机器人辅助颏成形术行截骨操作的精度评价实验研究

doi:10.3969/j.issn.1674-8115.2022.09.023

上海交通大学学报（医学版） ›› 2022, Vol. 42 ›› Issue (9): 1347-1352.doi: 10.3969/j.issn.1674-8115.2022.09.023

• 论著 · 技术与方法 • 上一篇

机器人辅助颏成形术行截骨操作的精度评价实验研究

回文宇¹(), 吴锦阳¹, 黄建华², 栾楠², 张志愿¹(), 张诗雷¹()

^1.上海交通大学医学院附属第九人民医院口腔颅颌面外科，上海交通大学口腔医学院，国家口腔医学中心，国家口腔疾病临床医学研究中心，上海市口腔医学重点实验室，中国医学科学院口腔颌面再生医学创新单元，上海 200011
^2.上海交通大学机械与动力工程学院，上海 200240

收稿日期:2022-06-15 接受日期:2022-08-17 出版日期:2022-09-28 发布日期:2022-09-28
通讯作者: 张志愿,张诗雷 E-mail:hwy_sjtusm@163.com;zhzhy0502@163.com;leinnymd@hotmail.com
作者简介:回文宇（1992—），男，回族，硕士生；电子信箱：hwy_sjtusm@163.com。
基金资助:
上海市科学技术委员会优秀技术带头人(20XD1433400);上海市科学技术委员会科技支撑项目(20S31902200);上海交通大学医学院技术转移推广项目(ZT202109);上海交通大学医学院附属第九人民医院“交叉”研究基金项目(JYJC201802);上海交通大学医学院附属第九人民医院多学科团队临床研究项目(201906);上海交通大学医学院附属第九人民医院临床研究项目(JYLJ201920)

Experimental study on the accuracy evaluation of robot-assisted osteotomy of genioplasty

HUI Wenyu¹(), WU Jinyang¹, HUANG Jianhua², LUAN Nan², ZHANG Zhiyuan¹(), ZHANG Shilei¹()

^1.Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200011, China
^2.School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China

Received:2022-06-15 Accepted:2022-08-17 Online:2022-09-28 Published:2022-09-28
Contact: ZHANG Zhiyuan,ZHANG Shilei E-mail:hwy_sjtusm@163.com;zhzhy0502@163.com;leinnymd@hotmail.com
Supported by:
Excellent Technical Leader of Science and Technology Commission of Shanghai Municipality(20XD1433400);Science and Technology Support Project of Science and Technology Commission of Shanghai Municipality(20S31902200);Technology Transfer Project of Shanghai Jiao Tong University School of Medicine(ZT202109);Cross-research Fund Project of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine(JYJC201802);Multidisciplinary Team Clinical Research Project of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine(201906);Clinical Research Project of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine(JYLJ201920)

摘要/Abstract

摘要：

目的·初步评价自主研发的颅颌面外科手术机器人（cranial-maxilofacial robot，CMF ROBOT）系统对头颅模型行颏成形术截骨操作的执行精度。方法·纳入2019年8月—2020年10月于上海交通大学医学院附属第九人民医院就诊的9例颏部畸形患者为研究对象。术前，采集患者的全头颅螺旋CT图像，通过三维打印制作头颅模型，并行虚拟手术规划。术中，实验组采用CMF ROBOT系统对9例头颅模型进行自动截骨；对照组采用三维打印手术导板辅助，由高年资外科医师对相同的9例头颅模型进行手动截骨。术后行螺旋CT扫描，对2组截骨平面的距离误差和方向误差进行三维测量，并对该2项误差的组间差异进行统计分析。结果·2组均顺利完成了颏成形术的截骨操作。实验组整体截骨的距离误差为（1.40±0.27）mm、方向误差为7.03°±3.02°，对照组整体截骨的距离误差为（1.23±0.27）mm、方向误差为6.08°±2.24°；且该2项误差的组间差异均无统计学意义（P=0.256，P=0.462）。结论·CMF ROBOT系统可根据术前规划完成颏成形术的自动截骨操作，其在截骨面的距离误差、方向误差均可达到以三维打印手术导板辅助的手动截骨操作的精度水平。

关键词: 医用机器人, 计算机辅助手术, 控制模式, 颏成形术

Abstract:

Objective ·To preliminarily evaluate the execution accuracy of the self-developed cranial-maxilofacial robot (CMF ROBOT) system for genioplasty osteotomy of skull models. Methods ·Nine patients with chin deformity who were admitted to Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from August 2019 to October 2020 were included in the study. Before the operation, the spiral CT images of the whole head of the patients were collected, the skull models were made by 3D printing, and the virtual surgical planning was carried out. During the operation, the experimental group used CMF ROBOT system to perform automatic osteotomy on 9 skull models; the control group was manually osteotomized by senior surgeons assisted by 3D printing surgical guide plate. After the operation, spiral CT scanning was performed to measure the distance error and the direction error of the osteotomy plane of the two groups in three dimensions, and the differences of the two errors between the two groups were statistically analyzed. Results ·The osteotomy of genioplasty was successfully completed in the two groups. The distance error of the overall osteotomy in the experimental group was (1.40±0.27) mm and the direction error was 7.03°±3.02°, while the distance error of the overall osteotomy in the control group was (1.23±0.27) mm, and the direction error was 6.08°±2.24°. There was no significant difference between the two errors mentioned above (P=0.256, P=0.462). Conclusion ·The CMF ROBOT system can complete the automatic osteotomy of genioplasty according to the preoperative planning, and the distance error and direction error of the osteotomy surface can reach the precision level of manual osteotomy assisted by 3D printing surgical guide plate.

Key words: medical robot, computer-assisted surgery, control mode, genioplasty

中图分类号:

R782.05

回文宇, 吴锦阳, 黄建华, 栾楠, 张志愿, 张诗雷. 机器人辅助颏成形术行截骨操作的精度评价实验研究[J]. 上海交通大学学报（医学版）, 2022, 42(9): 1347-1352.

HUI Wenyu, WU Jinyang, HUANG Jianhua, LUAN Nan, ZHANG Zhiyuan, ZHANG Shilei. Experimental study on the accuracy evaluation of robot-assisted osteotomy of genioplasty[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(9): 1347-1352.

图/表 5

图1 CMF ROBOT系统的构成Note： CMF ROBOT system is divided into hardware system and software system. The hardware system consists of a 6-DOF C8L industrial manipulator (EPSON, Japan), Polaris Spectra optical tracker (Northern Digital Inc., Canada), self-developed end-effector and Stryker System 5 (Stryker Corporation, USA) surgical power System. The software system is CMF Robot Plan 1.0 software (independently developed), which has the functions of preoperative three-dimensional virtual surgery planning, motion trajectory planning, intraoperative navigation and real-time communication.

Fig 1 Composition of CMF ROBOT system

图2 CMF ROBOT系统执行自动截骨操作Note： A. Trajectory planning. B. Osteotomy performing.

Fig 2 Automatic osteotomy by CMF ROBOT system

图3 三维打印手术导板辅助的手动截骨操作Note： A. Interface of 3D design of surgical guide plate (Geomagic Studio 12.0). B. Surgical guide plate is mounted on the skull model.

Fig 3 Manual osteotomy assisted by 3D printed guide plate

图4 两截骨平面法向量角度差 θ 的测量Note： A/A'. Intersection point between the bone surface of the cheek side of osteotomy and the midsagittal plane. B/B'. Intersection point between the osteotomy surface and the right mandible edge. C/C'. Intersection point between the osteotomy surface and the left mandible edge.

Fig 4 Measurement of angle difference θ of normal vector of the two osteotomy planes

图 5 两截骨平面欧氏距离的均值 h 的测量Note： A/A'. Intersection point between the bone surface of the cheek side of osteotomy and the midsagittal plane. B/B'. Intersection point between the osteotomy surface and the right mandible edge. C/C'. Intersection point between the osteotomy surface and the left mandible edge. D/D'. Intersection point between the right side at the edge of the buccal bone surface and the vertical line of the mental foramen. E/E'. Intersection point between the left side at the edge of the buccal bone surface and the vertical line of the mental foramen. F/F'. Intersection point between the lingual bone surface edges and the midsagittal plane.

Fig 5 Measurement of the mean h of Euclidean distance in the two osteotomy planes

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机器人辅助颏成形术行截骨操作的精度评价实验研究

Experimental study on the accuracy evaluation of robot-assisted osteotomy of genioplasty

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