目的:使用基于显微视频的喉手术器械跟踪来研究机器人辅助对器械震颤的影响。
方法:实验试验。
方法:高等医学中心。
方法:在这项随机交叉试验中,记录了6名外科医生对尸体猪喉部进行左右皮质切除术的36个视频。这些录音记录了三种不同的情况:没有机器人的帮助,用机器人辅助剪刀,还有机器人辅助的抓紧器。为了评估工具震颤,我们采用基于计算机视觉的算法来跟踪手术工具.绝对震颤频带功率和归一化路径长度被用作定量测量。Wilcoxon秩和精确检验用于试验之间的统计分析和比较。此外,进行了调查,以评估机器人系统的易用性。
结果:与徒手器械相比,使用机器人辅助器械时,绝对震颤频带功率显着降低(P=.012)。与徒手试验相比,机器人辅助的归一化路径长度显着降低(P=.001)。对于剪刀来说,机器人辅助试验导致绝对震颤频带功率(P=.002)和归一化路径长度(P<.001)显著降低。对于抓紧者来说,绝对震颤频带功率无显著差异(P=4),但在机器人辅助试验中,归一化路径长度显著较低(P=0.03).
结论:这项研究表明,基于计算机视觉的方法可用于评估模拟喉部手术中的工具运动。结果表明,机器人辅助能够减少器械震颤。
OBJECTIVE: Use microscopic video-based tracking of laryngeal surgical instruments to investigate the effect of robot assistance on instrument tremor.
METHODS: Experimental trial.
METHODS: Tertiary Academic Medical Center.
METHODS: In this randomized cross-over trial, 36 videos were recorded from 6 surgeons performing left and right cordectomies on cadaveric pig larynges. These recordings captured 3 distinct conditions: without robotic assistance, with robot-assisted scissors, and with robot-assisted graspers. To assess tool tremor, we employed computer vision-based algorithms for tracking surgical tools. Absolute tremor bandpower and normalized path length were utilized as quantitative measures. Wilcoxon rank sum exact tests were employed for statistical analyses and comparisons between trials. Additionally, surveys were administered to assess the perceived ease of use of the robotic system.
RESULTS: Absolute tremor bandpower showed a significant decrease when using robot-assisted instruments compared to freehand instruments (P = .012). Normalized path length significantly decreased with robot-assisted compared to freehand trials (P = .001). For the scissors, robot-assisted trials resulted in a significant decrease in absolute tremor bandpower (P = .002) and normalized path length (P < .001). For the graspers, there was no significant difference in absolute tremor bandpower (P = .4), but there was a significantly lower normalized path length in the robot-assisted trials (P = .03).
CONCLUSIONS: This study demonstrated that computer-vision-based approaches can be used to assess tool motion in simulated microlaryngeal procedures. The results suggest that robot assistance is capable of reducing instrument tremor.