北京生物醫(yī)學(xué)工程

腹腔鏡模擬手術(shù)三維糾偏系統(tǒng)的研究

Research on three-dimensional rectifying system based on the simulative laparoscopic operation

作者：劉云王殊軼于成龍徐明哲張燕群宋成利

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：腹腔鏡訓(xùn)練; 手術(shù)導(dǎo)航; 三維糾偏; 雙目視覺(jué)系統(tǒng); Micron Tracker

分類(lèi)號(hào)：R318；TH38

出版年·卷·期（頁(yè)碼）：2016·35·6（615-619）

摘要：

目的基于腹腔鏡模擬手術(shù)訓(xùn)練缺乏有效的訓(xùn)練系統(tǒng)的問(wèn)題，本文采用雙目視覺(jué)系統(tǒng)設(shè)計(jì)了一種腹腔鏡模擬手術(shù)三維糾偏系統(tǒng)，以達(dá)到將原設(shè)定切割路徑呈現(xiàn)在程序界面，同時(shí)實(shí)時(shí)顯示手術(shù)刀尖端切割路徑，并實(shí)現(xiàn)糾正切割路徑。方法在Visual Studio 2010軟件平臺(tái)上對(duì)Micron Tracker進(jìn)行二次開(kāi)發(fā)，調(diào)用Micron Tracker函數(shù)庫(kù)進(jìn)行Marker點(diǎn)的識(shí)別，采用拉格朗日擬合算法擬合出原定路徑，通過(guò)逐一調(diào)用器械尖端坐標(biāo)畫(huà)出器械尖端走過(guò)的軌跡。結(jié)果使用糾偏系統(tǒng)的A組志愿者和不使用糾偏系統(tǒng)的B組志愿者之間的偏移量比較得出：A組的25次實(shí)驗(yàn)整體X軸和Y軸正負(fù)平均偏移量均小于B組的偏移量；A、B兩組第1次和第5次實(shí)驗(yàn)相比，正負(fù)平均偏移量均顯著減少(P<0.05)，且隨著受試者操作次數(shù)的增加偏移量呈減小的趨勢(shì)；對(duì)A、B兩組的正負(fù)偏移量進(jìn)行方差分析，可得因素（糾偏系統(tǒng)）對(duì)實(shí)驗(yàn)指標(biāo)（偏移量）有顯著影響（F>F-crit）。結(jié)論本研究設(shè)計(jì)的糾偏系統(tǒng)能有效減少培訓(xùn)者在培訓(xùn)過(guò)程中的偏移量及培訓(xùn)時(shí)間，提高培訓(xùn)效率。

Objective The current situation is lacking of effective simulative laparoscopic operation training system. This paper mainly presents three-dimensional rectifying system based on Micron Tracker. The three-dimensional rectifying system can real-time display the cutting paths and knife tip trajectory on interface, and rectify the cutting paths. Methods We redevelop Micron Tracker based on Visual Studio 2010. Micron Tracker can identify Marker and get 3D coordinates of knife tip. The system fits the cutting path by Lagrange method and real-time displays knife tip trajectory by calling 3D coordinates of knife tip separately. Results The volunteers are divided into two groups. Group A with the training system and Group B without the training system are compared. Plus-minus average offset of Group A is less than that of Group B in 25 times experiments. In the first and fifth experiment, plus-minus average offset of the two groups are all decreased. With the increase of experimental frequency, offset shows a trend of decrease. The variance analysis of the two groups’ offset shows that the offset is influenced by the rectifying system (F>F-crit). Conclusions The rectifying system can decrease the offset, save time and improve operation efficiency.

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