Iordachita Iulian I, de Smet Marc D, Naus Gerrit, Mitsuishi Mamoru, Riviere Cameron N
Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD, USA.
Microinvasive Ocular Surgery Center (MIOS), Lausanne, Switzerland.
Proc IEEE Inst Electr Electron Eng. 2022 Jul;110(7):893-908. doi: 10.1109/JPROC.2022.3169466. Epub 2022 May 9.
Intraocular surgery, one of the most challenging discipline of microsurgery, requires sensory and motor skills at the limits of human physiological capabilities combined with tremendously difficult requirements for accuracy and steadiness. Nowadays, robotics combined with advanced imaging has opened conspicuous and significant directions in advancing the field of intraocular microsurgery. Having patient treatment with greater safety and efficiency as the final goal, similar to other medical applications, robotics has a real potential to fundamentally change microsurgery by combining human strengths with computer and sensor-based technology in an information-driven environment. Still in its early stages, robotic assistance for intraocular microsurgery has been accepted with precaution in the operating room and successfully tested in a limited number of clinical trials. However, owing to its demonstrated capabilities including hand tremor reduction, haptic feedback, steadiness, enhanced dexterity, micrometer-scale accuracy, and others, microsurgery robotics has evolved as a very promising trend in advancing retinal surgery. This paper will analyze the advances in retinal robotic microsurgery, its current drawbacks and limitations, as well as the possible new directions to expand retinal microsurgery to techniques currently beyond human boundaries or infeasible without robotics.
眼内手术是显微外科中最具挑战性的领域之一,它需要人类生理能力极限的感觉和运动技能,同时对准确性和稳定性有着极高的要求。如今,机器人技术与先进成像技术相结合,为推进眼内显微外科领域开辟了显著且重要的方向。与其他医疗应用一样,以更高的安全性和效率进行患者治疗为最终目标,机器人技术有潜力通过在信息驱动的环境中将人类优势与基于计算机和传感器的技术相结合,从根本上改变显微外科。眼内显微手术的机器人辅助仍处于早期阶段,在手术室中已被谨慎接受,并在有限数量的临床试验中成功进行了测试。然而,由于其已展现出的能力,包括减少手部震颤、触觉反馈、稳定性、增强的灵活性、微米级精度等,显微手术机器人技术已成为推进视网膜手术的一个非常有前景的趋势。本文将分析视网膜机器人显微手术的进展、其当前的缺点和局限性,以及将视网膜显微手术扩展到目前超出人类能力范围或没有机器人技术就不可行的技术的可能新方向。