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A Parallel Robot With Remote Centre-of-Motion for Eye Surgery: Design, Kinematics, Prototype, and Experiments 用于眼科手术的具有远程运动中心的并行机器人:设计、运动学、原型和实验。
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2024-08-13 DOI: 10.1002/rcs.2665
Yinglun Jian, Yan Jin, Mark Price, Johnny Moore

Background

Millions of patients suffering from eye disease cannot receive proper treatment due to the lack of qualified surgeons. Medical robots have the potential to solve this problem and have attracted significant attention in the research community.

Method

This paper proposes a novel parallel robot with a remote centre of motion for minimally invasive eye surgery. Kinematics models, singularity and workspace analyses, and dimension optimisation are conducted. A prototype was developed, and experiments were conducted to test its mobility, accuracy, precision and stiffness.

Results

The prototype robot can successfully perform the required motions, and has a precision ranging from 7 ± 2 μm to 30 ± 8 μm, accuracy from 21 ± 10 μm to 568 ± 374 μm, and stiffness ranging from 1.22 ± 0.39 N/mm to 10.53 ± 5.18 N/mm.

Conclusion

The prototype robot has a great potential for performing the minimally invasive surgery. Its stiffness meets the design requirement, but its accuracy and precision need to be further improved.

背景:由于缺乏合格的外科医生,数百万眼疾患者无法得到适当的治疗。医疗机器人有可能解决这一问题,并已引起研究界的极大关注:本文提出了一种用于微创眼科手术的具有远程运动中心的新型并联机器人。本文建立了运动学模型,进行了奇异性和工作空间分析,并对尺寸进行了优化。开发了一个原型,并进行了实验来测试其移动性、准确性、精确性和刚度:结果:机器人原型能够成功完成所需的动作,精度范围为 7 ± 2 μm 至 30 ± 8 μm,准确度范围为 21 ± 10 μm 至 568 ± 374 μm,刚度范围为 1.22 ± 0.39 N/mm 至 10.53 ± 5.18 N/mm:原型机器人在执行微创手术方面潜力巨大。结论:该机器人原型在执行微创手术方面具有巨大潜力,其刚度符合设计要求,但其准确性和精确度有待进一步提高。
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引用次数: 0
Design and Research of the Grasping Force Feedback Mechanism of Flexible Surgical Robots 柔性手术机器人抓取力反馈机制的设计与研究
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2024-08-09 DOI: 10.1002/rcs.2667
Fuhao Wang, Ye Wang, Qiqi Pan, Jingjing Luo, Hongbo Wang, Xiaoyang Kang, Xueze Zhang

Background

Robot-assisted microsurgery (RAMS) is gradually becoming the preferred method for some delicate surgical procedures. However, the lack of haptic feedback reduces the safety of the surgery. Surgeons are unable to feel the grasping force between surgical instruments and the patient's tissues, which can easily lead to grasping failure or tissue damage.

Methods

This paper proposes a tendon-driven grasping force feedback mechanism, consisting of a follower hand and a leader hand, to address the lack of grasping force feedback in flexible surgical robots. Considering the friction in the tendon transmission process, a grasping force estimation model is established for the follower hand. The admittance control model is designed for force/position control of the leader hand.

Results

Through experimental validation, it has been confirmed that the grasping force sensing range of the follower hand is 0.5–5 N, with a sensing accuracy of 0.3 N. The leader hand is capable of providing feedback forces in the range of 0–5 N, with a static force accuracy of 0.1 N.

Conclusions

The designed mechanism and control strategy can provide the grasping force feedback function. Future work will focus on improving force feedback performance.

Trial Registration

This research has no clinical trials.

背景:机器人辅助显微外科手术(RAMS)逐渐成为一些精细外科手术的首选方法。然而,触觉反馈的缺乏降低了手术的安全性。外科医生无法感受到手术器械与患者组织之间的抓取力,这很容易导致抓取失败或组织损伤:本文针对柔性手术机器人缺乏抓取力反馈的问题,提出了一种由跟随手和领导手组成的肌腱驱动抓取力反馈机制。考虑到肌腱传输过程中的摩擦,建立了从动手抓取力估计模型。结果:通过实验验证,确认从动手的抓取力感应范围为 0.5-5 N,感应精度为 0.3 N:结论:所设计的机构和控制策略能够提供抓取力反馈功能。今后的工作重点是提高力反馈性能:本研究没有临床试验。
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引用次数: 0
Tremor Estimation and Removal in Robot-Assisted Surgery Using Improved Enhanced Band-Limited Multiple Fourier Linear Combiner 利用改进的增强型带限多重傅立叶线性组合器在机器人辅助手术中估计和消除震颤
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2024-08-02 DOI: 10.1002/rcs.2666
Wenjie Wang, Boqiang Jia, Jianwei Ma, Xiaohua Wang, Huajian Song

Background

During a robot-assisted minimally invasive surgery, hand tremors in a surgeon's manipulation of the master manipulator can cause vibrations of the slave surgical instruments.

Methods

This letter addresses this problem by proposing an improved Enhanced Band-Limited Multiple Linear Fourier Combiner (E-BMFLC) algorithm for filtering the physiological tremor signals of a surgeon's hand. The proposed method uses the amplitude of the input signal to adapt the learning rate and a dense division of the combiner bands for the higher amplitude bands of the tremor signals.

Results

By using the proposed improved E-BMFLC algorithm, the compensation accuracy can be improved by 4.5%–8.9%, as well as a spatial position error of less than 1 mm.

Conclusion

The results show that among all filtering methods, the improved E-BMFLC filtering method has the highest number of successful experiments and the lowest experimental time.

背景:在机器人辅助微创手术过程中,外科医生操纵主机械手时的手部震颤会引起从属手术器械的振动:本文针对这一问题,提出了一种用于过滤外科医生手部生理震颤信号的改进型增强带限多重线性傅立叶组合器(E-BMFLC)算法。所提出的方法利用输入信号的振幅来调整学习率,并对震颤信号的较高振幅波段进行组合器波段的密集划分:通过使用所提出的改进型 E-BMFLC 算法,补偿精度可提高 4.5%-8.9%,空间位置误差小于 1 mm:结果表明,在所有滤波方法中,改进型 E-BMFLC 滤波方法的实验成功次数最多,实验时间最短。
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引用次数: 0
Robotic versus open mini-incision living donor nephrectomy: Single centre experience 机器人与开放式小切口活体供体肾切除术:单中心经验。
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2024-07-16 DOI: 10.1002/rcs.2658
Seung Duk Lee, Kush Savsani, Sarah Ziqi Wang, Chandra Bhati, Yuzuru Sambommatsu, Daisuke Imai, Aamir Khan, Irfan Saeed, Amit Sharma, Vinay Kumaran, Adrian Cotterell, Marlon Levy, David A. Bruno

Background

Robotic surgery is associated with less tissue manipulation and earlier recovery with minimal incision. The aim of this study was to compare the short-term clinical outcomes between robotic-assisted donor nephrectomy (RDN) and open mini-incision donor nephrectomy (ODN).

Methods

From 2016 to 2019, 141 cases involving RDN were analysed. Patient outcomes were compared with those of 191 patients who underwent ODN from 2010 to 2015. Demographics, operation factors, perioperative outcomes, and complications were retrospectively reviewed.

Results

The RDN group presented with less blood loss than the ODN group (p = 0.023). The length of hospital stay was significantly shorter in the RDN group than in the ODN group (p < 0.005). The overall rate of complications was low and there was no significant difference in complication rates between the groups.

Conclusion

The robotic approach has benefits over the traditional open approach, including shorter length of hospital stay and reduced intraoperative blood loss.

背景:机器人手术具有组织操作少、切口小、恢复快等优点。本研究旨在比较机器人辅助供体肾切除术(RDN)和开放式小切口供体肾切除术(ODN)的短期临床效果:方法:分析了2016年至2019年期间141例涉及RDN的病例。将患者的预后与 2010 年至 2015 年接受 ODN 的 191 例患者的预后进行比较。对人口统计学、手术因素、围手术期结果和并发症进行回顾性审查:RDN组的失血量少于ODN组(P = 0.023)。RDN组的住院时间明显短于ODN组(P 结论:机器人手术方法比ODN手术方法更有优势:与传统的开放式方法相比,机器人方法具有住院时间短、术中失血量减少等优点。
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引用次数: 0
The application of robotics in plastic and reconstructive surgery: A systematic review 机器人技术在整形外科中的应用:系统综述。
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2024-07-14 DOI: 10.1002/rcs.2661
Francesca Ruccia, Akash Mavilakandy, Hassan Imtiaz, John Erskine, Yong Yie Liew, Meyada Ali, Ankur Khajuria

Background

Robotic assisted surgery (RAS) has seen significant advancement in many surgical specialties, although the application of robotics in plastic and reconstructive surgery remains to be widely established. This systematic review aims to assess the role of RAS in plastic and reconstructive surgery.

Methods

The review protocol was published and registered a priori as CRD42024507420. A comprehensive electronic search for relevant studies was performed in MEDLINE, Embase and Google scholar databases.

Results

Overall, 132 studies were initially identified, of which, 44 studies satisfied the eligibility criteria with a cumulative total of 239 patients. RAS demonstrated a high degree of procedural success and anastomotic patency in microvascular procedures. There was no significant difference in periprocedural adverse events between robotic and manual procedures.

Conclusion

RAS can be feasibly implemented in plastic and reconstructive surgery with a good efficacy and safety profile, particularly for microsurgical anastomosis and trans-oral surgery.

背景:机器人辅助手术(RAS)在许多外科专科都取得了重大进展,但机器人技术在整形和重建外科的应用仍有待广泛确立。本系统综述旨在评估机器人辅助手术在整形与重建外科中的作用:综述方案已发布,并事先注册为 CRD42024507420。在 MEDLINE、Embase 和 Google scholar 数据库中对相关研究进行了全面的电子检索:总体而言,初步确定了 132 项研究,其中 44 项符合资格标准,累计 239 名患者。在微血管手术中,RAS 的手术成功率和吻合口通畅率都很高。机器人手术与人工手术在围手术期不良事件方面没有明显差异:结论:在整形和重建外科手术中使用机器人手术系统具有良好的疗效和安全性,尤其是在微创吻合术和经口手术中。
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引用次数: 0
Simulating blood accumulation with improved smoothed particle hydrodynamics in surgical simulation system 在手术模拟系统中利用改进的平滑粒子流体力学模拟血液积聚。
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2024-07-14 DOI: 10.1002/rcs.2663
Pengyu Sun, Peter Xiaoping Liu

Background

Blood accumulation often occurs during bleeding in surgery. Simulating the blood accumulation in surgical simulation system not only enhances the realism and immersion of surgical training, but also helps researchers better understand the physical properties of blood flow.

Methods

To realistically simulate the blood accumulation during the bleeding, this paper proposes a novel kernel function with non-negative second derivatives to improve the SPH method. Meanwhile, a simple form of boundary force equation is constructed to impose the solid boundary condition.

Results

We simulate the blood accumulation during liver bleeding and vessel bleeding respectively in the surgical simulation system. The simulation results show that there is no occurrence of blood physically penetrating the boundary.

Conclusions

Applying the solid boundary condition to the blood by using the method proposed in this paper is not only convenient but can also eliminate compression instability in the blood accumulation simulation.

背景:外科手术出血时经常会出现积血现象。在手术模拟系统中模拟积血不仅能增强手术训练的真实感和沉浸感,还能帮助研究人员更好地理解血流的物理特性:为了真实模拟出血过程中的积血现象,本文提出了一种具有非负二阶导数的新型核函数来改进 SPH 方法。结果:我们模拟了肝脏出血过程中的血液积聚:我们在手术模拟系统中分别模拟了肝脏出血和血管出血时的积血情况。模拟结果表明,没有出现血液物理穿透边界的情况:结论:利用本文提出的方法对血液应用固体边界条件不仅方便,而且可以消除积血模拟中的压缩不稳定性。
{"title":"Simulating blood accumulation with improved smoothed particle hydrodynamics in surgical simulation system","authors":"Pengyu Sun,&nbsp;Peter Xiaoping Liu","doi":"10.1002/rcs.2663","DOIUrl":"10.1002/rcs.2663","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Blood accumulation often occurs during bleeding in surgery. Simulating the blood accumulation in surgical simulation system not only enhances the realism and immersion of surgical training, but also helps researchers better understand the physical properties of blood flow.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To realistically simulate the blood accumulation during the bleeding, this paper proposes a novel kernel function with non-negative second derivatives to improve the SPH method. Meanwhile, a simple form of boundary force equation is constructed to impose the solid boundary condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We simulate the blood accumulation during liver bleeding and vessel bleeding respectively in the surgical simulation system. The simulation results show that there is no occurrence of blood physically penetrating the boundary.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Applying the solid boundary condition to the blood by using the method proposed in this paper is not only convenient but can also eliminate compression instability in the blood accumulation simulation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"20 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development and clinical validation of a deep learning-based knee CT image segmentation method for robotic-assisted total knee arthroplasty 为机器人辅助全膝关节置换术开发基于深度学习的膝关节 CT 图像分割方法并进行临床验证。
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2024-07-12 DOI: 10.1002/rcs.2664
Xingyu Liu, Songlin Li, Xiongfei Zou, Xi Chen, Hongjun Xu, Yang Yu, Zhao Gu, Dong Liu, Runchao Li, Yaojiong Wu, Guangzhi Wang, Hongen Liao, Wenwei Qian, Yiling Zhang

Background

This study aimed to develop a novel deep convolutional neural network called Dual-path Double Attention Transformer (DDA-Transformer) designed to achieve precise and fast knee joint CT image segmentation and to validate it in robotic-assisted total knee arthroplasty (TKA).

Methods

The femoral, tibial, patellar, and fibular segmentation performance and speed were evaluated and the accuracy of component sizing, bone resection and alignment of the robotic-assisted TKA system constructed using this deep learning network was clinically validated.

Results

Overall, DDA-Transformer outperformed six other networks in terms of the Dice coefficient, intersection over union, average surface distance, and Hausdorff distance. DDA-Transformer exhibited significantly faster segmentation speeds than nnUnet, TransUnet and 3D-Unet (p < 0.01). Furthermore, the robotic-assisted TKA system outperforms the manual group in surgical accuracy.

Conclusions

DDA-Transformer exhibited significantly improved accuracy and robustness in knee joint segmentation, and this convenient and stable knee joint CT image segmentation network significantly improved the accuracy of the TKA procedure.

研究背景本研究旨在开发一种名为双路径双注意变换器(DDA-Transformer)的新型深度卷积神经网络,以实现精确、快速的膝关节 CT 图像分割,并在机器人辅助全膝关节置换术(TKA)中进行验证:评估了股骨、胫骨、髌骨和腓骨的分割性能和速度,并对使用该深度学习网络构建的机器人辅助全膝关节置换术(TKA)系统的组件尺寸、骨切除和对位的准确性进行了临床验证:总体而言,DDA-Transformer在骰子系数、交集大于联合、平均表面距离和豪斯多夫距离方面的表现优于其他六个网络。DDA-Transformer 的分割速度明显快于 nnUnet、TransUnet 和 3D-Unet (p 结论:DDA-Transformer 的分割速度明显快于 nnUnet、TransUnet 和 3D-Unet :DDA-Transformer 在膝关节分割方面的准确性和鲁棒性都有明显提高,这种方便、稳定的膝关节 CT 图像分割网络显著提高了 TKA 手术的准确性。
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引用次数: 0
A review of robot-assisted ultrasound examination: Systems and technology 机器人辅助超声波检查综述:系统与技术。
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2024-07-08 DOI: 10.1002/rcs.2660
Haiyan Du, Xinran Zhang, Yongde Zhang, Fujun Zhang, Letao Lin, Tao Huang

Background

At present, the number and overall level of ultrasound (US) doctors cannot meet the medical needs, and the medical ultrasound robots will largely solve the shortage of medical resources.

Methods

According to the degree of automation, the handheld, semi-automatic and automatic ultrasound examination robot systems are summarised. Ultrasound scanning path planning and robot control are the keys to ensure that the robot systems can obtain high-quality images. Therefore, the ultrasound scanning path planning and control methods are summarised. The research progress and future trends are discussed.

Results

A variety of ultrasound robot systems have been applied to various medical works. With the continuous improvement of automation, the systems provide high-quality ultrasound images and image guidance for clinicians.

Conclusion

Although the development of medical ultrasound robot still faces challenges, with the continuous progress of robot technology and communication technology, medical ultrasound robot will have great development potential and broad application space.

背景:目前,超声(US)医生的数量和整体水平无法满足医疗需求,而医用超声机器人将在很大程度上解决医疗资源短缺的问题:目前,超声(US)医生的数量和整体水平无法满足医疗需求,而医用超声机器人将在很大程度上解决医疗资源短缺的问题:方法:根据自动化程度,总结了手持式、半自动式和全自动式超声检查机器人系统。超声扫描路径规划和机器人控制是确保机器人系统获得高质量图像的关键。因此,总结了超声波扫描路径规划和控制方法。讨论了研究进展和未来趋势:各种超声波机器人系统已被应用于各种医疗工作中。随着自动化程度的不断提高,这些系统为临床医生提供了高质量的超声图像和图像引导:结论:尽管医用超声机器人的发展仍面临挑战,但随着机器人技术和通信技术的不断进步,医用超声机器人将具有巨大的发展潜力和广阔的应用空间。
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引用次数: 0
Effects of perirenal fat thickness on postoperative renal dysfunction in patients who underwent robot-assisted partial nephrectomy for renal tumours 肾周脂肪厚度对肾肿瘤机器人辅助肾部分切除术患者术后肾功能障碍的影响
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2024-07-05 DOI: 10.1002/rcs.2662
Ryoma Nishikawa, Shuichi Morizane, Atsushi Yamamoto, Hiroshi Yamane, Ryutaro Shimizu, Yusuke Kimura, Noriya Yamaguchi, Katsuya Hikita, Masashi Honda, Atsushi Takenaka

Background

Despite partial nephrectomy (PN) renal function preservation benefits, postoperative renal dysfunction may occur. Perirenal fat thickness (PFT) is associated with renal dysfunction such as diabetes; however, its role in renal tumour surgery is unclear. This study investigates the role of PFT in renal function after robot-assisted partial nephrectomy (RAPN).

Methods

Pre-operative factors for postoperative renal dysfunction were analysed in 156 patients undergoing RAPN with ≥1-year follow-up. PFT measured using computed tomography categorised patients with PFT >21.0 mm (median) as high-PFT.

Results

Tumour size, total R.E.N.A.L. nephrometry score and its N component, renal calyx opening, achievement of trifecta, and PFT were risk factors for renal dysfunction 1 year postoperatively. Age ≥75 years (p = 0.024), total RNS ≥7 (p = 0.036), and PFT >21.0 mm (p = 0.002) significantly correlated with postoperative renal dysfunction.

Conclusions

CT-measured PFT is a valuable predictor of postoperative renal dysfunction.

背景:尽管肾部分切除术(PN)具有保留肾功能的优点,但术后仍可能出现肾功能障碍。肾周脂肪厚度(PFT)与糖尿病等肾功能障碍有关,但其在肾肿瘤手术中的作用尚不清楚。本研究探讨了PFT在机器人辅助肾部分切除术(RAPN)后肾功能中的作用:方法:对 156 名接受 RAPN 手术且随访时间≥1 年的患者进行了术前肾功能障碍因素分析。使用计算机断层扫描测量 PFT,将 PFT >21.0mm(中位数)的患者归为高 PFT:结果:肿瘤大小、R.E.N.A.L.肾测定总分及其 N 组分、肾萼开口、三联征完成情况和 PFT 是术后 1 年肾功能不全的危险因素。年龄≥75岁(p = 0.024)、总RNS≥7(p = 0.036)和PFT >21.0 mm(p = 0.002)与术后肾功能不全显著相关:结论:CT测量的PFT是预测术后肾功能不全的重要指标。
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引用次数: 0
Combining robotics and 3D printing facilitates closed reduction of humeral shaft fractures using a minimally invasive plate as a reduction template: A proof-of-concept study 结合机器人技术和 3D 打印技术,使用微创钢板作为还原模板,促进肱骨轴骨折的闭合还原:概念验证研究。
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2024-07-05 DOI: 10.1002/rcs.2656
Dapeng Liu, Jinghao Liang, Hongju Yang

Background

Minimally invasive percutaneous plate osteosynthesis for humeral shaft fractures (HSFs) has limitations due to malreduction and radiation exposure. To address these limitations, we integrated robotics and 3D printing by incorporating plates as reduction templates.

Method

The innovative technology facilitated closed reduction of HSFs in the operating theatre using 18 models with cortical marking holes. The dataset of the precontoured plate was imported into 3D planning software for virtual fixation and screw path planning. The models were divided into half to simulate transverse fractures. During the operation, the software generated drilling trajectories for robot navigation, and precise plate installation achieved automatic fracture reduction.

Results

The evaluation results of reduction accuracy revealed variations in length, apposition, alignment, and rotation that meet the criteria for anatomic reduction. High interoperator reliabilities were observed for all parameters.

Conclusions

The proposed technology achieved anatomic reduction in simulated bones.

背景:微创经皮钢板骨合成术治疗肱骨轴骨折(HSFs)有其局限性,原因是钢板还原不良和辐射暴露。为了解决这些局限性,我们整合了机器人技术和 3D 打印技术,将钢板作为还原模板:方法:这项创新技术利用 18 个带有皮质标记孔的模型,在手术室内完成了 HSF 的闭合复位。预轮廓钢板的数据集被导入三维规划软件,用于虚拟固定和螺钉路径规划。模型被分成两半,以模拟横向骨折。在操作过程中,软件为机器人导航生成钻孔轨迹,钢板的精确安装实现了骨折的自动复位:结果:骨折复位精确度的评估结果显示,长度、位置、对齐和旋转的变化符合解剖复位的标准。所有参数的操作员间可靠性都很高:结论:所提出的技术实现了模拟骨骼的解剖复位。
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引用次数: 0
期刊
International Journal of Medical Robotics and Computer Assisted Surgery
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