Department of Mechanical Engineering, Faculty of Engineering, Kyushu University, Motooka 744, Nishi-ku, Fukuoka, 819-0395, Japan.
Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan.
Int J Comput Assist Radiol Surg. 2018 Jul;13(7):1063-1072. doi: 10.1007/s11548-018-1709-7. Epub 2018 Feb 28.
Image guidance is a key technology that can improve the outcome of laparoscopic surgery. However, due to the large deformation caused by digestive organs, a computer-aided navigation system based on preoperative imaging data cannot indicate the correct target position of the lesion (e.g., liver tumors and vessels invisible from the organ surface). To overcome this issue, we developed a laparoscopic ultrasound manipulator with two motorized degrees of freedom at the tip, allowing for the performance of a dexterous ultrasound scan in a confined laparoscopic surgical area.
The developed manipulator consists of a compact and elastic structure using springs, enabling a safe ultrasound scan and avoiding excess force on the inspected organs. The manipulator is a handheld device equipped with four buttons at the handle, which the surgeon directly grasps to send a motion command to the tip structure. The developed prototype realizes two motorized degree-of-freedom motion at the tip. The size of prototype is 15.0 mm in diameter that is usable in conventional laparoscopy. The tip of the manipulator was carefully designed by considering the kinematic model and the results of the finite element analysis.
To assess the prototype, accuracy and rigidity were measured by using a motion processing microscope. The accuracy test showed that the proposed device has a fairly accurate characteristic as a handheld device. This was supposedly caused by the nature of compliant mechanism, which does not have mechanical play in motion. In addition, the intrinsic elastic structure (approximately 2.0 N/mm in most of the range of motion) allowed the ultrasound probe to adequately fit on the curved organ surface without extra effort of manipulation during the inspection. In the in vivo experiment, the yaw motion was found to be effective for investigating the vascular network because the manipulator allows the probe to be rotated while maintaining the same position.
The mechanical evaluation and in vivo test results showed high feasibility of the prototype. We are currently working on further mechanical improvement for commercialization and development of a real-time navigation system that can perform three-dimensional reconstruction of ultrasonographic images by implementing a magnetic position sensor at the tip of the manipulator.
图像引导是一种可以提高腹腔镜手术效果的关键技术。然而,由于消化器官的大变形,基于术前成像数据的计算机辅助导航系统无法指示病变的正确目标位置(例如,肝脏肿瘤和从器官表面不可见的血管)。为了克服这个问题,我们开发了一种具有两个在尖端的机动自由度的腹腔镜超声操纵器,允许在有限的腹腔镜手术区域内进行灵巧的超声扫描。
所开发的操纵器由使用弹簧的紧凑而有弹性的结构组成,允许安全地进行超声扫描,并避免对检查器官施加过大的力。操纵器是一种手持式设备,在手柄上配备有四个按钮,外科医生直接握住这些按钮向尖端结构发送运动命令。所开发的原型在尖端实现了两个机动自由度的运动。原型的尺寸为 15.0 毫米,可用于常规腹腔镜检查。操纵器的尖端经过精心设计,考虑了运动学模型和有限元分析的结果。
为了评估原型,使用运动处理显微镜测量了精度和刚性。精度测试表明,所提出的设备作为手持式设备具有相当准确的特性。这可能是由于柔顺机构的性质造成的,该机构在运动中没有机械间隙。此外,内在的弹性结构(在运动的大部分范围内约为 2.0 N/mm)允许超声探头在不额外用力操作的情况下充分贴合弯曲的器官表面。在体内实验中,发现偏航运动对于研究血管网络是有效的,因为操纵器允许探头在保持相同位置的同时旋转。
机械评估和体内测试结果表明原型具有很高的可行性。我们目前正在努力进一步改进机械设计,以便商业化,并开发一种实时导航系统,该系统通过在操纵器的尖端实现磁位置传感器,可以对超声图像进行三维重建。