In endoscopic endonasal transsphenoidal surgery, for the treatment of deep brain tumors, such as craniopharyngiomas, an endoscope and surgical instruments are inserted through a nasal cavity into the lesion to remove the tumor. This has recently become the preferred technique because there is less likelihood of neural damage and a low complication rate. Manually controlled rigid surgical instruments are available for this procedure, but they provide limited dexterity and field of view. Therefore, some areas remain inaccessible when these surgical instruments are used. To solve these problems, we propose a surgical robot system for endoscopic endonasal transsphenoidal surgery. We defined a target surgical space based on an analysis by a surgeon and designed surgical instruments to reach this target space. The system consists of two robot arms, end-effectors, surgical instruments, a master device, a control device, and a robot base. The robot arm has an end-effector exhibiting two degrees of freedom (DOFs) and an inner channel, into which flexible surgical instruments are inserted. The flexible surgical instrument can reach the target space by steering the robot arm and end-effector. The outer diameter of the end-effector is 4 mm, and the diameter of the instrument channel, into which commercial surgical instruments can be integrated, is 2 mm. We motorized the motion of the robot arms, end-effectors, and instruments and included motion capability with the necessary precision, and developed a master device and control device to operate them. The surgical robot base is used to place the surgical robot before the operation and allow for manual operation. In a cadaver experiment, it was confirmed that the robot system can reach a larger area than is accessible with current surgical instruments, and it can support or remove tissues in the target surgical space. We received productive feedback from the surgeon conducting the experiment, and further research is underway to improve the robot system.

中文翻译：

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内窥镜经鼻蝶手术机器人系统的研制与临床前试验

在内窥镜鼻内经蝶窦手术中，为了治疗颅咽管瘤等深部脑肿瘤，将内窥镜和手术器械通过鼻腔插入病灶以切除肿瘤。这最近已成为首选技术，因为神经损伤的可能性较小且并发症发生率较低。手动控制的刚性手术器械可用于此过程，但它们提供的灵活性和视野有限。因此，当使用这些手术器械时，某些区域仍然无法进入。为了解决这些问题，我们提出了一种用于内窥镜鼻内经蝶窦手术的手术机器人系统。我们根据外科医生的分析定义了目标手术空间，并设计了到达该目标空间的手术器械。该系统由两个机械臂组成，末端执行器、手术器械、主装置、控制装置和机器人底座。机器人手臂有一个末端执行器，具有两个自由度 (DOF) 和一个内部通道，柔性手术器械插入其中。灵活的手术器械可以通过操纵机械臂和末端执行器到达目标空间。末端执行器的外径为 4 mm，可集成商用手术器械的器械通道直径为 2 mm。我们对机器人手臂、末端执行器和仪器的运动进行了机动化，并包含了具有必要精度的运动能力，并开发了一个主设备和控制设备来操作它们。手术机器人底座用于在手术前放置手术机器人并允许手动操作。在尸体实验中，经证实，机器人系统可以达到比现有手术器械更大的区域，并且可以支撑或移除目标手术空间中的组织。我们从进行实验的外科医生那里收到了富有成效的反馈，并且正在进行进一步的研究以改进机器人系统。