2011-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/644479摘要：腹腔鏡手術是一高效率的特別的技術手術, 傳統的手術是以一單一切開的方式已進入腹腔進行手術, 而腹腔鏡手術只以幾個0.5-1cm 的小切開口來進行手術.手術時專用的器械及照像儀器都是經過這些管子深入腹腔. 在手術的一開始, 腹腔先灌入二氧化碳使腹腔膨脹以提供外科醫師的手術和視覺空間. 腹腔鏡的CCD 鏡頭取像於腹腔內並將此影像傳輸到手術室內的高畫質的顯示器. 手術時, 外科醫師是看著顯示器的腹腔內影像來進行手術. 如此可讓外科醫師完成與傳統手術同樣的手術行為但只有很小的傷口.比起傳統的手術方式腹腔鏡手術能讓病人通常較少疼痛, 較短的恢復期,及較小的手術傷口.目前的腹腔鏡手術設備之缺點:1. 須助手輔助調整握持CCD 鏡頭2. 手術時間會因為醫師與助手間默契的問題而拖長3. 人力有限助手難尋4. 因為手術時間拖長而使得手術室的使用效率降低5. 誤觸病人體內組織器官而不自覺.6. 全自動化腹腔鏡手術設備過於龐大笨重且費用貴, 其病人自費負擔往往高達20 多萬新台幣 Ex.達文西手術機器人7. 病人接受達文西手術機器人其心理壓力大.本計畫設計之腹腔鏡設備之優點:1. 不須助手, 醫師一人即可操控CCD 鏡頭及同時進行手術2. 縮短手術時間, 解決解決人力短缺及醫師與助手間配合默契的問題, 如此可增進醫師手術的效率同時也讓手術室的利用率提高3. 使用安裝在醫師頭部的MotionNode 來讓外科醫師能借由不同的頭部姿勢角度搭配安全啟動/鎖定機制來操作五個自由度的CCD 鏡頭去定位並同時執行手術.4. 醫師是配戴HMD 頭戴式顯示器, 所以可讓醫師在頭偏擺時不會失去對CCD 所傳回的3D 影像的掌握.5. 無感測器力回饋設計可讓醫師可感受到CCD 鏡頭移動的阻力, 以避免移動CCD 鏡頭時不慎觸傷病人體內組織器官6. 比起達文西手術機器人, 本計畫之腹腔鏡手術設備相對輕巧且便宜.7. 不增加病人手術之心理壓力8. 取代進口腹腔鏡手術設備, 為我國先進醫療器材科技作貢獻.<br> Abstract: Laparoscopic surgery is a specialized technique for performing surgery. In traditional “open” surgerythe surgeon uses a single incision to enter into the abdomen. Laparoscopic surgery uses several 0.5-1cmincisions. Specialized instruments and a special camera known as a laparoscope are passed through thetrochars during the procedure. At the beginning of the procedure, the abdomen is inflated with carbon dioxidegas to provide a working and viewing space for the surgeon. The laparoscope transmits images from theabdominal cavity to high-resolution video monitors in the operating room. During the operation the surgeonwatches detailed images of the abdomen on the monitor. This system allows the surgeon to perform the sameoperations as traditional surgery but with smaller incisions. Compared to traditional open surgery, patientsoften experience less pain, a shorter recovery, and less scarring with laparoscopic surgery.The disadvantage of the current laparoscopic surgery equipment:1. The CCD often be operated by assistant.2. If the cooperation between the assistant and surgeon is worst, then the surgery time will be longer.3. The problem of the manpower deficit can’t be solved.4. The available time of the surgeon room be decreased due to the longer surgery time.5. Moving CCD may hurt patient’s organ.6. Da Vinci surgery rototic is too heavy, big and expensive, the patient always pay more than NT $200,000dollars himself for treatment.7. It will increase the patient’s stress to be treated by Da Vinci surgery rototicThe advantage of our design of the laparoscopic surgery equipment:1. Don’t need the assistant, the surgeon can process the surgery and operate the CCD himself at the sametime.2. Decrease the surgery time, slove the problems of the manpower deficit and the bad cooperation betweenthe assistant and surgeon, we try to increase the efficient of the surgery and create more available time ofthe surgeon room.3. We provide a way to accord the different angle of the MotionNode which mount on the head of surgeonwith a ENABLE/LOCK function to operate the position of 5-DOF CCD, it make the surgeon can processthe surgery and operate the CCD himself at the same time.4. Surgeon won’t loss the 3D image which come from the CCD during adjust the position of CCD, becausethe HMD is mounted on the surgeon’s head.5. The Sensor less force feedback design will provide the moving resistance of CCD to surgeon when theCCD move, this design can avoid patient’s organ to be hurt by moving CCD.6. Compare to Da Vinci surgery rototic, our design of the laparoscopic surgery equipment is more light andcheaper.7. It wn’t increase the patient’s stress to be treated by our design of the laparoscopic surgery equipment.8. Our design of the laparoscopic surgery equipment will instead of the same kind of the import equipment,do some contribution to the advance medical instruments in our country.腹腔鏡手術CCD鏡頭頭戴式顯示器MotionNodeLaparoscopic surgeryCCDHead Mount Display (HMD)MotionNode