Ge Jiawei, Saeidi Hamed, Kam Michael, Opfermann Justin, Krieger Axel
Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD, USA.
Department of Computer Science, University of North Carolina Wilmington, Wilmington, NC, USA.
Proc IEEE Int Symp Bioinformatics Bioeng. 2021 Oct;2021. doi: 10.1109/bibe52308.2021.9635563. Epub 2021 Dec 15.
Surgical resection is the current clinical standard of care for treating squamous cell carcinoma. Maintaining an adequate tumor resection margin is the key to a good surgical outcome, but tumor edge delineation errors are inevitable with manual surgery due to difficulty in visualization and hand-eye coordination. Surgical automation is a growing field of robotics to relieve surgeon burdens and to achieve a consistent and potentially better surgical outcome. This paper reports a novel robotic supervised autonomous electrosurgery technique for soft tissue resection achieving millimeter accuracy. The tumor resection procedure is decomposed to the subtask level for a more direct understanding and automation. A 4-DOF suction system is developed, and integrated with a 6-DOF electrocautery robot to perform resection experiments. A novel near-infrared fluorescent marker is manually dispensed on cadaver samples to define a pseudotumor, and intraoperatively tracked using a dual-camera system. The autonomous dual-robot resection cooperation workflow is proposed and evaluated in this study. The integrated system achieves autonomous localization of the pseudotumor by tracking the near-infrared marker, and performs supervised autonomous resection in cadaver porcine tongues (N=3). The three pseudotumors were successfully removed from porcine samples. The evaluated average surface and depth resection errors are 1.19 and 1.83mm, respectively. This work is an essential step towards autonomous tumor resections.
手术切除是目前治疗鳞状细胞癌的临床标准治疗方法。保持足够的肿瘤切除切缘是取得良好手术效果的关键，但由于可视化困难和手眼协调问题，手动手术中肿瘤边缘的划定误差不可避免。手术自动化是机器人技术中一个不断发展的领域，旨在减轻外科医生的负担并实现一致且可能更好的手术效果。本文报道了一种用于软组织切除的新型机器人监督自主电外科技术，可实现毫米级精度。肿瘤切除过程被分解到子任务级别，以便更直接地理解和实现自动化。开发了一个四自由度吸力系统，并与一个六自由度电灼机器人集成以进行切除实验。在尸体样本上手动涂抹一种新型近红外荧光标记物来定义假肿瘤，并在术中使用双摄像头系统进行跟踪。本研究提出并评估了自主双机器人切除协作工作流程。该集成系统通过跟踪近红外标记物实现假肿瘤的自主定位，并在猪尸体舌头（N = 3）上进行监督自主切除。三个假肿瘤均成功从猪样本中切除。评估的平均表面和深度切除误差分别为1.19毫米和1.83毫米。这项工作是迈向自主肿瘤切除的重要一步。
