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A method of lumbar pedicle screw placement optimization applied to guidance techniques 一种应用于引导技术的腰椎椎弓根螺钉放置优化方法
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2016-11-03 DOI: 10.1080/24699322.2016.1240301
Chen Xiaozhao, Hu Jinfeng, Mao Baolin, Yan Chongnan, K. Yan
Abstract Pedicle screws are an established method for spinal segmental fixation. To pursue high accuracy and minimally invasive, various different guidance techniques have developed. However, the preoperative screw position plans are determined by manual selection which demands complex operations and costs a lot of time. In addition, the current paths planning only consider the position, without taking the postoperative screws retention into consideration. In order to solve the problems, a new method was proposed to plan the lumbar pedicle screw placement automatically. Firstly, identify pedicle area and establish initial path based on the current vertebrae segmentation technology. After that, optimize path via the improved boundary limited Nelder–Mead simplex algorithm, and get the highest firmness path in theory. We considered that both the accuracy of position and the firmness of postoperative screws, achieved a fully automatic optimal path planning, which can effectively assist operators, improve the firmness of screw placement.
椎弓根螺钉是脊柱节段性固定的常用方法。为了追求高精度和微创性,各种不同的制导技术得到了发展。然而,术前螺钉位置方案均为人工选择,操作复杂,耗时长。此外,目前的路径规划只考虑了位置,没有考虑术后螺钉的留位。为了解决这一问题,提出了一种自动规划腰椎椎弓根螺钉置入的新方法。首先,基于现有的椎体分割技术,识别椎弓根区域并建立初始路径;然后,通过改进的边界受限Nelder-Mead单纯形算法对路径进行优化,得到理论上最优的坚定度路径。我们综合考虑了术后螺钉位置的准确性和牢固性,实现了全自动的最优路径规划,可以有效地辅助操作人员,提高螺钉置入的牢固性。
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引用次数: 10
Free vibration model and theoretical solution of the tympanic membrane 鼓膜自由振动模型及理论解
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2016-10-28 DOI: 10.1080/24699322.2016.1240315
Can Wu, Ying Chen, M. Al-Furjan, Jing Ni, Xiao Yang
Abstract Myringoplasty is one of the routine surgeries in the treatment of tympanic membrane (TM) perforation. Since the gross anatomical structure of the middle ear cannot be simulated in clinical practice, the surgery is mainly performed by experience and expertise. Based on the mechanical properties of TM, four hypotheses are presented where TM is simplified as a sectorial annulus membrane. This paper proposes a free vibration model of TM whose natural frequency of free vibration and the analytical expressions of corresponding natural vibration mode are obtained by variables separation method and Bessel function. Compared with the ANSYS numerical results, it shows that natural frequency calculated by finite element (FE) method is slightly higher because of the increase of model stiffness by ignoring high-order quantity. Compared with the experimental data from volunteers, it shows that the first-order, second-order and third-order principal resonances in the test are the combined effects of multiple natural frequencies and natural vibration modes instead of the single one. The theoretical model deduced in this paper is in higher precision with comparatively fewer parameters. It provides more precise mechanical reference to myringoplasty by calculating the response of the normal human ear.
摘要鼓膜成形术是治疗鼓膜穿孔的常规手术之一。由于临床无法模拟中耳大体解剖结构,手术主要依靠经验和专业知识进行。基于TM的力学特性,提出了将TM简化为扇形环膜的四种假设。本文提出了一种TM的自由振动模型,利用变量分离法和贝塞尔函数得到了TM的自由振动固有频率和相应的固有振型解析表达式。与ANSYS数值计算结果对比表明,忽略高阶量时,由于模型刚度的增加,有限元法计算的固有频率略高。与志愿者实验数据的对比表明,试验中的一阶、二阶和三阶主共振是多个固有频率和固有振型的综合效应,而不是单一的固有频率和固有振型。本文推导的理论模型参数相对较少,精度较高。它通过计算正常人耳的反应,为鼓膜成形术提供了更精确的机械参考。
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引用次数: 4
Master–slave real-time control strategy in Cartesian space for a novel surgical robot for minimally invasive surgery 一种新型微创手术机器人笛卡尔空间主从实时控制策略
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2016-10-28 DOI: 10.1080/24699322.2016.1240316
Bo Pan, Xiaofeng Qu, Yue Ai, Yili Fu, Chang Liu
Abstract Robot-assisted systems can enhance the precision of surgical procedures, and have been widely used in minimally invasive surgery (MIS). This paper proposes the master–slave real-time control strategy for a novel surgical robot for MIS. The robot is equipped with two instrument manipulators and one laparoscope manipulator. The control strategy solves problems of kinematics transformation on consistency principle, intra-operative re-mapping and tremor attenuation in real-time. The kinematics model of slave instrument manipulators is established, and the master–slave control method in Cartesian space is proposed. Intra-operative re-mapping and real-time tremor attenuation algorithms are also proposed as auxiliary functions to improve surgical robot’s performance. The proposed methods are verified by respective experiments. Finally, animal experiment is performed to verify the correctness and efficiency of the control strategy in this research.
机器人辅助系统可以提高手术的精度,在微创手术中得到了广泛的应用。提出了一种用于管理信息系统的新型手术机器人的主从实时控制策略。该机器人配备两个器械机械手和一个腹腔镜机械手。该控制策略解决了一致性原则下的运动学变换、术中重映射和实时震颤衰减问题。建立了从式仪表机械手的运动学模型,提出了笛卡尔空间中的主从控制方法。此外,还提出了术中重映射和实时震颤衰减算法作为辅助功能,以提高手术机器人的性能。通过实验验证了所提方法的正确性。最后,通过动物实验验证了本研究控制策略的正确性和有效性。
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引用次数: 7
A Hessian plate filter and shape feature-based approach to automatically localizing the NT VOI of 3D ultrasound data 一种基于Hessian板滤波和形状特征的三维超声数据NT VOI自动定位方法
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2016-10-28 DOI: 10.1080/24699322.2016.1240317
Siqing Nie, Jinhua Yu, Ping-Han Chen, Yuanyuan Wang, Jian Qiu Zhang
Abstract The thickness of nuchal translucency (NT) is one of the most important parameters to be detected in prenatal screening during the first trimester of pregnancy. In this paper, an automatic method is proposed for the localization of the volume of interest (VOI) of NT in three-dimensional (3D) ultrasound data. With the size and position of the fetal head and the equation of the sagittal plane in the 3D ultrasound data as the prior knowledge, the method can be divided into three steps. First, a Hessian-based plate filter is proposed to enhance the possible plates in the volume. Second, several VOIs with large filter responses are selected as candidates. Those VOIs consisting of several connected planes are segmented according to the prior knowledge of the sagittal plane. Third, a set of shape features is proposed to select the NT VOI with the maximum probability. Automatic fetal head localization and sagittal plane detection can be achieved using our previously proposed methodology, which means fully automatic NT volume detection could be reached by using our method. The proposed method produces 86.36% localization accuracy with the manual selection as the ground truth.
摘要颈半透明厚度(NT)是妊娠早期产前筛查中最重要的检测参数之一。提出了一种三维超声数据中NT感兴趣体积(VOI)的自动定位方法。该方法以胎儿头部的大小和位置以及三维超声数据中的矢状面方程为先验知识,分为三步。首先,提出了一种基于hessian的平板滤波器来增强体积中可能存在的平板。其次,选取滤波响应较大的几个voi作为候选voi;根据矢状面的先验知识对由多个连通平面组成的VOIs进行分割。第三,提出了一组形状特征,以最大概率选择NT VOI。使用我们之前提出的方法可以实现自动胎头定位和矢状面检测,这意味着使用我们的方法可以实现全自动NT体积检测。该方法以人工选择为地面真值,定位精度为86.36%。
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引用次数: 2
Control system design for a novel minimally invasive surgical robot 一种新型微创手术机器人的控制系统设计
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2016-10-28 DOI: 10.1080/24699322.2016.1240313
Yue Ai, Bo Pan, Yili Fu, Shuguo Wang
Abstract A novel separate robotic system for minimally invasive surgery (MIS) has been presented in this paper. Control system architectures were designed, basing on versatile performance criteria. The compact control and mechanical structure were suitable for medical environment. Function and safety design satisfying medical application were integrated into the robot system as well. Additionally, intuitive control algorithm solved the problems of hand-eye incoordination and workspace mismatch between master hands and slave arms during the master–slave control process. A series of experiments have been accomplished to evaluate the performance of the robotic system at last. The results demonstrated that the robotic system was capable of executing surgical operation intuitively and implementing auxiliary functions perfectly, which meant that the control system was feasible and reliable.
摘要:本文提出了一种新型的独立微创手术机器人系统。基于通用性能标准,设计了控制系统架构。紧凑的控制和机械结构适合于医疗环境。将满足医疗应用的功能和安全设计融入到机器人系统中。此外,直观控制算法还解决了主从控制过程中存在的手眼不协调、主从臂工作空间不匹配等问题。最后完成了一系列的实验来评估机器人系统的性能。结果表明,该机器人系统能够直观地执行手术操作,并能较好地实现辅助功能,说明该控制系统可行、可靠。
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引用次数: 5
Evaluating environment radiations at Axesse linac undergoing NPC treatment of VMAT 评估Axesse linac接受鼻咽癌治疗的环境辐射
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2016-10-28 DOI: 10.1080/24699322.2016.1240308
L. F. Chen, H. Tseng, L. Pan, J. B. Lin, H. S. Huang, W. Lai, C. Y. Chen
Abstract Environment radiations in vault rooms resulting from Axesse linac use was assessed at Medical University Hospital using Thermoluminescent dosimeters (TLDs) during the use of the new radiation treatment known as volumetric modulated arc therapy (VMAT) in the treatment of nasopharyngeal cancer (NPC). The TLD-100H was calibrated using linac 6 MV photons. A total of 75 measurement points of the TLD-100H were utilized for environmental monitoring. The measured environment radiations were then visualized as three-dimensional graphical representations. Environment radiations were visualized using colored three-dimentional graphical representations. The radiations in NPC treatment of Rando phantom was found to reach levels up to 370 mSv/treatment. Many researchers consider TLD, which is the most cost-effective method to environment radiations. The minimum detectable dose (MDD) was also identified to demonstrate the reliability of the TLD approach. Quantitative results that provide practical guidance with regarded radiation protections. Potentially hazardous of secondary radiations from the operating linac is evaluated with regard to its potential health effects on both patients and the public. KEY POINTS This work tried to evaluate the environment radiation and minimal detectable limit of TLD inside the LINAC maze.
摘要:本文在医科大学附属医院使用热释光剂量计(TLDs)对使用Axesse直线加速器治疗鼻咽癌(NPC)的拱顶室环境辐射进行了评估。TLD-100H使用直线加速器6 MV光子进行校准。利用TLD-100H的75个测点进行环境监测。然后将测量到的环境辐射可视化为三维图形表示。环境辐射使用彩色三维图形表示可视化。在NPC治疗中发现Rando幻影的辐射水平高达370毫西弗/次治疗。许多研究人员认为TLD是最具成本效益的环境辐射处理方法。还确定了最小可检测剂量(MDD),以证明TLD方法的可靠性。定量结果为有关辐射防护提供实用指导。根据对病人和公众的潜在健康影响,评估了操作直线机二次辐射的潜在危害。本工作试图评价LINAC迷宫内的环境辐射和TLD的最低检测限值。
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引用次数: 3
Space calibration of the cranial and maxillofacial robotic system in surgery 颅颌面外科机器人系统的空间标定
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2016-10-28 DOI: 10.1080/24699322.2016.1240314
Gangfeng Liu, Xianfu Yu, Chang-le Li, Ge Li, Xuehe Zhang, Liyi Li
Abstract Space registration in cranial and maxillofacial surgery is intended to map the image space to the robot space. This requires calibration of multiple coordinate systems. In this process, the calibration accuracy between the robot coordinate system and the NDI vision coordinate system directly determines the precision of the surgical navigation system, which is the key to success. In this paper, the relationship between robot space and visual space is studied according to the requirements of surgery, and with reference to the characteristics of the vision system itself. Based on this analysis and traditional methods, a new linear rotation calibration method is presented. Calibration can be automated to decrease human error and increase the reliability and stability. Finally, an experiment is conducted in order to evaluate the effectiveness of the calibration algorithm. The results show that the minimum position error was less than 0.87 mm and the minimum posture deviation was about 0.83 degrees, indicating that the calibration precision can meet the operation requirements. There are good prospects for this method using in surgical calibration application.
颅颌面外科的空间配准是将图像空间映射到机器人空间。这需要对多个坐标系进行校准。在此过程中,机器人坐标系与NDI视觉坐标系之间的标定精度直接决定了手术导航系统的精度,是手术成功的关键。本文根据手术的要求,结合视觉系统本身的特点,研究了机器人空间与视觉空间的关系。在此基础上,结合传统方法,提出了一种新的线性旋转标定方法。可自动校准,减少人为误差,提高可靠性和稳定性。最后,通过实验验证了标定算法的有效性。结果表明,最小位置误差小于0.87 mm,最小姿态偏差约0.83度,标定精度满足运行要求。该方法在外科标定中具有良好的应用前景。
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引用次数: 8
Optimal pressure for measuring objective lymphedema with postoperative ultrasonography in patients with breast cancer 乳腺癌术后超声测量客观淋巴水肿的最佳压力
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2016-10-27 DOI: 10.1080/24699322.2016.1240310
C. Lim, Byungkwan Hwang, Heejung Park, Do-Hong Lee, Jieun Park, Kyu Jin Lee, Sun Kwon Kim, K. Seo
Abstract Objective: To examine the reliability of ultrasonographic thickness and compressibility along with real-time pressure monitoring to evaluate postmastectomy lymphedema and to suggest a reference range of appropriate pressure. Design: Measurement reliability study. Setting: Research laboratory. Participants: Fifteen patients with prior mastectomy for breast cancer who were diagnosed with secondary lymphedema, and 16 healthy control subjects. Methods: The thickness and compressibility of the subcutaneous layer in the arms of 15 postmastectomy patients with secondary lymphedema were measured using B-mode and M-mode ultrasonography. An ultrasound machine was equipped with a real-time pressure-monitoring device to monitor downward compression pressure on the arms at a constant velocity. The ratio of thickness change defined the compressibility index. Two different experienced examiners participated in the measurement of lymphedema. Intrarater reliability and inter-rater reliability were estimated using the intraclass correlation coefficient. Very good reliability was defined as an ICC of more than 0.8. Main outcome measurements: The thickness of the subcutaneous layer, the compressibility index, and the intrarater and inter-rater reliability were measured. Results: The measured thicknesses demonstrated very good intrarater and inter-rater reliability for the forearm and upper arm. For the compressibility index, the upper arm and forearm had very good intrarater and inter-rater reliability at over 2000 Pa of compression (>0.9). Conclusions: Ultrasonography with real-time pressure monitoring may be useful for evaluating the severity and characteristics of lymphedema, particularly at compression pressures more than 2000 Pa.
摘要目的:探讨超声厚度和可压缩性结合实时压力监测评价乳腺切除术后淋巴水肿的可靠性,并提出合适的压力参考范围。设计:测量可靠性研究。环境:研究实验室。参与者:15名先前因乳腺癌切除并诊断为继发性淋巴水肿的患者和16名健康对照者。方法:对15例乳腺切除术后继发性淋巴水肿患者的手臂皮下层厚度和可压缩性进行b超和m超测量。在超声机上安装实时压力监测装置,以恒速监测手臂上的向下压缩压力。厚度变化的比值定义了压缩系数。两名不同的经验丰富的检查员参与了淋巴水肿的测量。用组内相关系数估计组内信度和组间信度。非常好的信度定义为ICC大于0.8。主要结果测量:测量皮下层厚度、可压缩性指数、肺内和肺间可靠性。结果:测量的前臂和上臂的厚度显示出非常好的内部和内部可靠性。在压缩指数方面,上臂和前臂在超过2000 Pa的压缩时具有非常好的内径和内径信度(>0.9)。结论:实时压力监测的超声检查可能有助于评估淋巴水肿的严重程度和特征,特别是在压缩压力超过2000 Pa时。
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引用次数: 3
An improved 10-tissue human head model with real anatomical structure and hexahedral discretization feature in magnetic induction measurement simulation 磁感应测量仿真中具有真实解剖结构和六面体离散特征的改进的10组织人头模型
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2016-10-26 DOI: 10.1080/24699322.2016.1240302
Ziyi Zhang, Peiguo Liu, Dongming Zhou, L. Ding
Abstract Magnetic induction measurement (MIM) is a promising technique for biomedical applications in craniocerebral disease detection and monitoring. For the purposes of the MIM simulation, a human head model with real anatomic structure is required. However, nearly anatomically realistic models used in the MIM simulations are discretized using tetrahedral elements of subsequent finite elements method computation. The head model supplied by the Third Military Medical University (TMMU) is currently the only model suitable for hexahedral discretization and finite difference/integral computation. This model has nonetheless number of defects. In order to deal with these, we construct an improved 10-tissue human head model with real anatomical structures and hexahedral discretization features. In this paper, the operation and optimization methods used to construct for the new head model are presented and discussed in detail. We use the 10-tissue head model to conduct the time sensitivity simulation of the magnetic induction sensor which was described in our previous publication and compare the simulation data with those based on the TMMU’s head model. The result shows that the new head model has a higher time sensitivity, meaning better performance in the MIM simulation.
磁感应测量(MIM)是一种很有前途的生物医学技术,可用于颅脑疾病的检测和监测。为了达到MIM仿真的目的,需要一个具有真实解剖结构的人体头部模型。然而,MIM仿真中使用的接近解剖真实的模型在随后的有限元方法计算中使用四面体单元进行离散化。第三军医大学提供的头部模型是目前唯一适用于六面体离散化和有限差分积分计算的模型。尽管如此,这个模型还是有一些缺陷。为了解决这些问题,我们构建了一个具有真实解剖结构和六面体离散特征的改进的10组织人头模型。本文详细介绍了新水头模型构建的操作和优化方法。我们使用10组织头部模型对我们之前发表的文章中描述的磁感应传感器进行了时间敏感性仿真,并将仿真数据与基于TMMU头部模型的仿真数据进行了比较。结果表明,新头部模型具有更高的时间灵敏度,在MIM仿真中具有更好的性能。
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引用次数: 2
Fabrication and characterization of disposable wireless electronic endoscope 一次性无线电子内窥镜的制造与表征
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2016-10-25 DOI: 10.1080/24699322.2016.1240299
Ho Chang, C. Chen, Minghanbo Liu, Li-Ke Chien, Tung-Sun Huang, Bo-Hsiang Tu
Abstract A wireless electronic endoscope that transmits signals by Wi-Fi is developed for use in single-hole endoscopic surgery and future application to natural orifice surgery. The innovative electronic endoscope developed in this study has a disposable design, completely preventing patents from taking risks of cross infection. The main components of the endoscope are a disposable component of the front tip and the hand-held part of the rear tip. The front tip consists of a lens, metallic tube, and electronic joint whereas the rear tip consists of a power switch, image converter, wireless transceiver chip, and antenna. Experimental applications of the wireless electronic endoscope show that after 3 hours and 30 minutes of normal use, the temperature of metallic tube at the front tip averages 45 °C. Regarding the measured luminance result, when the focal distance is 5 cm, luminance reaches 1410 lux. In an indoor environment, when the measured distance is 3 m and there is no disruptor, the Wi-Fi transmitted signal of the endoscope is at strength −51 dBm. If the disruptor is established between the sending and receiving ends, signal strength is −53 dBm. Increasing the measured distance to 8 m obtains a signal strength of −74 dBm. Test practical applications indicate that the wireless Wi-Fi electronic endoscope fully meets the needs of surgery room.
开发了一种通过Wi-Fi传输信号的无线电子内窥镜,用于单孔内窥镜手术,未来将应用于自然口手术。本研究开发的创新电子内窥镜采用一次性设计,完全避免了专利交叉感染的风险。内窥镜的主要部件是前尖端的一次性部件和后尖端的手持部分。前尖端由透镜、金属管和电子接头组成,后尖端由电源开关、图像转换器、无线收发芯片和天线组成。无线电子内窥镜的实验应用表明,正常使用3小时30分钟后,前尖端金属管的平均温度为45℃。对于测量亮度结果,当焦距为5 cm时,亮度达到1410勒克斯。在室内环境下,当测量距离为3m且无干扰时,内窥镜的Wi-Fi传输信号强度为−51 dBm。如果在发送端和接收端之间建立干扰,信号强度为- 53dbm。将测量距离增加到8m,信号强度为−74dbm。测试实际应用表明,无线Wi-Fi电子内窥镜完全满足手术室的需要。
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引用次数: 1
期刊
Computer Assisted Surgery
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