血管介入手术机器人及其力反馈技术研究进展

血管介入手术是一种利用导管和导丝等器械,在视觉影像引导下,通过皮肤微创穿刺进入血管,对病变部位进行诊疗的手术方式。它具有创伤小、恢复快、并发症少等优点,已成为心脑血管疾病等多种疾病的首选治疗方法。然而,由于血管的狭窄性和复杂性,在血管内部操作导管难以做到,加重了医生的认知负荷,延长了手术时间,继而增加操作者和患者的疲劳程度以及手术风险。另一方面,血管介入手术对医生操作熟练程度要求高,而可以开展大量手术的医生数量有限。这些都大大限制了血管介入手术的广泛应用。为了解决这些问题,机器人辅助血管介入手术因其精确性、灵活性、便捷性已经受到患者和医生的共同期待,是实现血管介入手术远程化、智能化、数字化的重要手段。然而,相对于血管介入手术机器人图像导航、机械臂结构等其他关键技术,力反馈技术仍然有较大空白,力反馈的缺失使其在复杂困难病变、钙化病变、慢性闭塞病变中的应用受到了限制。故笔者在此分析血管介入手术机器人力反馈技术的基本问题、实现方式和技术需求,并结合国内外研究进展,探讨了力反馈技术的发展方向,为血管介入手术机器人力反馈技术的研究提供了理论参考和实践指导。从工程设计的角度出发,从人手感知力问题和...

Vascular interventional surgery robot and its force feedback technology

Vascular interventional surgery is a surgical method that uses instruments such as catheters and guide wires to enter the blood vessels through a minimally invasive skin puncture under visual image guidance and performs diagnosis and treatment on the lesion site. It has the advantages of small trauma, fast recovery, and few complications, and it has become the preferred treatment method for various diseases, such as cardiovascular and cerebrovascular diseases. However, due to the narrow and complex nature of blood vessels, manipulating catheters inside them becomes challenging, increasing the cognitive load on doctors, prolonging surgery time, and raising fatigue levels and surgical risks for operators and patients. On the other hand, vascular interventional surgery requires the high proficiency of doctors, and the number of doctors who can carry out many operations is limited. These greatly limit the broad application of vascular interventional surgery. Robot-assisted vascular interventional surgery has been expected to solve these problems for its accuracy, flexibility, and convenience. Realizing vascular interventional surgery''s remoteization, intelligentization, and digitalization is essential. However, compared with other key technologies, such as image navigation and mechanical arm structure of vascular interventional surgery robots, force feedback technology still has a large gap. The lack of force feedback limits its application in complex and challenging, calcified, and chronic occlusive lesions. Therefore, this paper analyzes the fundamental problems, implementation methods, and technical requirements of force feedback technology for vascular interventional surgery robots and discusses the development direction of force feedback technology in combination with domestic and foreign research progress, providing theoretical reference and practical guidance for the research of force feedback technology for vascular interventional surgery robots. From the perspective of engineering design, the fundamental problems faced by force feedback technology are explained from two aspects: the problem of manual force perception and the problem of force compensation force loss, and the process of manual force perception, the range of perceived force, the causes of force loss and the method of force compensation are briefly described. Domestic and foreign research on force feedback technology for vascular interventional surgery robots is still in its infancy, mainly focusing on experimental verification and system development based on mechanical action, electrorheological fluid, and magnetorheological fluid. Although these methods can achieve a certain degree of force feedback effect, they also have some limitations and shortcomings: mechanical force feedback is difficult to overcome inertia; noise interference and large volume limit application scenarios; electrorheological fluid force feedback working voltage greatly exceeds human body safety threshold; magnetorheological fluid force feedback is accompanied by a large amount of heat and friction from the passive viscosity that interferes with accurate force presentation. Therefore, exploring more efficient, sensitive, stable, and suitable remote operation force feedback technology is necessary. In addition, "local force feedback" and "perceptual substitution" are two promising force feedback methods worth exploring. For the technical requirements of force feedback implementation, this paper analyzes in depth from sensor, force detection, and force feedback based on the force transmission process and elaborates on the latest research results at home and abroad. With the development of other interdisciplinary disciplines such as artificial intelligence, big data, the Internet of Things, wireless communication, materials science, and physics, more possibilities and innovations can be provided for force feedback technology for vascular interventional surgery robots. At the same time, establishing a monitoring platform based on information fusion technology, improving relevant laws and regulations, reducing costs, conducting clinical trials and validations, and integrating 5G and virtual reality technologies can enable broader applications of robot-assisted vascular intervention surgery.