Kam M, Saeidi H, Wei S, Opfermann J D, Leonard S, Hsieh M H, Kang J U, Krieger A
Department of Mechanical Engineering, University of Maryland, College Park, MD 20742, USA.
Electrical and Computer Science Engineering Department, Johns Hopkins University, Baltimore, MD 21211, USA.
Med Image Comput Comput Assist Interv. 2019 Oct;11768:65-73. doi: 10.1007/978-3-030-32254-0_8. Epub 2019 Oct 10.
Autonomous robotic anastomosis has the potential to improve surgical outcomes by performing more consistent suture spacing and bite size compared to manual anastomosis. However, due to soft tissue's irregular shape and unpredictable deformation, performing autonomous robotic anastomosis without continuous tissue detection and three-dimensional path planning strategies remains a challenging task. In this paper, we present a novel three-dimensional path planning algorithm for Smart Tissue Autonomous Robot (STAR) to enable semi-autonomous robotic anastomosis on deformable tissue. The algorithm incorporates (i) continuous detection of 3D near infrared (NIR) markers manually placed on deformable tissue before the procedure, (ii) generating a uniform and consistent suture placement plan using 3D path planning methods based on the locations of the NIR markers, and (iii) updating the remaining suture plan after each completed stitch using a non-rigid registration technique to account for tissue deformation during anastomosis. We evaluate the path planning algorithm for accuracy and consistency by comparing the anastomosis of synthetic vaginal cuff tissue completed by STAR and a surgeon. Our test results indicate that STAR using the proposed method achieves 2.6 times better consistency in suture spacing and 2.4 times better consistency in suture bite sizes than the manual anastomosis.
与手动吻合相比，自主机器人吻合术有可能通过实现更一致的缝线间距和咬合尺寸来改善手术效果。然而，由于软组织形状不规则且变形不可预测，在没有连续组织检测和三维路径规划策略的情况下进行自主机器人吻合术仍然是一项具有挑战性的任务。在本文中，我们提出了一种用于智能组织自主机器人（STAR）的新型三维路径规划算法，以实现对可变形组织的半自动机器人吻合术。该算法包括：（i）在手术前连续检测手动放置在可变形组织上的三维近红外（NIR）标记；（ii）基于NIR标记的位置，使用三维路径规划方法生成均匀且一致的缝线放置计划；（iii）在每次完成缝合后，使用非刚性配准技术更新剩余的缝线计划，以考虑吻合过程中的组织变形。我们通过比较STAR和外科医生完成的合成阴道袖口组织吻合术，评估了路径规划算法的准确性和一致性。我们的测试结果表明，使用所提出方法的STAR在缝线间距上的一致性比手动吻合术高2.6倍，在缝线咬合尺寸上的一致性高2.4倍。
