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Robots can perform eye surgery on humans?

Posting time:2023-01-31 13:37:10

Robots can perform eye surgery on humans?

Editor's note Thyroid-related ophthalmopathy (TAO) is an autoimmune disease with multiple organ damage throughout the body, which seriously affects the patient's appearance and may cause serious damage to the patient's vision, so many patients will come to the hospital to seek help from a doctor . Orbital decompression surgery is an effective method for the treatment of TAO, which can retract the protruding eyeball, protect the cornea, and relieve optic nerve compression, but the traditional orbital decompression surgery still needs to be improved. On the academic stage of WOC 2022, Professor Zhou Huifang from the Department of Ophthalmology, Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine shared the valuable experience of robot-assisted orbital decompression surgery in the treatment of TAO, providing a new option for better treatment of TAO. TAO seriously affects the quality of life of patients. TAO is the most common orbital disease in adults, which can seriously impair the visual function of patients. The data show that 80% of patients will have eyelid retraction or proptosis, 50% of patients will have strabismus, and 5% of patients will even become blind. Because TAO not only seriously affects the patient's appearance, but also seriously impairs the patient's visual function, the quality of life (QOL) score of TAO patients is even lower than that of diabetes, emphysema and heart failure. 20% of TAO patients require surgical treatment, and the first step is to perform orbital decompression surgery. TAO severely impairs the visual function of patients with traditional orbital decompression surgery vs robotic-assisted orbital decompression surgery Orbital surgery is very difficult for doctors, because the orbital space is small, which also contains the eyeball and 6 pairs of cranial nerves, and the deep part is adjacent to the skull, Surgeons need to have rich experience and superb skills to perform orbital surgery. Although traditional orbital decompression surgery has been used clinically for a long time, it has the disadvantages of small surgical field, difficult operation, and high risk of tissue damage. Ophthalmologists have never stopped exploring better surgical methods. Different from traditional orbital decompression surgery, robot-assisted orbital decompression surgery has the advantages of high precision, clear enlargement of the surgical field, and filtering out hand tremors. Surgical robots expand the capabilities of humans. Research Overview of Robot-assisted Orbital Decompression Surgery The Da Vinci Surgical Robot System is the most commonly used surgical robotic platform today. It has 7 degrees of freedom and adopts a master-slave working mode. It is widely used in thoracic, abdominal and pelvic surgery. In addition, it has also been tried in craniofacial and ocular surgery. DaVinci robot has been successfully applied in craniofacial surgery In order to explore the feasibility of DaVinci robot-assisted orbital decompression surgery, Professor Zhou carried out the following clinical research: Research subjects: 10 patients with quiescent TAO who meet the surgical indications and intervention measures : Orbital fat decompression surgery with da Vinci Xi robot Evaluation index: Safety: Operation time, blood loss and complications Surgical effect: Changes in exophthalmos and quality of life scores after 3 months after Da Vinci robotic surgery Equipment display Spatial layout of the operating room Spatial layout of the DaVinci robot robotic arm: robotic arm 2 holding the endoscope vertically above the eyeball between robotic arms 1 and 2, 2 and 3, 3 and 4 is a 30-degree angle between robotic arms 1~4 The average distances between the "trocar" and the eyeball were 10.15, 10.25, 10.25 cm, and 10.40 cm, respectively. Spatial layout of the robotic arm. Surgical procedure: Plan the amount of fat removal based on the patient's symptoms and orbital CT. The incision operator telecontrols the da Vinci robot to perform orbital fat decompression with a zoom ratio of 3:1, and the operative field is magnified 10 times. The surgeon: remote operation (left), assistant: operative field exposure and bedside monitoring (right) The Finch robot-assisted surgery can clearly identify and protect important tissues such as extraocular muscles. The results of the surgery showed that the patients' postoperative proptosis was ideally improved, from 20.2±1.8 to 17.9±1.4 mm (P<0.0001); quality of life (P<0.0001) Facial appearance and visual function) were significantly improved. Moreover, orbital fat decompression surgery using the da Vinci Xi robot has good safety, and none of the 10 patients had serious complications caused by robotic manipulation or surgery. Detailed data of 10 patients After surgery, patients' exophthalmos and quality of life scores were significantly improved. Summary Professor Zhou concluded that the DaVinci robot has good visualization and can provide 10 times magnification stereo vision to clearly distinguish fat and fascia. , muscles and blood vessels. In addition, the Da Vinci robot also has good dexterity, has the functions of motion scaling, filtering hand tremors, and can also be loaded with multiple minimally invasive instruments. However, the Da Vinci robot also has limitations. At present, it lacks a force feedback mechanism, has few fine instruments for ophthalmic surgery, and cannot perform high-rigidity operations such as osteotomy. Therefore, a new type of ophthalmic robot is developed to solve these problems. , is the future direction of medical robotics. Expert Profile Professor Zhou Huifang Chief Physician, Professor, Doctoral Supervisor of the Department of Ophthalmology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine Visiting scholar at the University Hospital, director of the Asia-Pacific Society of Ophthalmic Plastic Surgery, member of the Ophthalmic Immunology Group of the Ophthalmology Branch of the Chinese Medical Association, member of the Ophthalmology and Orbital Disease Group of the Chinese Medical Doctor Association, undertaking 19 projects including 4 National Natural Science Foundation of China, and selected as 7 talents The training plan has published more than 80 papers in professional journals at home and abroad, and won the second prize of National Science and Technology Progress Award, the first prize of Shanghai Science and Technology Progress Award, and the first prize of Science and Technology Progress of Higher Education Institutions of the Ministry of Education. The first prize of the 16th Silver Snake Award, the Most Beautiful Physician in China, the Shanghai Women's Innovation Rookie Award, the Shanghai March 8th Red Banner Bearer, the Shanghai Women's Achievement Model, the President's Award of Shanghai Jiaotong University, and was awarded the "Celebration of the founding of the People's Republic of China" 70th Anniversary" Medal

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