DeCou James M, Timberlake Tyler, Dooley R Larry, Gauderer Michael W L
Department of Pediatric Surgery, The Children's Hospital of Greenville Hospital System, Greenville, South Carolina, USA.
Pediatr Surg Int. 2002 Jan;18(1):72-4. doi: 10.1007/s003830200019.
As a test of the applicability of modern bioengineering tools to pediatric surgery, we developed by computer-aided design (CAD) methods and evaluated a virtual reality (VR) model of laparoscopic pyloromyotomy (LP) and created a set of retractable hook instruments, called Pylorohooks. Our VR model of LP incorporated the infant's body wall, stomach, and hypertrophied pylorus as well as laparoscopic cannulas and two Pylorohooks. CAD software was used to design the 3-mm-diameter, retractable, double-pronged, minimally-traumatic hook instrument. A rapid prototype processor was employed to create a plastic model of the instrument. Surgical-grade stainless-steel prototypes were then manufactured and used in actual LPs. A working VR model was achieved. Following an initial correction in the angulation of the hooks, the instruments were successfully employed in nine consecutive LPs in infants weighing from 3.4 to 5.7 kg. VR and CAD thus proved instrumental in the development of a new LP approach. Because of increasing pressure to limit human and animal experimentation, computer-based bioengineering methods offer promising alternatives that are clearly applicable to pediatric surgery.
作为对现代生物工程工具在小儿外科手术中适用性的一项测试，我们通过计算机辅助设计（CAD）方法开发并评估了腹腔镜幽门肌切开术（LP）的虚拟现实（VR）模型，并创建了一套名为幽门钩的可伸缩钩状器械。我们的LP虚拟现实模型纳入了婴儿的体壁、胃和肥厚的幽门，以及腹腔镜套管和两个幽门钩。利用CAD软件设计了直径3毫米、可伸缩、双叉、微创的钩状器械。采用快速原型处理器制作了该器械的塑料模型。然后制造了手术级不锈钢原型并用于实际的LP手术中。实现了一个可用的VR模型。在对钩的角度进行初步校正后，这些器械成功应用于9例体重在3.4至5.7千克的婴儿连续进行的LP手术中。因此，VR和CAD在开发一种新的LP手术方法中发挥了重要作用。由于限制人体和动物实验的压力不断增加，基于计算机的生物工程方法提供了有前景的替代方案，显然适用于小儿外科手术。
