Zhang Bo, Kobayashi Yo, Chiba Toshio, Fujie Masakatsu G
Graduate School of Science and Engineering, Waseda University, Tokyo, Japan.
Annu Int Conf IEEE Eng Med Biol Soc. 2009;2009:5076-9. doi: 10.1109/IEMBS.2009.5334245.
The clinical target of this study is intrauterine patch coverage of fetal myelomeningocele. We propose a new surgical robotic system for intrauterine fetal surgery with patch-stabilizer and laser manipulator. The target disease of the fetal surgery is spina bifida or myelomeningocele, which is incomplete closure in the spinal column and one of the common fetal diseases. In the fetal surgery, the collagen patch is supposed to be stabilized onto the fragile fetal tissue during the laser fixation process. In this study, a prototype of the patch-stabilizer using wire driven mechanism has been developed for precise force control on the patch without damaging fetal tissue. The diameter of the patch-stabilizer's shaft is 2.4 mm. The patch-stabilizer including one ball joint and wire driven mechanism is able to bend through 40 degrees. The stabilizing part holds collagen patch with diamond shape mechanism using wire driven. In this paper, we showed that the patch-stabilizer is developed with the stabilizing force control using the tension control of wires. Results of the experiment showed that the tension of driven wires was controlled at 0.3 N to stabilize the collagen patch onto the lesion surface without the damages of fetal tissues and the influence by the amnion liquid.
本研究的临床目标是对胎儿脊髓脊膜膨出进行宫内补片覆盖。我们提出了一种用于宫内胎儿手术的新型手术机器人系统，该系统配备补片稳定器和激光操纵器。胎儿手术的目标疾病是脊柱裂或脊髓脊膜膨出，这是脊柱闭合不全的一种常见胎儿疾病。在胎儿手术中，胶原补片应在激光固定过程中稳定在脆弱的胎儿组织上。在本研究中，已开发出一种采用线驱动机制的补片稳定器原型，用于在不损伤胎儿组织的情况下对补片进行精确的力控制。补片稳定器的轴直径为2.4毫米。该补片稳定器包括一个球形接头和线驱动机构，能够弯曲40度。稳定部分通过线驱动采用菱形机构固定胶原补片。在本文中，我们展示了通过对线的张力控制来实现稳定力控制而开发的补片稳定器。实验结果表明，驱动线的张力控制在0.3牛，以便在不损伤胎儿组织且不受羊水影响的情况下将胶原补片稳定在病变表面。
