全膝關節置換手術輔助機器人之研究

Development of a Surgical Robot for Total Knee Replacement

賴志仲(Chi-Chung Lai)

指導教授 ： 顏炳郎

國立臺北科技大學/機電學院/自動化科技研究所/碩士(2006年)

摘要

全膝關節置換手術(Total Knee Replacement)近十年來，逐漸成為治療退化性關節炎主要選項之一，雖然可利用特殊製具進行置換手術，但因各人在骨頭生理特徵上不盡相同，由製具執行手術結果並非十分完善，故結合機器人輔助手術技術，利用其彈性設定手術條件與高精度骨頭切除的特性，進行新手術技術開發。
輔助手術機器人為論文研究目標，且為因應手術上的便利性、安全性、正確性，對於機構研發提出訴求：輕量化、高強度、高精確性。依照前述條件平行機構則成最佳首選，本論文以3-DOF之CPM作為輔助手術機器人之核心，針對其運動學、剛性等作分析，並利用此機構之解耦（單一輸入單一輸出）特性修改設計串聯三旋轉軸增其自由度以符合手術需要，使之在執行切割過程之步驟中以一軸驅動即可完成。利用此特性配合位置控制與路徑規劃，讓使用者能輕易控制平台位置而又能確實完成切割任務輔助手術之功效。
在本論文中已完成實物設計製作，最後以Saw bone作為切割實驗，利用量測點取特徵點得其骨頭方位並加入補償值調整切割路徑，其結果股骨和脛骨之連線與機械軸誤差為2.44°、epicondylar axis角度誤差為0.75°，以目前實驗誤差已可符合實際膝關節手術之要求。

關鍵字

全膝關節置換手術 （TKR） ； 手術機器人 ； 平行式卡氏平台（CPM） ； 解耦

並列摘要

Total Knee Replacement Surgery becomes the main selection of knee treatment in the last decade. Although the replacement surgery could be achieved by utilizing specific tools, however, the physiological features of the bones from each patient are not exactly the same, which resulting imperfect bone cutting and alignment of implants. Therefore, by combining the technique of operating surgery in assistant of the robots, the outperform characteristics of flexibility to different surgery conditions and high-precise bone cutting techniques can be achieved through the use of robots.
This paper aims to present a development of this new operating technology. Due to the capability of convenience, safety and precision required in the process of a surgery. The characteristics of light-weight, high-stiffness and high-precision are needed according to the above specifications. Thus a parallel structure is the best choice among various mechanisms. This paper adopts a 3-DOF Cartesian parallel manipulator as the core of the assist-surgery robot, which performs the analysis of the mechanics and stiffness to this structure. Besides, by emphasizing the feature of decoupling (Single Input-Single Output), a modification of attaching three rotating axis is added so as to increase the degree-of-freedom which may become more suitable for the surgical operation. By utilizing the above function with position control and path planning algorithm, the doctor can control the position of the platform easily and accomplish the task of assisting bone cutting in this system.
The material of imitated human bones has been manufactured, and the Saw bone cutting experiments are peformed as the last stage of our whole experiments. By measuring the point features to obtain the orientation of the bone and by adding compesated cutting path, results shows that the angle error between the connection of Femoral and Tebial mechanical axis is 2.44 degree and the angle error is 0.75 degree in epicondylar axis, which met the error in practical requirement for total knee replacement surgery.

並列關鍵字

Total Knee Replacement（TKR) ； Surgical Robot ； Cartesian parallel manipulator（CPM) ； decoupling

參考文獻

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[1]http://medicalimages.allrefer.com/large/knee-arthroscopy-series.jpg