摘要
目的验证国产手术机器人妙手S系统远程手术的安全性和稳定性。方法将国产手术机器人妙手S系统的主从手分开,主手放置在天津大学机械工程学院机器人实验室,从手放置在北京第二炮兵总医院(现火箭军总医院)机器人外科实验室。在天津操作手术机器人主手,通过因特网远程控制北京的机器人臂(从手)进行远程猪胆囊切除、胃穿孔修补、肝脏楔形切除术。检测机器人远程进行切除、缝合、打结、止血等操作的安全性和稳定性。天津至北京距离118 km。结果本次动物(猪)实验完成远程胆囊切除、胃穿孔修补、肝脏楔形切除术,为国内首次动物腹部外科远程手术成功案例。胆囊切除手术时间为50 min,出血5 nl;胃穿孔修补手术时间为20 min,出血0 ml;肝脏楔形切除手术为30 min,出血15 ml。顺行法切除胆囊,先解剖胆囊三角,显露出胆囊管、胆囊动脉和胆总管,离断胆囊管后,顺行剥离胆囊浆膜,注意避免损伤肝脏及右肝管、右肝动脉。胃穿孔修补采用2-0慕丝线行全层间断缝合术,共缝合3针。肝脏楔形切除肝叶边缘大小约2 cm×1cm肝组织。术中无周围脏器损伤等并发症。手术过程有延时效应,延时平均小于250 ms,机器人手术系统无明显抖动等不良状况,实验顺利完成。结论国产手术机器人妙手S系统具有良好的安全性和稳定性,可顺利完成腹部外科远程手术。
Objective To verify the safety, stability and validity of the self-developed Micro- Hand S robotic surgical system in telesurgery. Methods The master-slave MicroHand S system has been deconstructed into a master console and several assisted robotic arms and further set in different venues. The master console has been settled in the robot laboratory of School of Mechanical Engineering of Tianjin University, and the assisted manipulation arms have been placed in the visual surgery lab of General Hospital of PLA Second Artillery （now renamed Rocket Forces General Hospital） in Beijing. Through the internet, several telesurgeries have been successfully performed like cholecystectomy, suture of gastric perforation and hepatic wedge resection by remote control in Tianjin and assistant manipulation in Beijing. The distance between Tianjin and Beijing is 118 km. Results The implementation of animal （porcine） experiments in the remote cholecystectomy, suture of gastric perforation and hepatic wedge resection has been considered as the first success of abdominal telesurgery in China. Operation time for cholecystectomy, suture for gastric perforation and liver wedge resection was 50 min, 20 min and 30 min respectively, with estimated blood loss of 5,0 and 15 mL respectively. After dissecting the Calot triangle,the cholecystic duct, cholecystic artery and common bile duct were confirmed. The cholecystic duct was cut and the cholecyst was removed from the liver carefully, avoiding injury of liver,right hepatic bile duct and right hepatic artery. The 2-0 mersilk was used for suture of gastric perforation, with three whole layer interrupted sutures. Liver wedge resection was performed from the edge of liver,2 cm 1 cm hepatic tissue acquired. No injury of peripheral organs occurred during the operation. There were time delays in the operation process and the delays were less than 250 ms averagely. All the telesurgeries have been conducted smoothly with no obvious robotic jitters and other sys temic errors. Conclusions Th
出处
《腹部外科》
2016年第6期473-477,共5页
Journal of Abdominal Surgery
基金
国家国际科技合作专项项目(2014DFA70710)
国家自然科学基金资助项目(51405339)
关键词
机器人
远程手术
远程医学
胆囊切除术
微创外科
猪
Robotics
Telesurgery
Telemedicine
Cholecystectomy
Minimally invasive surgery
Poricine
