| Objective:1.Retrofit the UR5 collaborative industrial robot prototype and perform osteotomy experiments on an isoscale plaster model of a patient with a wide chin deformity.Quantitative analysis of osteotomy result measurement indicators was carried out to verify the characteristics of the transformed UR5 collaborative industrial robot in osteotomy.In the pre-clinical research,the feasibility of cobot contour plastic surgery was proved and a reasonable research route was explored,and a prototype of the ultrasonic contour plastic surgery robot was created.2.A set of diagnostic,measurement and surgical simulation methods for simple mandibular angle hypertrophy were designed for the ultrasound contour plastic surgery robot,and under the operation of human-machine collaboration,the bilateral mandibular angles of the equal proportions of the mandibular angle hypertrophy patients were performed for mandibular angle long arc osteotomy.Through quantitative comparative analysis,the symmetry between the two sides before and after the operation and the difference before and after the operation were verified to verify the accuracy of the contour plastic surgery robot in the application of mandibular angle long arc osteotomy,the accuracy of the surgical robot and the clinical surgical method was compared by performing traditional clinical surgical operations and postoperative measurements of the same plaster model.The experience of ultrasonic contour plastic surgery robot in the actual clinical surgery of mandibular angle long arc osteotomy is summarized to verify its safety.3.A set of quantitative analysis indicators for the evaluation of the effect of chin-level osteotomy surgery in ultrasound contour plastic surgery robots was designed.The accuracy of the patient’s horizontal osteotomy is compared with that of traditional clinical surgical procedures by performing a pre-expulsion immobilization of the patient’s isoscale plaster cast model using an ultrasound contour plastic surgery robot.Through the plaster model robot osteotomy free bone mass fixation experiment,a method to improve the accuracy.of free bone mass fixation in chin horizontal osteotomy surgery using surgical robots was explored,and the problem of free bone mass could not be tracked using a navigator.Through the experimental study of the actual robot surgical operation of human skull specimens,the possible complications of chin level osteotomy titanium nail titanium plate internal fixation in the actual clinical surgery of ultrasonic contour plastic surgery robots are summarized.Methods:1.From the database,the digitized data of patients with chin reduction and plastic surgery who visited the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from September 2019 to March 2022 were selected,and appropriate patients were included.With the help of digital technology,the three-dimensional coordinate system is established,and the reference point,reference plane and measurement index of preoperative measurement are established,and the surgical simulation scheme is designed by printing and transforming the scale plaster model using data.Transform the UR5 collaborative industrial robot prototype,perform osteotomy on the plaster model,and quantify the evaluation of the measurement indicators after surgery.2.CT data of patients with simple mandibular angle hypertrophy admitted to the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from December 2019 to December 2020 were collected from the database.Through the criteria of inclusion and exclusion,appropriate patients were included.A new 3D measurement and analysis method more suitable for collaborative robot surgical research was designed,and the surgical protocol was designed;two equal proportions of plaster cast models of the same patient were performed with robotic mandibular angle long arc osteotomy and traditional osteotomy surgery,respectively.After the operation,statistical analysis and comparison were carried out to verify the accuracy of the two,and the intraoperative operation experience was evaluated according to the comparison of simulation protocols,and the complications that might be speculated in clinical practice were speculated.3.From January 2016 to December 2020,10 typical patients with small chin deformity were selected from the craniomaxillofacial plastic surgery team,and all patients used digital three-dimensional technology to simulate the preoperative preoperative chin horizontal osteotomy,based on the previous experiments of this research team,setting measurement project indicators on the three-dimensional reconstruction model and completing preoperative measurements.Before printing an equal-scale plaster cast for osteotomy,before the ultrasonic contouring surgery robot osteotomy is performed,the fixed position of the titanium plate titanium nail after the bone block is fixed is first determined in the simulation.Before the osteotomy,make nail holes in the model and prepare the pre-bent titanium plate in advance.According to the simulated osteotomy planning path,the surgical robot is used for horizontal osteotomy,and the free bone mass is fixed using a prefabricated curved titanium plate,and the CT scan is scanned again after the operation for measurement,which is compared with the measurement index after clinical surgery.Results:1.After the modification of the complete contour plastic surgery robot prototype occupies a small space,with a separate robotic arm that can cooperate with the surgeon,the position of the osteotomy experiment is unchanged,the single robotic arm can move flexibly and the range of motion completely covers the required surgical area;under the guidance of the navigator,the surgical robot equipped with an piezosurgery end actuator is held by the operator,and under the condition that the position of the cobot is unchanged,the bilateral chin part is obliquely performed,and the postoperative measurement indicators 1,3,6H(R),1,3 There was no obvious statistical difference between the 6H(L)and the control group simulation indicators,and the osteotomy route was consistent with the preoperative osteotomy route of the control group(p>0.05);the osteotomy experimental process was stable,and there were no traces of burning around the osteotomy line.2.A set of preoperative mirror image diagnosis and index measurement methods suitable for ultrasonic contour plastic surgery robots for mandibular angle long arc osteotomy surgery were designed,and the anatomical characteristics of the mandibular bone of the recipient were obtained,which can guide the design of surgical simulation.Each case data was printed out of two cast models of the mandible,which were modified to perform surgical operations by traditional clinical osteotomy and robotic osteotomy according to the simulation design scheme.Each time the surgical robot cuts a small arc,the robot arm needs to be readjusted to smoothly perform a long arcosteotomy.No model injury due to excessive temperature occurred during osteotomy.The bilateral measurement indicators of go-W,Co-H and Ag in the simulated group of patients with mandibular angle hypertrophy were compared with the measurement indicators of the robot group,and the difference between the two sets of indicators was not statistically significant(P>0.05),and the bilateral measurement indicators of the mandible go-W,Co-H and Ag in the simulated group were compared with the measurement indicators of the clinical group,and the difference between the two groups was obvious and statistically significant(P<0.05).3.Compared with the measurement indicators of Pog-N ⊥ FH,Go-Mf and ANS-Me in the simulated control group,there was no obvious statistical difference(p>0.05)in the postoperative measurement index of the contour plastic surgery robot surgery,and the statistical difference between the postoperative measurement index after the clinical operation operation and the postoperative index of the simulated control group(p<0.05).The route of the robot surgery osteotomy was consistent with the preoperative osteotomy route of the control group(p>0.05).There was a difference between the route of osteotomy in the clinical surgery and the simulated control group(p<0.05).The MfL after robotic osteotomy was 0.36±0.05,and the MfL after surgery in the clinical group was 0.09 ± 0.06.When the surgical robot performed a linear osteotomy of the chin of a cadaver specimen,no muscle damage was found in the posterior chin muscle group after the osteotomy line.After osteotomy,according to pre-positioned drilling holes and prefabricated titanium plates,distal free bone mass fixation can be carried out smoothly.Conclusion:1.The UR5 collaborative robot prototype was transformed,and a complete set of experimental planning routes and verification methods for the feasibility analysis of contour plastic surgery research were established;through the evaluation and analysis of the structural characteristics of the UR5 collaborative robot prototype,compared with fully automatic or passive robots,the robot of human-robot collaborative mode was more in line with the needs of contour plastic surgery;and the collaborative robot was quantitatively evaluated before and after the chin body oblique osteotomy surgery through digital technology.The modified UR5 collaborative robot prototype can be used for clear exposure of the surgical area,straight osteotomy route,convenient operating angle,and no need for post-osteotomy fixation.2.Through digital technology,a set of digital measurement methods have been developed for the ultrasonic contour plastic surgery robot to perform mandibular angle long arc osteotomy surgery,and based on it,the robot mandibular long arc osteotomy surgery scheme has been successfully designed;in future research,it is necessary to solve the surgical robot to perform mandibular long arc osteotomy surgery by improving the ultrasound blade,and the angle of the knife head needs to be readjusted to cut out the long arc osteotomy line;the plaster model and the human skull specimen osteotomy surgery are guided by the surgical robot equipped with a navigator.The preoperative simulation scheme can be accurately converted to the plaster cast model,and the accuracy,symmetry and safety of the ultrasound contour plastic surgery robot are higher than those of the traditional human hand osteotomy operation.3.A set of quantitative analysis indicators for the comparative evaluation of the effect before and after the chin horizontal osteotomy of the contour plastic surgery robot was designed;the same surgical methods were compared with the patient’s isoscale plaster cast model,and compared with the traditional clinical surgical operation,the accuracy of the horizontal osteotomy of the chin was higher and closer to the surgical simulation design;the problem of the distal part of the chin free bone block could not be tracked and fixed using the navigator was solved by drilling holes and pre-bending titanium plates in advance.The accuracy of the fixed position of the free bone mass is guaranteed.Through the experimental study of the actual surgical operation of human skull specimens,it is inferred that in actual clinical surgery,the use of robots for chin level osteotomy titanium nail titanium plate internal fixation can reduce the occurrence of complications,with good stability and safety. |
PDF Full Text Request