Research On Minimally Invasive Spinal Surgery Robotic System (Romote Type) And Key Techniques For Miss Robot

Precision, digital and intelligent is the sign of modern surgical techniques, but also thefuture direction of development of surgical techniques.Developed countries invested heavily in research and development of automation,intelligent surgical equipment which is on behalf of surgical robot, and the milestone is the DaVinci system developed by the United States. However, the system is designed asmaster-slave structure robotic system (i.e., main side-doctor control and slave side-manipulator control) based on the technology needs of endoscopy. Therefore, the operativeobject of the Da Vinci system aimed is endoscopic, real-time3D visual needed, and tactilefeedback surgery, such as general surgery. Hence, for the surgeries which need fluoroscopicequipment assisted, there is no benefit. In view of the above restrictions, the Da Vincisystem is not currently used in orthopedics.Throughout the history of research and clinical application of orthopedic surgery robot, itis more than20years. But all these surgical robots are mainly concentrated in the area of joint.Due to the special structure of the spine, close to important nerves and blood vessels, thespinal surgeries need a very high accuracy, security and stability. Has been Germany, Israel,the United States, Japan, Korea and other countries on the spine surgical robotic systems withyears of research, the commercialization is still only one robotic system, the SpineAssistsystem, which could guide the surgeons to drill in spinal surgeries.Minimally invasive Spinal surgery is one of the main directions of the spinal surgery.Less lesion, bleed losing and recovery time make the patients like the minimal invasivesurgery more. For the minimizing of the surgical trauma, the surgeon requires to use theintraoperative fluoroscopy repeat to ensure the accuracy and safety of the operation. While,long time and large doses of X-ray direct irradiation not only cause the bodily harm, but alsohindered the development of minimally invasive spinal surgical. And the "keyhole" surgical field, which is much smaller, compared with the open surgery, not only for the surgeons ofminimally invasive spinal surgery to perform procedures more difficult and also limits thetraining of them. In recent years, based on image-guided computer-assisted surgery may bepossible to solve the problems above.For this situation, combined with the characteristics of the minimally invasive spinalsurgery, under the guidance of instructors, our team design and developed the minimallyinvasive spinal surgery robotic system, and experimental environment. On this basis, thesurgical robot system operational and accurate experimental studied. And the main contents:1．The establishment of the minimally invasive spinal surgery robotic experimentalenvironmentFocus on the development of orthopedics and our department, combination ofdepartment characteristics, we designed and development the minimally invasive spinalsurgery robotic system (remote type). To specify the operation of the robotic system, thematter need attention and the duty of the experimenters is very necessary for laying thefoundation for the further experiments with the minimally invasive spinal surgical roboticsystem. And at the same time, we need to determine the position of the instruments in thelaboratory related with this study.We did a preliminary study on experimental animals and decided to use the bovinelumbar spine as the experiment subject on the basis of the above experimental results. Andafter that, we design a note to identify the bovine lumber spine specimens, and manufacturedthe cattle spine clamp base on the morphology and the effect of the practical application of thebovine lumber spine. And then determine the size of the wooden bench according to theflexibility analysis of the surgical robotic system. After that we made it to ensure theexperiment implementing smoothly.2．The operational performance of minimally invasive spinal surgery robotic systemWe evaluate the temperature of the joints and the angle of displacement of themanipulator after long time, repeated and multi-angle operation. On the basis of the abovestudy, we assess stability and security preliminarily. And we found that this robotic system issafe and stable. But there is autonomous phenomenon of the "Depth mobile". A series of"gravity compensation" experiments proved that the phenomenon is caused by measurementvalues drift of the torque sensor. This issue is currently conquered by shifting the levers as follow,"drilling"-"stop operation"-"drilling". And the ultimate solution depends on theresearch and development of the specific manipulator of spinal surgery.3．Punching accuracy research of minimally invasive spinal surgical robotic systemThough solely rely on the C-arm and the combination of CT scan and intraoperativeC-arm image assisted the robotic system methods, we drill on the bovine spine specimens inthe experiments. And the results showed that the operation of the surgical robot system fordrilling could avoid the X-ray damage to the surgeons. And the accuracy of punching satisfiedthe clinical needs. There was no statistical difference between the plan and the punching. Andthe deviation within1mm accounted for91.6%, accounting for99.5within2mm; alldeviations are3mm of lateral film using solely C-arm assisted. And with the other way toassist, there were still3Kirschner wire not in the bovine spine specimens pedicle, besides thefact of no significant difference between the actual punch and the punch plan designed by thepreoperative CT scan. In addition, both of the two methods show obvious learning curveexists.We create an appropriate environment for the pre-clinical experiments of minimallyinvasive spinal surgical robotic system (remote) by designing laboratory and apparatus. In thisexperimental environment, we did research against the operating performance and precisionof minimally invasive spinal surgical robotic system (remote type). The results show that thissurgical robotic system operate security, stability, and can avoid the X ray damage to thedoctors during punching process. Although the robotic system has a certain learning curve,there is no significant difference between the Kirschner wire placed and the punch plan usingthis surgical robot assisted by the imaging equipment after familiar with the system.