UG平台机器人辅助微创冠状动脉搭桥手术的创口术前规划

UG platform based preoperative wound planning of minimal invasive robot-assisted coronary artery bypass grafting

目前机器人辅助微创冠状动脉搭桥手术的创口规划停留在术前阅片,术中结合骨性标志决定手术方案的方式,个体差异大,依赖主观经验,缺乏客观衡量指标。针对现状,文章提出并实现了一套交互式创口术前规划方法。该方法首先根据解剖学知识和手术机器人运动学规律,建立了创口规划的优化标准,其次利用患者计算机断层扫描数据,重建患者心脏和肋骨模型,建立了交互式创口规划环境,具有创口放置和优选等功能,医生在该环境下进行虚拟创口放置,由计算机根据优化标准进行筛选,给出3个最优创口位置用来通过内窥镜和左右器械。6例患者数据统计表明,在手术器械可操作性、灵活性、手术视野覆盖范围等指标上较传统方法有明显改善。此方法在通用计算机辅助设计软件平台上通过二次开发完成,使用直观,结果具有客观性。

Preoperative wound planning is of great significance to minimal invasive robot-assisted coronary artery bypass grafting. The current program and method are based on the bone markers and the surgeons＇ experience, lacking of quantitative rules. In this paper, a quantitative preoperative wound planning method is proposed. First, quantitative wound planning rules are built up based on anatomy and kinematic rules of operative robot. Patient 3D model of heart and rib is reconstructed on CT scanning images and imported to an interactive graphical environment, where surgeons can place the wound on the 3D model. Three placed wounds are selected based on the rules automatically and presented under endoscope and operative tools. By comparing the selected and regular wounds of 6 cases, the agility of operation, surgical site accessibility, and view scope relative to traditional method are significantly improved. The novel method and graphic environment are implemented on general purpose computer aided design software platform UG, so the results are objective.