Shanghai Key Laboratory of Stomatology; Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases.
Department of Mechanical Engineering, Shanghai Jiao Tong University.
J Craniofac Surg. 2022 Oct 1;33(7):2011-2018. doi: 10.1097/SCS.0000000000008684. Epub 2022 Jul 22.
Surgical robot has advantages in high accuracy and stability. But during the robot-assisted bone surgery, the lack of force information from surgical area and incapability of intervention from surgeons become the obstacle. The aim of the study is to introduce a collaborative control method based on the force feedback and optical navigation, which may optimally combine the excellent performance of surgical robot with clinical experiences of surgeons.
The CMF ROBOT system was integrated with the force feedback system to ensure the collaborative control. Force-velocity control algorithm based on force feedback was designed for this control method. In the preliminary experimental test, under the collaborative control mode based on force feedback and optical navigation, the craniomaxillofacial surgical robot entered the osteotomy line area according to the preoperative surgical plan, namely, right maxillary Le Fort I osteotomy, left maxillary Le Fort I osteotomy, and genioplasty.
The force sensor was able to collect and record the resistance data of the cutting process of the robot-assisted craniomaxillofacial osteotomy assisted in real time. The statistical results showed that the repeatability of collaborative control mode was acceptable in bilateral maxillary Le Fort I osteotomies (right, P =0.124>0.05 and left, P =0.183>0.05) and unfavorable in genioplasty ( P =0.048<0.05).
The feasibility of robot-assisted craniomaxillofacial osteotomy under the collaborative control method based on the force feedback and optical navigation was proved in some extent. The outcome of this research may improve the flexibility and safety of surgical robot to meet the demand of craniomaxillofacial osteotomy.
手术机器人具有高精度和高稳定性的优势。但在机器人辅助骨手术中，缺乏手术区域的力信息和外科医生无法进行干预成为障碍。本研究旨在介绍一种基于力反馈和光学导航的协作控制方法，该方法可以将手术机器人的卓越性能与外科医生的临床经验最佳结合。
CMF ROBOT 系统与力反馈系统集成，以确保协作控制。为该控制方法设计了基于力反馈的力-速度控制算法。在初步的实验测试中，在基于力反馈和光学导航的协作控制模式下，颅颌面外科手术机器人根据术前手术计划进入截骨线区域，即右侧上颌 Le Fort I 截骨术、左侧上颌 Le Fort I 截骨术和下颌成形术。
力传感器能够实时采集和记录机器人辅助颅颌面截骨术中的阻力数据。统计结果表明，双侧上颌 Le Fort I 截骨术（右侧，P=0.124>0.05；左侧，P=0.183>0.05）的协作控制模式的重复性可以接受，但下颌成形术的重复性不理想（P=0.048<0.05）。
在基于力反馈和光学导航的协作控制方法下，机器人辅助颅颌面截骨术的可行性得到了一定程度的证明。该研究结果可能会提高手术机器人的灵活性和安全性，以满足颅颌面截骨术的需求。
