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主从式微创血管介入手术机器人系统设计与控制
奉振球
学位类型工学博士
导师侯增广
2016-06-02
学位授予单位中国科学院大学
学位授予地点北京
关键词手术机器人 血管介入 主从控制 力检测与力反馈
摘要心血管病是目前全世界范围内威胁人类健康的第一大杀手。相比开放式的冠状动脉搭桥手术,血管介入手术属于微创手术,因其创伤小、痛苦小、术后恢复快等优势而成为冠心病治疗的主要方式。但是,目前的血管介入手术仍然存在一些突出的问题:X射线累积辐射导致介入医生患白内障和脑肿瘤的几率高;沉重的铅衣负担造成医生颈椎、腰椎严重损伤;血管介入手术流程复杂且介入器械直径小、操作难度大,医生长时间工作极易因手部疲劳和颤抖而影响器械的精准递送。利用机器人的高精度、高稳定性、可遥操作等特点辅助医生进行血管介入手术,可以使医生有效避免X射线辐射、降低工作强度,并提高器械操作的精度。本文在国家863计划项目“微创血管介入手术机器人实用系统研究”(2010AA044001)和国家自然科学基金重点项目“血管微创介入手术机器人基础理论与关键技”(61533016)等课题的支持下,针对血管介入手术存在的问题,围绕微创血管介入手术机器人系统的设计和相关控制方法展开研究。本文的主要工作和创新点如下:
(1)针对传统微创血管介入手术中X射线辐射伤害大、器械操作复杂等问题,设计了一款由递送装置、医生控制台和定位机械臂等组成的微创血管介入手术机器人。该机器人采用主从控制模式,递送装置放置在导管室中手术台旁,医生控制台则处于控制室。医生可以在控制室中通过机器人以主从操作方式进行血管介入手术,从而解决了X射线对医生的辐射等问题。递送装置基于仿生启发式机理,模拟医生手指的操作方法,具有操作灵巧的特点;控制台保留了介入医生的操作习惯,有利于医生运用已有的操作经验。
 (2)为实现微创血管介入手术机器人对导管、导丝等介入器械的高精度递送,建立了微创血管介入手术机器人主端控制台和从端递送装置间的操作模式并进行了递送精度分析。递送装置主指和副指的旋转和平移分别实现介入器械的轴向平移和周向旋转运动,控制台的操作手柄具有平移和旋转两个自由度。面向介入器械在血管内的递送,建立了轴向平移、周向旋转、同时平移和旋转、以及球囊/支架导管递送等四种不同的操作模式,通过不同模式间的配合,确保将介入器械递送至靶血管。
 (3)针对手术过程中介入器械递送不同阶段的特点和要求,提出了一种基于比例缩放的主从控制方法,实现了机器人递送装置侧对医生操作的放大、缩小或等比例缩放。根据手术流程,将递送过程分为主动脉阶段、冠状动脉入口阶段和靶血管阶段,通过在主从控制中引入比例缩放因子,对主动脉阶段采用放大的比例因子以减少X射线照射时间,对冠脉入口阶段采用等比例缩放提高对器械的操控能力,对靶血管阶段采用缩小的比例因子以提高器械操作的分辨率,实验结果验证了该方法的有效性。
 (4)力觉反馈是医生递送介入器械过程中的重要依据,为了实现微创血管介入手术机器人医生控制台侧的力反馈,设计了一种沿导丝轴向的力检测和力反馈方法。利用导丝与递送装置的相互作用,提出了在递送装置主指中采用扭矩传感器检测沿导丝轴向阻力的方法,结合机器人主从操作模式下不同的双边控制结构,设计了适合微创血管介入手术机器人平台的控制器,最后通过对导丝轴向力检测的校验和力反馈实验,验证了力检测和力反馈方法的可行性。
 (5)通过实验研究了微创血管介入机器人对导丝的操控性以及在活体内的可行性,利用机器人辅助递送导丝比徒手递送导丝精度要高,活体动物试验对整个系统进行了有效验证。为了比较机器人辅助导丝递送与徒手导丝递送的区别,采集并分析了实验过程中导丝的运动信息,在此基础上,利用微创血管介入手术机器人在活体动物的冠状动脉、颈动脉和肾动脉开展了10例血管介入支架置入和消融手术,取得了满意的试验效果。
其他摘要Cardiovascular disease is currently the No.1 killer all over the world. Compared with coronary artery bypass grafting, vascular intervention belongs to minimally invasive surgery. Because of the advantages such as less trauma, less pain and shorter recovery time, the vascular intervention has become a major treatment for the coronary heart disease. However, several crucial problems are still exist in the current vascular intervention: the interventional radiologist is more probably to have the cataract and brain tumor for the accumulation of X-ray radiation; the heavy load of lead apron causes severe damages to the cervical and lumbar vertebra of the surgeon; long time work during the vascular intervention offer leads to hand fatigue and tremor because the procedure is complex and the interventional devices are thin and difficult to manipulate. The robot has the characteristics of high precision, high stability and remote operation. By using the robot to assist the surgeon in the vascular intervention, the surgeon is protected from the X-ray radiation. Moreover, the work load of the surgeon is reduced and the precision of the guidewire delivery is improved. Supported by the National Hi-Tech R \& D Program (863) of China (Grant 2010AA044001) and the key project of the National Natural Science Foundation of China (Grant 61533016), this paper focuses on the design and control of the minimally invasive surgical robot for vascular intervention, aiming to solve the problems in the current vascular intervention. The main contributions and innovations of this research are as follows:
(1) A minimally invasive surgical robot is developed to solve the X-ray radiation, complex manipulation problems in the vascular intervention surgery. The robot is implemented in master-slave control method. The dual-finger robot hand (DRH) of the robot is placed beside the operation table in the catheterization lab and the console is put in the control room. Thus, the X-ray radiation to the surgeon is avoided by using the robot to conduct vascular intervention. The DRH of the robot is bio-inspired by the surgeon's fingers and can dexterously manipulate the devices. The console maintains the manipulation habits of the surgeon, so the surgeon can easily apply the experience during the surgery.
(2) The operation modes between the console and the DRH are built to obtain a high precision delivery for the guidewire and catheter. The translation and rotation of the interventional devices are realized by the rotation and translation of the bionic thumb and bionic forefinger of the DRH. The joystick of the console contains one translation degree of freedom (DOF) and one rotation DOF. Thus, we design translation mode, rotation mode, simultaneously translation and rotation mode, and balloon/stent catheter mode to deliver the devices in the vascular intervention. The devices can be delivered to the stenosis by combining different operation modes.
(3) By considering different requirements in the delivering procedure, a motion scaling based master-slave control method is proposed to magnify, minify or equally repeated the motion of the console. The delivery of the device is divided into three phases: the aorta phase, the coronary entry phase and the target vessel phase. By introducing the motion scaling factors into master-slave control, the aorta phase is magnified to reduce the X-ray exposure time. The coronary entry phase is reproduced to improve the controllability of the devices. In the target vessel phase, the manipulation is scaled-down to obtain a high precision. The effectiveness of the method is validated by experiment.
(4) To realize the force feedback in the console, force detection and force feedback methods are proposed. A force detection method is firstly designed in the bionic thumb of the DRH by using a torque sensor. Then, different structures of bilateral control method are combined with the mater-slave control of the robot. Bilateral controller is designed considering the structure of the vascular interventional robot. The force detection calibration experiment and force feedback experiment verify the feasibility of the proposed methods.
(5) The advantages of the guidewire delivery assisted by the robot is studied and in vivo trial is conducted. To compare the guidewire delivery between the robot assisted and freehand, the motions of the guidewire are collected and analyzed. The result shows that the guidewire delivery assisted by the robot has a high precision than freehand delivery. On this basis, we use the vascular interventional robot to conduct 10 cases of in vivo stent implantation and ablation, and the results of the in vivo trial are satisfying.
语种中文
文献类型学位论文
条目标识符http://ir.ia.ac.cn/handle/173211/11687
专题毕业生_博士学位论文
作者单位中国科学院自动化研究所
推荐引用方式
GB/T 7714
奉振球. 主从式微创血管介入手术机器人系统设计与控制[D]. 北京. 中国科学院大学,2016.
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