Liao Hongen, Suzuki Hirokazu, Matsumiya Kiyoshi, Masamune Ken, Dohi Takeyoshi, Chiba Toshio
Graduate School of Engineering, the University of Tokyo, Japan.
Med Image Comput Comput Assist Interv. 2006;9(Pt 1):412-9. doi: 10.1007/11866565_51.
A novel manipulator is described for stabilizing fetus and preventing it from free-floating during the endoscopic intrauterine surgery. Minimally invasive endoscopic fetal surgery enables intrauterine intervention with reduced risk to the mother and fetus. We designed and fabricated a prototype of a fetus supporting manipulator equipped with a flexible bending/curving mechanisms and a soft balloon-based stabilizer. The flexible bending and curving mechanisms enable the stabilizer to reach the target sites within the uterus under an ultrasound-guidance. The balloon-based stabilizer could be inserted into the uterus with a small incision for entry. The accuracy evaluation showed that the maximum error of the curving mechanism was as small as 7 mm and the standard deviation of the bending mechanism was just 1.6 degrees. In the experiments using a fetus model, the manipulator could be well controlled under ultrasound guidance and its curving mechanism with the balloon-based stabilizer could be clearly visualized during the implementation of fetus model supporting. The manipulator has the potential to be used in minimally invasive intrauterine surgery, though further improvements and experiments remain to be carried out.
本文描述了一种新型操纵器，用于在内镜子宫内手术中稳定胎儿并防止其自由漂浮。微创内镜胎儿手术能够在降低对母亲和胎儿风险的情况下进行子宫内干预。我们设计并制造了一种胎儿支撑操纵器的原型，该操纵器配备了灵活的弯曲/卷曲机构和基于软球囊的稳定器。灵活的弯曲和卷曲机构使稳定器能够在超声引导下到达子宫内的目标部位。基于球囊的稳定器可以通过一个小切口插入子宫。精度评估表明，卷曲机构的最大误差小至7毫米，弯曲机构的标准偏差仅为1.6度。在使用胎儿模型的实验中，该操纵器在超声引导下能够得到很好的控制，并且在实施胎儿模型支撑过程中，其带有基于球囊稳定器的卷曲机构能够清晰可见。尽管仍有待进一步改进和实验，但该操纵器有潜力用于微创子宫内手术。
