脊柱微創(chuàng)手術(shù)醫(yī)療機(jī)器人結(jié)構(gòu)設(shè)計案例目錄TOC\o"1-3"\h\u15149脊柱微創(chuàng)手術(shù)醫(yī)療機(jī)器人結(jié)構(gòu)設(shè)計案例 1237351.1引言 1125851.2脊柱微創(chuàng)手術(shù)的需求分析 199341.2.1醫(yī)療機(jī)器人的功能需求分析 1210881.2.2醫(yī)療機(jī)器人的工作空間需求分析 4148111.3醫(yī)療機(jī)器人構(gòu)型設(shè)計 5219631.3.1整體構(gòu)型設(shè)計 561501.3.2具體構(gòu)型選型 7101461.4醫(yī)療機(jī)器人結(jié)構(gòu)設(shè)計 10引言脊柱周圍遍布著重要的中樞神經(jīng)，因此脊柱微創(chuàng)手術(shù)對可靠性和安全性的要求遠(yuǎn)高于普通手術(shù)，作為輔助脊柱微創(chuàng)手術(shù)的醫(yī)療機(jī)器人，在幫助醫(yī)生完成手術(shù)操作時要保證定位精確，手術(shù)中會對脊柱進(jìn)行穿刺而產(chǎn)生不小的沖擊力，這要求機(jī)器人具有足夠的穩(wěn)定性與抗沖擊能力，確保手術(shù)的可靠性與安全性。本章分析了脊柱微創(chuàng)手術(shù)的需求條件與手術(shù)環(huán)境，確定輔助醫(yī)療機(jī)器人的設(shè)計要求和設(shè)計指標(biāo)，完成了輔助醫(yī)療機(jī)器人的構(gòu)型設(shè)計和結(jié)構(gòu)設(shè)計，使機(jī)器人能夠?qū)崿F(xiàn)病灶定位，夾持手術(shù)工具并為手術(shù)器具提供導(dǎo)向準(zhǔn)確指向手術(shù)位置的功能。脊柱微創(chuàng)手術(shù)的需求分析醫(yī)療機(jī)器人的功能需求分析當(dāng)前脊柱微創(chuàng)手術(shù)的主流方向包括：（1）后路經(jīng)皮椎切除術(shù)ADDINCSL_CITATION{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"池永龍","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"中國脊柱脊髓雜志","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2005"]]},"page":"133-134","title":"脊柱外科的微創(chuàng)意識、微創(chuàng)觀念與微創(chuàng)技術(shù)","type":"article-journal","volume":"15"},"uris":["/documents/?uuid=57232fd4-45e8-4a95-9aae-e1b5f4351bdf"]}],"mendeley":{"formattedCitation":"^[29]","plainTextFormattedCitation":"[29]","previouslyFormattedCitation":"^[29]"},"properties":{"noteIndex":0},"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}[29]；（2）經(jīng)椎板間隙入路切除術(shù)；（3）脊柱前路腔鏡手術(shù)；（4）微創(chuàng)腰椎減壓與融合術(shù)；（5）微創(chuàng)后路內(nèi)固定技術(shù)ADDINCSL_CITATION{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"周躍","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"中華醫(yī)學(xué)信息導(dǎo)報","id":"ITEM-1","issue":"22","issued":{"date-parts":[["2013"]]},"page":"11","title":"微創(chuàng)脊柱外科手術(shù)的發(fā)展與展望","type":"article-journal","volume":"28"},"uris":["/documents/?uuid=ac41ec17-b10f-4a33-9cb6-d7ca43a26650"]}],"mendeley":{"formattedCitation":"^[30]","plainTextFormattedCitation":"[30]","previouslyFormattedCitation":"^[30]"},"properties":{"noteIndex":0},"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}[30]。以上脊柱微創(chuàng)手術(shù)中均涉及到醫(yī)療機(jī)器人的使用，其中使用醫(yī)療機(jī)器人較早，發(fā)展較成熟的技術(shù)為微創(chuàng)后路內(nèi)固定技術(shù)，即椎弓根釘技術(shù)。因為其安全性高、治療效果好，是醫(yī)生治療脊柱骨折中最常使用的治療方案，不過由于微創(chuàng)手術(shù)的創(chuàng)口小，醫(yī)生的視野受阻無法直接觀測脊柱情況，病灶多是通過CT影像或者X光影像來確定的，醫(yī)生與病人不可避免的會頻繁受到射線輻射。而輔助醫(yī)療機(jī)器人可以幫助醫(yī)生直接定位病灶，避免在術(shù)中使用x光、CT投影對病人與醫(yī)生造成傷害。椎弓根釘技術(shù)如圖2.1所示，是在發(fā)生骨折或者錯位的脊椎與兩側(cè)相鄰的脊椎上打入“螺釘”，然后在“螺釘”間穿過一根固定棒來矯正螺釘相對位置，從而矯正發(fā)生偏移的脊柱。在醫(yī)療機(jī)器人輔助椎弓根釘植入過程中，機(jī)器人導(dǎo)向孔按照指定的入釘角度指向病灶位置，接著醫(yī)生沿機(jī)器人導(dǎo)向孔在病人背部插入導(dǎo)向套筒，沿著導(dǎo)向套筒插入定位針，抽離導(dǎo)向套筒，沿著定位針進(jìn)行擴(kuò)孔、攻絲、進(jìn)釘，醫(yī)生完成椎弓根釘植入后，機(jī)器人定位下一入針點。圖2.1椎弓根釘技術(shù)經(jīng)過分析以上脊柱微創(chuàng)手術(shù)流程，在設(shè)計脊柱微創(chuàng)手術(shù)輔助醫(yī)療機(jī)器人的結(jié)構(gòu)時，重點需要解決兩個問題：為手術(shù)器具提供支撐、導(dǎo)向微創(chuàng)手術(shù)中，輔助醫(yī)療機(jī)器人的主要功能是在手術(shù)過程中幫助醫(yī)生定位病灶并固定椎弓根釘導(dǎo)向套筒，這是脊柱手術(shù)中的核心任務(wù)，機(jī)器人要設(shè)計穩(wěn)定的導(dǎo)向孔結(jié)構(gòu)，承受手術(shù)操作的各種外力作用，導(dǎo)向孔可以靈活的調(diào)整指向角度以滿足手術(shù)要求，同時可以到達(dá)病人脊柱任意錐段的位置，機(jī)器人要能夠適應(yīng)手術(shù)環(huán)境，并滿足安全性可靠性要求。精確定位病人椎體病灶位置因為脊柱周圍遍布著重要神經(jīng)，要精確定位病灶并嚴(yán)格按照醫(yī)生的手術(shù)方案調(diào)整入針角度保證入針路徑?jīng)]有偏差。在現(xiàn)有醫(yī)學(xué)水平下，病灶多是通過CT影像或者X光影像來確定的，但是如果在手術(shù)過程中使用CT機(jī)和x光機(jī)，醫(yī)生與病人會頻繁受到射線輻射ADDINCSL_CITATION{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"葉哲偉","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"楊述華","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"中華骨科雜志","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2002"]]},"page":"125-127","title":"三維醫(yī)學(xué)圖像重建及計算機(jī)手術(shù)導(dǎo)航在脊柱外科的應(yīng)用","type":"article-journal","volume":"24"},"uris":["/documents/?uuid=0d2609df-04de-4a90-9168-82b4d9a93482"]}],"mendeley":{"formattedCitation":"^[31]","plainTextFormattedCitation":"[31]","previouslyFormattedCitation":"^[31]"},"properties":{"noteIndex":0},"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}[31]，因此要采用更安全的方式來定位病灶。本課題對病灶的定位方法進(jìn)行了相關(guān)研究，最后確定了一種定位靶輔助標(biāo)記的定位方法。首先在患者體表粘貼用于輔助定位的定位靶點，這種定位靶點采用金屬制成，可以在CT影像和X光影像中很清晰的顯示位置，圖2.2-2.3為實驗中采用羊脊柱模擬人體脊柱的效果。在得到配有定位靶的病人CT影像后，使用計算機(jī)系統(tǒng)結(jié)合可視化技術(shù)將病人的脊柱結(jié)構(gòu)、病灶位置以及靶點位置進(jìn)行三維重建ADDINCSL_CITATION{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"葉哲偉","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"楊述華","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"中華骨科雜志","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2002"]]},"page":"125-127","title":"三維醫(yī)學(xué)圖像重建及計算機(jī)手術(shù)導(dǎo)航在脊柱外科的應(yīng)用","type":"article-journal","volume":"24"},"uris":["/documents/?uuid=0d2609df-04de-4a90-9168-82b4d9a93482"]},{"id":"ITEM-2","itemData":{"author":[{"dropping-particle":"","family":"林曉梅","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"魏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向軸線與人體水平橫切面的夾角變化范圍在±30°內(nèi)。圖2.5人體坐標(biāo)系結(jié)合前文所述人體脊柱長度男性70-75cm女性60-65cm，設(shè)定人體坐標(biāo)系中脊柱總長為750mm，截面寬50mm，導(dǎo)向軸線正傾角30°，側(cè)傾角15°。為了提升機(jī)器人操作的靈活性，避免活動空間不足給醫(yī)生手術(shù)操作帶來不便，多余5°的余量，設(shè)定正傾角35°，側(cè)傾角20°，得到脊柱微創(chuàng)手術(shù)中，輔助醫(yī)療機(jī)器人的導(dǎo)向軸線的終端位置集合如圖2.5所示。圖中倒置立方梯形描述了脊柱微創(chuàng)手術(shù)中手術(shù)工具的活動范圍，下底面寬50mm，長750mm，側(cè)面與人體坐標(biāo)系縱軸夾角分別為20°和35°。機(jī)器人的工作空間需要覆蓋圖中所示空間以輔助醫(yī)生操作手術(shù)工具，滿足脊柱微創(chuàng)手術(shù)的空間要求。醫(yī)療機(jī)器人構(gòu)型設(shè)計整體構(gòu)型設(shè)計在脊柱微創(chuàng)手術(shù)中，輔助醫(yī)療機(jī)器人的主要功能是在手術(shù)過程中為醫(yī)生操作手術(shù)工具提供導(dǎo)向輔助。將導(dǎo)向輔助功能解剖開，實際上就是在醫(yī)生打入椎弓根釘?shù)臅r候能夠確定一條準(zhǔn)確的入釘軸線。三維坐標(biāo)中，只要知道直線通過的一個點的位置以及與各坐標(biāo)的夾角就可以確定一條直線。確定一點的位置需要三個坐標(biāo)軸參數(shù)，確定直線方向，需要至少兩個坐標(biāo)軸的夾角參數(shù)，因此，確定一條直線在坐標(biāo)系中的位姿需要5個自由度。根據(jù)以上自由度的判斷方式，將機(jī)器人設(shè)計為導(dǎo)向(空間導(dǎo)向，兩個自由度)和定位(病灶定位，三個自由度)兩個模塊串聯(lián)工作實現(xiàn)精確的病灶定位。手術(shù)開始前需要確定病人的姿態(tài)，并與術(shù)前掃描生成的可視化三維影像坐標(biāo)系統(tǒng)重合，這里需要給機(jī)器人安裝識別定位靶的傳感器，可以識別病人身上的定位靶，并將位置信息反饋回系統(tǒng)。醫(yī)療機(jī)器人的基本功能為導(dǎo)向輔助，即攜帶末端導(dǎo)向套筒，通過運動實現(xiàn)套筒軸線在空間中的位姿與置釘通道軸線目標(biāo)位姿重合；椎弓根釘?shù)闹萌肴杂舍t(yī)生完成，一個有經(jīng)驗的醫(yī)生經(jīng)過長年累月的手術(shù)積累，可以通過手術(shù)刀反饋的觸感來確定切割的深度夠不夠深，有沒有達(dá)到理想的位置，置入椎弓根釘?shù)牟僮饕彩且粯拥牡览?，醫(yī)生在置釘過程中仍能夠感覺到椎弓根釘?shù)牧Ψ答?，?zhǔn)確的把握進(jìn)釘?shù)纳疃?，這可消除醫(yī)生、病人對機(jī)器人手術(shù)的顧慮，保證了脊柱微創(chuàng)手術(shù)入釘?shù)某晒β?；機(jī)器人自身并不安裝手術(shù)器具，也保證了機(jī)器人使用的安全性，不會在手術(shù)之外誤傷病人或工作人員。在對目前脊柱微創(chuàng)手術(shù)現(xiàn)場數(shù)據(jù)以及已投入使用的脊柱微創(chuàng)手術(shù)輔助機(jī)器人的相關(guān)數(shù)據(jù)進(jìn)行分析后，目前臨床上使用的醫(yī)療機(jī)器人大多屬于分體式設(shè)計的串聯(lián)機(jī)器人，脊柱手術(shù)因為涉及到人體神經(jīng)最密集的部位，要保證高精度，而脊柱手術(shù)中手術(shù)器具穿刺進(jìn)入脊柱會產(chǎn)生不小的沖擊力，串聯(lián)結(jié)構(gòu)的累積誤差與其穩(wěn)定性能否保證脊柱微創(chuàng)手術(shù)順利進(jìn)行都是需要考慮的問題。因此，為了提高機(jī)器人的穩(wěn)定性、抗沖擊能力，針對脊柱微創(chuàng)手術(shù)的特點，在保證機(jī)器人定位精度的情況下，本文拋棄了傳統(tǒng)的串聯(lián)式結(jié)構(gòu)設(shè)計，對醫(yī)療機(jī)器人進(jìn)行了全新的設(shè)計，確定機(jī)器人整體采用串并聯(lián)混合機(jī)構(gòu)，以適應(yīng)脊柱微創(chuàng)手術(shù)需求。相較于串聯(lián)機(jī)構(gòu)，混聯(lián)機(jī)構(gòu)能夠簡化運動學(xué)分析中復(fù)雜的求解過程，降低機(jī)器人操作的難度，方便醫(yī)生在手術(shù)過程中實時調(diào)整，同時機(jī)器人要在手術(shù)中承受手術(shù)器械的反作用力、醫(yī)生操作工具的作用力，并聯(lián)結(jié)構(gòu)機(jī)器人的剛性比串聯(lián)結(jié)構(gòu)要好很多，能夠進(jìn)一步保證手術(shù)器具導(dǎo)向軸線不發(fā)生偏移。本項目脊柱微創(chuàng)手術(shù)輔助醫(yī)療機(jī)器人的具體結(jié)構(gòu)包括用于安放病人實現(xiàn)普通手術(shù)平臺功能的主體支撐結(jié)構(gòu)，即底部的醫(yī)療床與固定支架，手術(shù)工具的輔助定位結(jié)構(gòu)，其中輔助定位結(jié)構(gòu)又包括粗定位機(jī)構(gòu)和精確導(dǎo)向定位機(jī)構(gòu)兩部分，即龍門式的直角坐標(biāo)(橋式三坐標(biāo))結(jié)構(gòu)串聯(lián)6-SPS并聯(lián)機(jī)構(gòu)，以及手術(shù)中的負(fù)載要求。結(jié)構(gòu)簡圖如圖2.6所示。其中直角坐標(biāo)結(jié)構(gòu)具有3個構(gòu)件3個移動副，具有3個自由度，6-SPS并聯(lián)機(jī)構(gòu)具有25個構(gòu)件6個移動副24個旋轉(zhuǎn)副，具有6個自由度，滿足機(jī)器人的設(shè)計要求。圖2.6置釘軸線姿態(tài)角度定義具體構(gòu)型選型橋式直角坐標(biāo)系機(jī)器人最為人們熟知，具體有一下幾個特點：超大行程，滿足脊柱手術(shù)的范圍要求；負(fù)載能力強(qiáng)，可以承受手術(shù)中的反作用力；高動態(tài)特性，快速定位；高精度，滿足手術(shù)精度要求；擴(kuò)展性強(qiáng)，可以配合更復(fù)雜的結(jié)構(gòu)并且操作方便；簡單經(jīng)濟(jì)，直角坐標(biāo)機(jī)器人結(jié)構(gòu)直觀，并且操作簡單，更方便醫(yī)生在手術(shù)中操作，可以快速培訓(xùn)醫(yī)生進(jìn)入臨床試驗；壽命長，維護(hù)簡單方便。6-SPS構(gòu)型又稱為Stewart平臺ADDINCSL_CITATION{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"李健","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"李帥","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"張豪","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"李思奇","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"計算機(jī)仿真","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2018"]]},"page":"337-343","title":"仿咬合Stewart并聯(lián)機(jī)器人模擬與誤差分析","type":"article-journal","volume":"35"},"uris":["/documents/?uuid=ad23b854-4bee-4c7d-97eb-33f0c1a7ae55"]}],"mendeley":{"formattedCitation":"^[42]","plainTextFormattedCitation":"[42]","previouslyFormattedCitation":"^[42]"},"properties":{"noteIndex":0},"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}[42]。是一種十分常見的機(jī)器人并聯(lián)結(jié)構(gòu)，逆解較容易求解ADDINCSL_CITATION{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"楊宏兵","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2004"]]},"publisher":"合肥工業(yè)大學(xué)","title":"6-SPS并聯(lián)機(jī)器人運動學(xué)及工作空間的仿真研究","type":"thesis"},"uris":["/documents/?uuid=e3a68a4b-0f24-4a2b-8147-1de265c8533a"]}],"mendeley":{"formattedCitation":"^[43]","plainTextFormattedCitation":"[43]","previouslyFormattedCitation":"^[43]"},"properties":{"noteIndex":0},"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}[43]，其中比較典型的機(jī)構(gòu)如圖2.7-圖2.12所示。圖2.76-SPS機(jī)構(gòu)圖2.86-SPS三角機(jī)構(gòu)圖2.96-SPS雙三角機(jī)構(gòu)圖2.106-PSS機(jī)構(gòu)圖2.116-RSS機(jī)構(gòu)圖2.123-RRR球面機(jī)構(gòu)這種機(jī)構(gòu)分為上下兩個平臺，平臺多是不規(guī)則六邊形。圖2.13為Stewart平臺的運動結(jié)構(gòu)簡圖，下平臺為固定底座，上平臺通過6個可以調(diào)節(jié)長度的驅(qū)動桿連接，6根驅(qū)動桿兩頭通過球鉸連接。驅(qū)動桿內(nèi)置有移動副，每根桿均可獨立完成伸縮動作，這種結(jié)構(gòu)使上平臺可在6個自由度下進(jìn)行靈活調(diào)整，通過調(diào)整驅(qū)動桿的伸縮量，上平臺可以調(diào)整到任意位姿。6-SPS并聯(lián)機(jī)構(gòu)的特點總結(jié)如下：不存在累積誤差，能夠進(jìn)一步保證精度；對稱的結(jié)構(gòu)設(shè)計，具有各向同性并且熱變形量較??；伸縮桿主要承受軸向力，結(jié)構(gòu)緊湊，施加在一個點的力會被多跟桿分散抵充掉，保證了穩(wěn)定性和剛性；伸縮桿的電機(jī)可設(shè)置在靠近下平臺的地方，重心靠近下平臺，運動過程中運動慣性更小動態(tài)特性好。圖2.13Stewart平臺運動結(jié)構(gòu)簡圖綜上所述，龍門式的直角坐標(biāo)(橋式三坐標(biāo))結(jié)構(gòu)串聯(lián)6-SPS并聯(lián)機(jī)構(gòu)保證了醫(yī)療機(jī)器人操作的精度，并滿足安全性、可靠性要求，機(jī)器人的結(jié)構(gòu)精簡，滿足了空間需求。與洪在地研制的神經(jīng)穿刺手術(shù)輔助機(jī)器人ADDINCSL_CITATION{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"洪在地","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"贠超","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"趙磊","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"機(jī)器人","id":"ITEM-1","issued":{"date-parts":[["2009"]]},"page":"204-209","title":"用于神經(jīng)外科手術(shù)的磁共振圖像導(dǎo)航機(jī)器人的兼容性研究","type":"article-journal","volume":"31"},"uris":["/documents/?uuid=6759dfe1-5dee-4602-af41-396d2bf4848a"]}],"mendeley":{"formattedCitation":"^[26]","plainTextFormattedCitation":"[26]","previouslyFormattedCitation":"^[26]"},"properties":{"noteIndex":0},"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}[26]與陳珂設(shè)計的核磁環(huán)境下穿刺手術(shù)輔助機(jī)器人相比ADDINCSL_CITATION{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"洪在地","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"贠超","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"趙磊","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"機(jī)器人","id":"ITEM-1","issued":{"date-parts":[["2009"]]},"page":"204-209","title":"用于神經(jīng)外科手術(shù)的磁共振圖像導(dǎo)航機(jī)器人的兼容性研究","type":"article-journal","volume":"31"},"uris":["/documents/?uuid=6759dfe1-5dee-4602-af41-396d2bf4848a"]}],"mendeley":{"formattedCitation":"^[26]","plainTextFormattedCitation":"[26]","previouslyFormattedCitation":"^[26]"},"properties":{"noteIndex":0},"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}[26]，本文所設(shè)計的脊柱微創(chuàng)手術(shù)輔助醫(yī)療機(jī)器人定位靶輔助標(biāo)記的定位方法實現(xiàn)病灶定位，避免醫(yī)生在手術(shù)過程中頻繁使用x光儀器與核磁共振儀確認(rèn)病灶情況，同時，因為沒有核磁共振儀的結(jié)構(gòu)干涉，機(jī)器人設(shè)計為輔助導(dǎo)向功能為主，在手術(shù)過程中醫(yī)生可以直接控制手術(shù)器具，在置釘過程中仍能夠感覺到椎弓根釘?shù)牧Ψ答仯瑴?zhǔn)確的把握進(jìn)釘?shù)纳疃?，這可消除醫(yī)生、病人對機(jī)器人手術(shù)的顧慮，保證了脊柱微創(chuàng)手術(shù)入釘?shù)某晒β?；機(jī)器人自身并不安裝手術(shù)器具，也保證了機(jī)器人使用的安全性，不會在手術(shù)之外誤傷病人或工作人員；與汪澤濤設(shè)計的脊柱微創(chuàng)手術(shù)輔助機(jī)器人ADDINCSL_CITATION{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"洪在地","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"贠超","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"趙磊","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"機(jī)器人","id":"ITEM-1","issued":{"date-parts":[["2009"]]},"page":"204-209","title":"用于神經(jīng)外科手術(shù)的磁共振圖像導(dǎo)航機(jī)器人的兼容性研究","type":"article-journal","volume":"31"},"uris":["/documents/?uuid=6759dfe1-5dee-4602-af41-396d2bf4848a"]}],"mendeley":{"formattedCitation":"^[26]","plainTextFormattedCitation":"[26]","previouslyFormattedCitation":"^[26]"},"properties":{"noteIndex":0},"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}[26]相比，橋式三坐標(biāo)結(jié)構(gòu)的設(shè)計進(jìn)一步提升了輔助醫(yī)療機(jī)器人可完成的手術(shù)范圍，可以實現(xiàn)全錐段手術(shù)；此外，楊朝設(shè)計的脊柱微創(chuàng)手術(shù)輔助機(jī)器人ADDINCSL_CITATION{"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"楊朝","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"馮源","given":"","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"王石剛","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"機(jī)電一體化","id":"ITEM-1","issued":{"date-parts":[["2018"]]},"page":"42-57","title":"脊柱微創(chuàng)手術(shù)輔助機(jī)器人結(jié)構(gòu)設(shè)計與優(yōu)化","type":"article-journal","volume":"4"},"uris":["/documents/?uuid=b05c3805-2b9e-43ae-ba4d-c1ae3a59e5c4"]}],"mendeley":{"formattedCitation":"^[28]","plainTextFormattedCitation":"[28]","previouslyFormattedCitation":"^[28]"},"properties":{"noteIndex":0},"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}[28]在手術(shù)中需要完全依賴導(dǎo)航系統(tǒng)完成定位，而本文所設(shè)計的輔助醫(yī)療機(jī)器人采用定位靶輔助定位，可以隨時對病灶位置進(jìn)行確認(rèn)，醫(yī)生可以對病灶位置進(jìn)行更準(zhǔn)確地把控。醫(yī)療機(jī)器人結(jié)構(gòu)設(shè)計脊柱微創(chuàng)手術(shù)輔助醫(yī)療機(jī)器人的設(shè)計參數(shù)如表2.1所示，根據(jù)以上構(gòu)型設(shè)計，確定設(shè)計方案如圖2.14。表2.1脊柱微創(chuàng)手術(shù)輔助醫(yī)療機(jī)器人設(shè)計參數(shù)名稱設(shè)計參數(shù)運動范圍X方向±150mmY方向±125mmZ方向0~135mm傾角θx(-15°,15°)傾角θy(-30°,-10°)∪(10°,30°)直線運動重復(fù)定位精度≤0.01-0.3mm扭轉(zhuǎn)運動重復(fù)定位精度≤0.2°末端負(fù)載額定值30N最大值50N并聯(lián)機(jī)構(gòu)最高直線速度10mm/s并聯(lián)機(jī)構(gòu)最高角速度15°/s橋式三坐標(biāo)結(jié)構(gòu)固定于醫(yī)療床上，末端與6-SPS結(jié)構(gòu)下平臺固定，并設(shè)計有探測傳感器用于手術(shù)定位，手術(shù)器械的固定裝置與6-SPS結(jié)構(gòu)上平臺固連。在手術(shù)過程中，醫(yī)生可以通過調(diào)整橋式三坐標(biāo)結(jié)構(gòu)動作控制醫(yī)療機(jī)器人運動，待調(diào)整好位置后，通過6-