- 學位論文
機械式巡航系統於手術訓練之應用研究
Research on Application of Robotic Navigation System to Surgical Training
摘要
現今的臨床手術中，許多手術仍僅憑著醫師經驗動刀，伴隨著高風險與不確定性，本研究擬開發出一套機械式巡航系統輔助手術，為醫師規劃出準確的位置開刀，提升手術的安全性與便捷性。 談到提升精準度與安全性，醫學影像導航手術 (Image-Guided Surgery) 的普及帶來了許多貢獻，臨床上對於避免術後併發症、縮短病患術後復原時間的需求也逐漸增加。 因此，一套精準、靈巧、好用的醫學影像導航系統在這全新世代中，已成為醫師不可或缺的得力助手，縱觀機械式、光學式、電磁式三種醫學影像導航系統，機械式手術導航系統擁有構造簡單、架設方便、行動限制小、應用靈活等優點，使用前不需費時進行繁瑣的設定，也不會產生醫師進行手術時遮蔽光線而失去追蹤的問題，諸多面向，機械式導航系統相較於其它兩者，有著明顯的優勢。 而本研究先針對治療水腦症病患的腦室穿刺引流手術進行規劃，透過機械手臂搭配CT斷層掃描的資訊，準確地指出最適合穿刺的位置，協助醫師迅速且準確地完成手術，同時擬將這套系統搭配上自製頭形假體，提供新進實習醫師一個精準方便的穿刺練習系統。 利用工業級機械手臂搭配雷射測距儀組合成定位器，輔以3D Slicer三維影像重建軟體、Matlab GUI圖形化人機介面進行數學演算、座標疊合與訊息傳遞，為醫師做好整組手術的臨床規劃，並經過多次實驗交叉驗證其精準度，以期將此系統盡快推上臨床使用，為腦室疾病病患謀福祉。
並列摘要
In order to achieve the greater safety during surgeries, The Image-Guided Surgery becomes more and more popular, also the needs of avoiding complications and shortening the recovery time after the surgery gradually expands. Therefore, an accurate, clever, and useful Image-Guided System in the new generation becomes indispensable. Seeing between the three types of Image-Guided System among Robotic, Optical, and Electro-Magnetical ones, the Robotic Image-Guided System has the advantages of: simpler structure, conveniently equipped, movable, clever applications, and there’s no need for complicated time-cost setup, it also avoids the light-shielding problem in the Optical ones. By multiple points-of-view, the Robotic Image-Guided System has an obvious superiority compared with the others. The research’s main idea is to create a Robotic Surgical Navigation System, so far we have focused on clinical planning for the VP Shunt surgery which cures the patients suffering from Hydrocephalus. We use a robot arm and a laser pointer, combined with the CT images’ information, pointing at the most suitable point to insert, helping the doctors to finish the surgery rapidly and accurately. In addition, we want to add the system with a self-made head-like phantom, providing the new surgeons a convenient and accurate Insertion-Practice System. We combine an Industrial Robot Arm with a Laser Pointer to construct a localizer, taking the advantages of some softwares: 3D Slicer for 3D Visualization, Matlab Graphical User Interface for the numerical inputs / outputs and calculations, registrations and communications, planning a complete clinical surgery process for the doctor. Through many experiments and cross-validations to make sure the accuracy, we expect to put the system to real clinical uses as soon as possible, playing goods for the patients suffering from brain diseases.