Kuniholm J F, Buckner G D, Nifong W, Orrico M
Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA.
J Biomech Eng. 2005 Nov;127(6):1001-8. doi: 10.1115/1.2055307.
Cardiovascular disease (CVD) is perhaps the most significant worldwide health issue. While open-heart surgery remains the predominant treatment, significant advancements have been made in minimally invasive surgery (MIS) and minimally invasive robot-assisted (MIRA) surgery. MIRA techniques offer many advantages over open-heart procedures and have extended the capabilities of MIS. However, these benefits come at the cost of increased operating times due to time spent tying knots. The additional bypass time limits patient access and is the most significant barrier to the adoption of MIRA techniques. This research seeks to overcome this barrier by designing a device for MIRA cardiac procedures that automates the knotting of sutures. If this task can be automated while ensuring the delivery of high-quality knots, great progress can be made in transforming the field. MIRA cardiac procedures can move from novel procedures performed by a select group of surgeons on a limited pool of patients to a viable alternative available to the majority of patients with CVD. In this research we propose a design for a self-contained device that delivers a locking knot. Results suggest that consistent knots can be delivered at a time savings of 12.5% and 26.4% over manual knots for trained and untrained users of a surgical robot, respectively.
心血管疾病（CVD）或许是全球最重要的健康问题。虽然心脏直视手术仍然是主要的治疗方式，但微创手术（MIS）和微创机器人辅助（MIRA）手术已取得了重大进展。与心脏直视手术相比，MIRA技术具有诸多优势，并扩展了MIS的能力。然而，由于打结耗时，这些优势是以增加手术时间为代价的。额外的搭桥时间限制了患者的可及性，并且是采用MIRA技术的最大障碍。本研究旨在通过设计一种用于MIRA心脏手术的设备来克服这一障碍，该设备可自动完成缝线打结。如果能在确保打出高质量结的同时实现这一任务的自动化，那么在变革该领域方面就能取得巨大进展。MIRA心脏手术可以从由少数外科医生为有限数量的患者实施的新型手术，转变为大多数CVD患者都可采用的可行替代方案。在本研究中，我们提出了一种用于实现自锁结的独立设备的设计方案。结果表明，对于手术机器人的经过培训和未经培训的用户，分别比手动打结节省12.5%和26.4%的时间，且能打出一致的结。
