自动缝合的现状：系统评价。

The current state of autonomous suturing: a systematic review.

机构信息

Department of Otolaryngology - Head and Neck Surgery, University of California San Diego Health, San Diego, CA, USA.

School of Medicine, University of California San Diego, La Jolla, CA, USA.

出版信息

Surg Endosc. 2024 May;38(5):2383-2397. doi: 10.1007/s00464-024-10788-w. Epub 2024 Mar 29.

DOI:10.1007/s00464-024-10788-w

PMID:38553597

Abstract

BACKGROUND

Robotic technology is an important tool in surgical innovation, with robots increasingly being used in the clinical setting. Robots can be used to enhance accuracy, perform remote actions, or to automate tasks. One such surgical task is suturing, a repetitive, fundamental component of surgery that can be tedious and time consuming. Suturing is a promising automation target because of its ubiquity, repetitive nature, and defined constraints. This systematic review examines research to date on autonomous suturing.

METHODS

A systematic review of the literature focused on autonomous suturing was conducted in accordance with PRISMA guidelines.

RESULTS

6850 articles were identified by searching PubMed, Embase, Compendex, and Inspec. Duplicates and non-English articles were removed. 4389 articles were screened and 4305 were excluded. Of the 84 remaining, 43 articles did not meet criteria, leaving 41 articles for final review. Among these, 34 (81%) were published after 2014. 31 (76%) were published in an engineering journal9 in a robotics journal, and 1 in a medical journal. The great majority of articles (33, 80%) did not have a specific clinical specialty focus, whereas 6 (15%) were focused on applications in MIS/laparoscopic surgery and 2 (5%) on applications in ophthalmology. Several suturing subtasks were identified, including knot tying, suture passing/needle insertion, needle passing, needle and suture grasping, needle tracking/kinesthesia, suture thread detection, suture needle shape production, instrument assignment, and suture accuracy. 14 articles were considered multi-component because they referred to several previously mentioned subtasks.

CONCLUSION

In this systematic review exploring research to date on autonomous suturing, 41 articles demonstrated significant progress in robotic suturing. This summary revealed significant heterogeneity of work, with authors focused on different aspects of suturing and a multitude of engineering problems. The review demonstrates increasing academic and commercial interest in surgical automation, with significant technological advances toward feasibility.

摘要

背景

机器人技术是外科创新的重要工具，越来越多的机器人被应用于临床环境中。机器人可以用于提高准确性、执行远程操作或自动化任务。例如，缝合是一种重复的、基本的手术操作，可能会很繁琐和耗时。缝合是一个很有前途的自动化目标，因为它无处不在、具有重复性并且受到明确的限制。本系统综述检查了迄今为止关于自主缝合的研究。

方法

根据 PRISMA 指南，对自主缝合的文献进行了系统综述。

结果

通过搜索 PubMed、Embase、Compendex 和 Inspec，共确定了 6850 篇文章。删除了重复项和非英文文章。筛选了 4389 篇文章，排除了 4305 篇。剩下的 84 篇中，有 43 篇不符合标准，最终有 41 篇文章进行了综述。其中，34 篇（81%）是在 2014 年后发表的。9 篇发表在工程杂志上，31 篇发表在机器人学杂志上，1 篇发表在医学杂志上。绝大多数文章（33 篇，80%）没有特定的临床专业重点，而 6 篇（15%）专注于微创/腹腔镜手术应用，2 篇（5%）专注于眼科应用。确定了几个缝合子任务，包括打结、缝线传递/针插入、针传递、针和缝线抓取、针跟踪/动觉、缝线检测、缝线针形状生成、器械分配和缝线准确性。有 14 篇文章被认为是多组件的，因为它们涉及到之前提到的几个子任务。