IEEE Trans Biomed Eng. 2022 Sep;69(9):2926-2934. doi: 10.1109/TBME.2022.3157818. Epub 2022 Aug 19.
Steerable surgical drills have the potential to minimize intraoperative tissue damage to patients. However, due to their large shaft diameters, large bend radii, and small bend angles, existing steerable drills are unsuitable for dexterous operations in confined spaces. This article presents a handheld steerable drill with a ϕ4.5-mm miniaturized tip, capable of abruptly bending up to ±65.
To achieve a small tip diameter and a large bend angle, we propose a novel articulated joint module composed of a tendon-driven geared rolling joint and a double universal joint for steering the drill shaft and transmitting drilling torques, respectively. We integrate this joint module with a customized compact actuation unit into a handheld device. The integrated handheld steerable drill is slim and lightweight, supporting burdenless, single-handed grips and easy integration into existing surgical procedures.
Experiments and analysis showed the proposed steerable drill has high distal dexterity and is capable to remove target tissues dexterously through a small passage/incision with minimized collateral damage.
The results suggest the potential of the proposed miniaturized articulated drill for dexterous bone work in confined spaces.
By enhancing distal dexterity and reach for surgeons when dealing with hard bony tissues, the proposed device can potentially minimize surgical invasiveness and thus collateral tissue damage to patients for a better clinical outcome.
可控手术钻头具有最大限度减少患者术中组织损伤的潜力。然而，由于其轴直径较大、弯曲半径较大且弯曲角度较小，现有的可控钻头不适合在狭小空间内进行灵巧操作。本文提出了一种具有 4.5mm 微型尖端的手持式可控钻头，能够突然弯曲至±65°。
为了实现小尖端直径和大弯曲角度，我们提出了一种由肌腱驱动的齿轮滚动关节和双万向节组成的新型铰接关节模块，分别用于控制钻头轴和传递钻孔扭矩。我们将该关节模块与定制的紧凑型驱动单元集成到一个手持式设备中。集成的手持式可控钻头小巧轻便，支持无负担的单手握持，并且易于集成到现有的手术程序中。
实验和分析表明，所提出的可控钻头具有很高的远端灵巧性，能够通过最小化的附带损伤，通过小通道/切口灵巧地去除目标组织。
结果表明，所提出的微型铰接钻头在狭小空间内进行灵巧的骨操作具有潜力。
通过增强外科医生在处理坚硬骨组织时的远端灵巧性和可达性，该设备有可能最大限度地减少手术的侵入性，从而减少对患者的附带组织损伤，以获得更好的临床效果。
