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Usability of cooperative surgical telemanipulation for bone milling tasks.

协同手术远程操作用于骨铣削任务的可用性。

  • 影响因子:2.34
  • DOI:10.1007/s11548-020-02296-8
  • 作者列表:"Schleer P","Vossel M","Heckmann L","Drobinsky S","Theisgen L","de la Fuente M","Radermacher K
  • 发表时间:2021-02-01
Abstract

PURPOSE:Cooperative surgical systems enable humans and machines to combine their individual strengths and collaborate to improve the surgical outcome. Cooperative telemanipulated systems offer the widest spectrum of cooperative functionalities, because motion scaling is possible. Haptic guidance can be used to assist surgeons and haptic feedback makes acting forces at the slave side transparent to the operator, however, overlapping and masking of forces needs to be avoided. This study evaluates the usability of a cooperative surgical telemanipulator in a laboratory setting. METHODS:Three experiments were designed and conducted for characteristic surgical task scenarios derived from field studies in orthopedics and neurosurgery to address bone tissue differentiation, guided milling and depth sensitive milling. Interaction modes were designed to ensure that no overlapping or masking of haptic guidance and haptic feedback occurs when allocating information to the haptic channel. Twenty participants were recruited to compare teleoperated modes, direct manual execution and an exemplary automated milling with respect to usability. RESULTS:Participants were able to differentiate compact and cancellous bone, both directly manually and teleoperatively. Both telemanipulated modes increased effectiveness measured by the mean absolute depth and contour error for guided and depth sensitive millings. Efficiency is decreased if solely a boundary constraint is used in hard material, while a trajectory guidance and manual milling perform similarly. With respect to subjective user satisfaction trajectory guidance is rated best for guided millings followed by boundary constraints and the direct manual interaction. Haptic feedback only improved subjective user satisfaction. CONCLUSION:A cooperative surgical telemanipulator can improve effectiveness and efficiency close to an automated execution and enhance user satisfaction compared to direct manual interaction. At the same time, the surgeon remains part of the control loop and is able to adjust the surgical plan according to the intraoperative situation and his/her expertise at any time.

摘要

目的: 合作手术系统使人类和机器能够结合其各自的优势并协作以改善手术结果。合作远程管理系统提供了最广泛的合作功能,因为运动缩放是可能的。触觉引导可用于辅助外科医生,并且触觉反馈使得从侧的作用力对操作者透明,然而,需要避免力的重叠和掩蔽。本研究评估了在实验室环境中合作手术telemanipulator的可用性。 方法: 针对骨科和神经外科现场研究中得出的特色手术任务场景,设计并进行了三个实验,以解决骨组织分化、引导铣削和深度敏感铣削。交互模式被设计成确保在向触觉信道分配信息时不会发生触觉引导和触觉反馈的重叠或掩蔽。招募了20名参与者来比较远程操作模式、直接手动执行和示例性自动铣削的可用性。 结果: 无论是直接手动还是远程操作,参与者都能区分致密骨和松质骨。对于引导和深度敏感的碾磨,通过平均绝对深度和轮廓误差测量,两种远程管理模式都增加了有效性。如果在硬质材料中仅使用边界约束,则效率降低,而轨迹引导和手动铣削执行类似。关于主观用户满意度轨迹,引导被评定为引导磨浆的最佳,其次是边界约束和直接手动交互。触觉反馈仅改善主观用户满意度。 结论: 与直接手动交互相比,合作手术电视脉冲发生器可以提高接近自动化执行的有效性和效率,并提高用户满意度。同时,外科医生仍然是控制回路的一部分,并且能够根据术中情况和他/她的专业知识随时调整手术计划。

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影响因子:2.68
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DOI:10.1007/s11033-021-06299-9
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