Amirabdollahian Farshid, Livatino Salvatore, Vahedi Behrad, Gudipati Radhika, Sheen Patrick, Gawrie-Mohan Shan, Vasdev Nikhil
School of Computer Science, University of Hertfordshire, Hatfield, AL10 9AB, UK.
School of Engineering, University of Hertfordshire, Hatfield, AL10 9AB, UK.
J Robot Surg. 2018 Mar;12(1):11-25. doi: 10.1007/s11701-017-0763-4. Epub 2017 Dec 1.
With the successful uptake and inclusion of robotic systems in minimally invasive surgery and with the increasing application of robotic surgery (RS) in numerous surgical specialities worldwide, there is now a need to develop and enhance the technology further. One such improvement is the implementation and amalgamation of haptic feedback technology into RS which will permit the operating surgeon on the console to receive haptic information on the type of tissue being operated on. The main advantage of using this is to allow the operating surgeon to feel and control the amount of force applied to different tissues during surgery thus minimising the risk of tissue damage due to both the direct and indirect effects of excessive tissue force or tension being applied during RS. We performed a two-rater systematic review to identify the latest developments and potential avenues of improving technology in the application and implementation of haptic feedback technology to the operating surgeon on the console during RS. This review provides a summary of technological enhancements in RS, considering different stages of work, from proof of concept to cadaver tissue testing, surgery in animals, and finally real implementation in surgical practice. We identify that at the time of this review, while there is a unanimous agreement regarding need for haptic and tactile feedback, there are no solutions or products available that address this need. There is a scope and need for new developments in haptic augmentation for robot-mediated surgery with the aim of improving patient care and robotic surgical technology further.
随着机器人系统成功应用于微创手术,且机器人手术(RS)在全球众多外科专业中的应用日益增加,现在有必要进一步开发和改进这项技术。其中一项改进是将触觉反馈技术应用并融入机器人手术中,这将使控制台前的主刀医生能够获得有关正在操作的组织类型的触觉信息。使用该技术的主要优势在于,主刀医生在手术过程中能够感知并控制施加于不同组织的力量大小,从而将机器人手术过程中因过度施加组织力或张力的直接和间接影响而导致组织损伤的风险降至最低。我们进行了一项双评估者系统综述,以确定在机器人手术中向控制台前的主刀医生应用和实施触觉反馈技术时的最新进展以及改进技术的潜在途径。本综述总结了机器人手术中的技术改进,涵盖了从概念验证到尸体组织测试、动物手术,最终到手术实践中的实际应用等不同工作阶段。我们发现,在本次综述之时,虽然对于触觉和触感反馈的需求已达成一致意见,但尚无能够满足这一需求的解决方案或产品。为了进一步改善患者护理和机器人手术技术,机器人辅助手术的触觉增强方面存在新进展的空间和需求。