背景:机器人技术是外科手术创新的重要工具,随着机器人越来越多地用于临床环境。机器人可以用来提高准确性,执行远程操作,或自动化任务。一个这样的手术任务是缝合,一个重复的,手术的基本组成部分,可能是繁琐和耗时的。Suturing是一个有前途的自动化目标,因为它无处不在,重复性,和定义的约束。本系统综述审查了迄今为止关于自主缝合的研究。
方法:根据PRISMA指南对集中于自主缝合的文献进行了系统综述。
结果:6850篇文章是通过搜索PubMed,Embase,Compendex,和Inspec。删除了重复和非英语文章。筛选4389篇,排除4305篇。剩下的84个,43篇文章不符合标准,留下41篇文章供最后审查。其中,34(81%)在2014年之后发布。31(76%)发表在工程学杂志9在机器人杂志上,在医学杂志上排名第一。绝大多数文章(33%,80%)没有具体的临床专业重点,而6例(15%)专注于MIS/腹腔镜手术的应用,2例(5%)专注于眼科应用.确定了几个缝合子任务,包括打结,缝合线通过/针插入,针通过,针和缝线抓,针跟踪/动觉,缝合线检测,缝合针形状制作,仪器分配,和缝合精度。14篇文章被认为是多部分的,因为它们提到了前面提到的几个子任务。
结论:在这项系统综述中,探索迄今为止关于自主缝合的研究,41篇文章证明了机器人缝合方面的重大进展。这一总结揭示了工作的显著异质性,作者专注于缝合的不同方面和许多工程问题。该综述表明,人们对外科自动化的学术和商业兴趣日益增加。随着技术向可行性的重大进步。
BACKGROUND: Robotic technology is an important tool in surgical innovation, with robots increasingly being used in the clinical setting. Robots can be used to enhance accuracy, perform remote actions, or to automate tasks. One such surgical task is
suturing, a repetitive, fundamental component of surgery that can be tedious and time consuming. Suturing is a promising automation target because of its ubiquity, repetitive nature, and defined constraints. This systematic review examines research to date on autonomous
suturing.
METHODS: A systematic review of the literature focused on autonomous
suturing was conducted in accordance with PRISMA guidelines.
RESULTS: 6850 articles were identified by searching PubMed, Embase, Compendex, and Inspec. Duplicates and non-English articles were removed. 4389 articles were screened and 4305 were excluded. Of the 84 remaining, 43 articles did not meet criteria, leaving 41 articles for final review. Among these, 34 (81%) were published after 2014. 31 (76%) were published in an engineering journal9 in a robotics journal, and 1 in a medical journal. The great majority of articles (33, 80%) did not have a specific clinical specialty focus, whereas 6 (15%) were focused on applications in MIS/laparoscopic surgery and 2 (5%) on applications in ophthalmology. Several suturing subtasks were identified, including knot tying, suture passing/needle insertion, needle passing, needle and suture grasping, needle tracking/kinesthesia, suture thread detection, suture needle shape production, instrument assignment, and suture accuracy. 14 articles were considered multi-component because they referred to several previously mentioned subtasks.
CONCLUSIONS: In this systematic review exploring research to date on autonomous
suturing, 41 articles demonstrated significant progress in robotic
suturing. This summary revealed significant heterogeneity of work, with authors focused on different aspects of suturing and a multitude of engineering problems. The review demonstrates increasing academic and commercial interest in surgical automation, with significant technological advances toward feasibility.