasks, location of the insert point, and left-right hand are important factors to determine actual motion space. The study can be used not only for motion analysis of instrument for traditional laparoscopic surgery, but also for motion analysis and instrument design via different surgical incisions.

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