微創手術套管開口佈局之醫師舒適度評估

Evaluation of Surgeon Comfort for Port Placement Planning in Minimally Invasive Surgery

盧卉萱(Hui-Hsuan Lu)

指導教授 ： 陳永耀

國立臺灣大學/電機資訊學院/生醫電子與資訊學研究所/碩士(2015年)

https://doi.org/10.6342/NTU.2015.02193

摘要

微創手術中，倘若外科醫師選擇不佳的腹壁套管開口位置，會因為長久的手術時間造成外科醫師在操作中感到疲勞與痠痛。本論文目的在於探討評估外科醫師在微創手術中操作舒適度的方法，期望其結果在未來能協助微創手術腹壁套管開口佈局的分析。首先，將手術前的電腦斷層掃描影像與病患氣腹後的腹部表面比對，以建立病患肝臟與腹部表面的立體關係模型，依此模型，研究手術器械可碰觸肝臟切割面的腹部區域與外科醫師在手術中的操作舒適度。為了找到在手術中，能讓外科醫生操作手術器械較舒適的套管開口位置，以機器人模型描述外科醫師在手術中的動作姿態，將其動作姿態的維持時間和不同手腕角度產生的肌肉壓力當作舒適度的評估標準。最後合併肝臟的可碰觸分析，找到微創手術中，外科醫師操作相對舒適的腹壁套管開口位置之區域。

關鍵字

套管開口佈局分析 ； 微創手術 ； 肝臟切割 ； 氣腹腹部表面 ； 舒適度評估 ； 持久時間 ； 手腕角度

並列摘要

In minimally invasive surgery, if the bad port selections is happened, surgeons would feel fatigued and painful as they perform the operation during long time surgery. In this thesis, surgeon comfort evaluation in minimally invasive surgery are studied to help the port placement planning in the future. Firstly, based on the preoperative computed tomography (CT) imaging and patient's inflated abdominal surface, a 3D patient model of spatial relationship between liver and abdominal surface is constructed. Then, calculate the region of abdominal surface where can reach the liver resection plane. In order to find the port sites to help surgeons perform the operation comfortably, a robotic model is adopted to describe the surgeon’s motions. Endurance time of posture configurations and muscle pressure of different wrist angles are as comfort indexes to evaluate the surgeon comfort. Eventually, combined the reachability test to obtain the relatively comfortable port region for surgeons in minimally invasive surgery.

並列關鍵字

Port placement planning ； Minimally Invasive Surgery (MIS) ； liver resection ； inflated abdominal surface ； comfort evaluation ； endurance time ； wrist angle

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