智慧型可撓性機器人直覺式腹腔鏡控制系統於微創手術之應用

Abstract

微創手術是外科手術中較具挑戰性的，現今的腹腔鏡手術，除了負責執行開刀動作的醫師之外，腹腔鏡的使用需要仰賴另一位助理醫生以手動的方式調整鏡頭位置，這就需要外科醫師和助手之間的培訓和高合作工作操作。因此，本研究的目的是開發一種腹腔鏡系統，希望可以讓主刀醫師親自以簡單、直覺的方式調整腹腔鏡的鏡頭位置。我們實做了機器人多關節可撓性腹腔鏡系統（RFLS），此系統由外科醫師的頭部動作控制，控制方式十分直觀，且外科醫師可以使用他/她的手操縱腹腔鏡器械。除了直觀地操縱腹腔鏡，可撓性腹腔鏡機器人系統最顯著優點是記憶位置的功能，只需簡單的命令就可使腹腔鏡回到已記憶的視野，而不須重新以頭部移動腹腔鏡位置。此外，頭部轉動角度相對於腹腔鏡轉動角度的比率是可調整的。此系統使外科醫師直覺性控制腹腔鏡，而不需要以傳統方式和助理溝通協調，提高了手術過程中的效率，也有節省醫療人力的附加價值。實驗結果表明，多關節可撓性腹腔鏡可以始終跟隨使用者的頭部轉動、記憶所需的位置並返回到的那些點。

Laparoscopic surgery remains a challenging procedure because the laparoscope has to be operated by an assistant during surgery, which requires training and high coopera-tion work between the surgeon and assistants. Accordingly, the objective of this study is to develop a laparoscopic system providing intuitive maneuverability. We developed and implemented a Robotic Flexible Laparoscope System (RFLS) which is controlled by the surgeon’s head movements, so the surgeon can use his/her hands to manipulate the laparoscopic instruments while maneuvering the laparoscope intuitively. In addition, scalable ratio adjustment of head movement with respect to laparoscope movement is also included in our system. Furthermore, in maneuvering the laparoscope intuitively, the most significant advantage is the ability of RFLS can at least save three anatomical positions, which could be retrieved by a single command with small errors. This system makes surgeon-in-charge maneuver the laparoscope intuitively without communication and coordination with assistant needed in conventional way. As a result, it is expected to replace the assistant, thus reduce manpower and enhance the efficiency during the surgery. Experimental results demonstrate that the articulating flexible laparoscope can always follow user’s head motion, memorize the required points and return back to those points in all necessary orientations.