微創手術機器人之縫合控制

Robotic suturing for minimally invasive surgery

沈寬(Kuan Shen)

指導教授 ： 顏家鈺

國立臺灣大學/工學院/機械工程學研究所/碩士(2019年)

https://doi.org/10.6342/NTU201901987

摘要

微創手術有著出血量少與術後復原快速等優點，能夠減輕患者的痛苦，因此近年來在臨床使用上日益廣泛，然而微創手術的難度較傳統開腹手術高，造成外科醫師執行手術時較大的負擔。將機器手臂應用於微創手術中扮演輔助的角色，能夠減少醫師的工作量，並使手術過程更加精確且有效率。
本文旨在設計具備自動手術縫合功能之微創手術機器人系統。首先針對微創手術機器人設計基本控制架構，在遠端運動中心限制的前提下，能夠在腹腔內操作手術器械而不會對患者肚皮造成損傷，接著規劃腹腔內的手術縫合動作，以模擬驗證控制演算法與手術縫合動作的正確性，最後利用實驗驗證微創手術機器人應用於手術縫合動作的可行性。

關鍵字

微創手術 ； 微創手術機器人 ； 遠端運動中心 ； 手術縫合

並列摘要

Minimally invasive surgery (MIS) has the advantages of less bleeding and rapid postoperative recovery, which can alleviate the suffering of patients. Therefore, it has become more and more widely used in clinical use in recent years. However, MIS is more difficult than traditional open surgery, causing a greater burden on surgeons while performing surgery. Applying the robotic arm to MIS as an auxiliary role can reduce the workload of the surgeon and make the surgical procedure more precise and efficient.
　　This article aims to design a MIS robot system with automatic surgical suturing. First, we design the basic control architecture for the MIS robot. Under the limitation of remote center of motion, the surgical instrument was operated in the abdominal cavity without causing damage to the patient's belly. Then, plan the surgical suture motion in the abdominal cavity. Verify the correctness of the control algorithm and the surgical suture motion by simulation. Lastly, the feasibility of using MIS robot for surgical suturing is verified by experiments.

並列關鍵字

Minimally Invasive Surgery ； MIS Robot ； Remote Center of Motion ； Surgical Suturing

參考文獻

[1] K. Fuchs, "Minimally invasive surgery," Endoscopy, vol. 34, no. 02, pp. 154-159, 2002.

[2] B. A. Salky, J. J. Bauer, I. M. Gelernt, and I. Kreel, "The use of laparoscopy in retroperitoneal pathology," Gastrointestinal endoscopy, vol. 34, no. 3, pp. 227-230, 1988.

[3] H. Kaneko et al., "Laparoscopic liver resection of hepatocellular carcinoma," The American journal of surgery, vol. 189, no. 2, pp. 190-194, 2005.

[4] K. T. Nguyen, T. C. Gamblin, and D. A. Geller, "World review of laparoscopic liver resection—2,804 patients," Annals of surgery, vol. 250, no. 5, pp. 831-841, 2009.

[5] V. Patnaik, R. Singla, and B. Sanjus, "Surgical incisions—their anatomical basis: Part 1—head and neck," J Anat Soc India, vol. 49, no. 1, pp. 69-77, 2000.