Choi Ho Seon, Lee Seung Jun, In Hyunki
Department of Artificial Intelligence and Robotics, Sejong University, Seoul, Republic of Korea.
Center for Healthcare Robotics, Korea Institute of Science and Technology, Seoul, Republic of Korea.
Front Bioeng Biotechnol. 2024 Dec 16;12:1418148. doi: 10.3389/fbioe.2024.1418148. eCollection 2024.
During tasks like minimally invasive surgery (MIS), various factors can make working environment not be ergonomic, and those situations will accumulate fatigue in the surgeon's muscles which will inevitably lead to poor surgical performance. Therefore, there has been a need for technical solutions to solve this problem and one of the methods is exoskeleton robots.
We designed a passive shoulder exoskeleton whose workspace could be used for MIS to assist the surgeon's movements and performed computational and clinical validation. First, the joint order of the shoulder exoskeleton, which consists of three degrees of freedom, was configured differently from previous studies so that the singularity can be located outside the workspace. And a novel gravity compensation mechanism was developed to replace the existing one, which could no longer be used due to these changes on order of joints. Afterwards, it was computationally verified using statics and kinematics whether sufficient shoulder muscle assistance could be implemented for the entire developed system. Lastly, we manufactured an apparatus that simulated the surgical environment in which the shoulder exoskeleton robot would actually be used, recruited human participants, and conducted an experiment.
Through computational validation, we can guess that the developed shoulder exoskeleton can provide 18.14% reduction of muscle activation to the wearers in workspace. And the results of clinical experiments with human subjects show that activation of deltoid posterior, medial and anterior decreased with average -8.33%, -14.55%, and -21.0%, respectively during MIS-simulated tasks with developed shoulder exoskeleton than without it. And arm tremor which is equals to movement variability also decreased with average 9.85% by using shoulder exoskeleton and maximum -19.5% in a certain position.
These experimental results show that our shoulder exoskeleton and its novel gravity compensation mechanism has enough clinical effectiveness for workers of underhead tasks, especially surgeons who conduct MIS. It reduced deltoid activations of wearers and also stabilized arm tremor which are directly related to performance of fine manipulative task, so that this research implies that shoulder exoskeletons are also need for underhead tasks and our shoulder exoskeleton has possibility to contribute to those utilities.
在诸如微创手术（MIS）等任务中，各种因素会导致工作环境不符合人体工程学，这些情况会使外科医生的肌肉积累疲劳，这将不可避免地导致手术表现不佳。因此，需要技术解决方案来解决这个问题，其中一种方法是外骨骼机器人。
我们设计了一种被动式肩部外骨骼，其工作空间可用于微创手术，以辅助外科医生的动作，并进行了计算和临床验证。首先，由三个自由度组成的肩部外骨骼的关节顺序与先前的研究不同，这样奇异点可以位于工作空间之外。并且开发了一种新颖的重力补偿机制来取代现有的机制，由于关节顺序的这些变化，现有机制不再适用。之后，使用静力学和运动学对整个开发系统是否能够实现足够的肩部肌肉辅助进行了计算验证。最后，我们制造了一个模拟肩部外骨骼机器人实际使用的手术环境的装置，招募了人类参与者并进行了实验。
通过计算验证，我们可以推测，所开发的肩部外骨骼在工作空间中可为佩戴者减少18.14%的肌肉激活。人体受试者的临床实验结果表明，在使用所开发的肩部外骨骼进行模拟微创手术任务期间，三角肌后部、中部和前部的激活分别比不使用时平均降低了8.33%、14.55%和21.0%。并且等于运动变异性的手臂震颤也通过使用肩部外骨骼平均降低了9.85%，在某个位置最大降低了19.5%。
这些实验结果表明，我们的肩部外骨骼及其新颖的重力补偿机制对于低头工作的人员，尤其是进行微创手术的外科医生具有足够的临床有效性。它降低了佩戴者三角肌的激活，还稳定了与精细操作任务表现直接相关的手臂震颤，因此这项研究表明低头工作也需要肩部外骨骼，并且我们的肩部外骨骼有可能为这些应用做出贡献。
