2012-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/644481摘要：微創手術發展至近已近二十餘年，由於具有傷口小，失血量低，傷口復原速度快與併發症少等優點，目前微創手術已漸漸取代許多的傳統開腹手術，例如膽囊切除、腸胃道手術、脾臟切除、腎臟摘除、和肝臟切除手術等，成為主要的手術方法之一。縱使微創手術具備許多優點，但還是無法完全取代傳統手術，其主要的原因有二：一為視野受限，醫療團隊只能透過腹腔鏡鏡得知腹腔臟器的表面狀況，無法精確辨識器官內部血管分布與深層腫瘤的位置，而且所得到的畫面為區域影像，無法了解整體腹腔狀態；二為操作空間受限，醫師只能藉由穿刺套管將器械伸入體內執行手術，因此穿刺套管的位置侷限了操作範圍，醫生也無法大範圍直接接觸患部，在手術過程中會減少觸覺資訊的輔助，影響切除面的精確性。因此各子計畫將針對以上這些困難個別發展出一套解決方法，本子計畫將結合各子計畫的成果，包含器械位置、多維度影像與腹腔三維模型等資訊，建立協助外科醫師，提升整體手術的安全性，提供臨床使用之擴增實境微創手術輔助系統。第一年計畫將針對個別病患建立腹腔之三維模型，利用其模型並考量腹腔生理限制範圍與手術時操作器械之方便性和流暢度，進行穿刺套管位置安排與器械位置交替擺放的規劃；第二年將設計操作介面之軟體架構與硬體配置，並根據外科醫生使用習慣與人體工學建立力回饋、全域與焦點區域、器械位置等資訊之介面設計；第三年計畫將對其他子計畫進行多重資訊整合，建立完整之微創手術資訊整合系統，並以活體豬實驗進行試驗，驗證系統之準確性與穩定性。本子計畫的研發成果將可以提供執行腹腔鏡手術時更完整的解剖學與影像資訊，配合上器械自由度與力回饋的改善，將可以讓腹腔鏡手術的過程更加簡單、順暢，進一步改善腹腔鏡手術的安全性和治療效果。<br> Abstract: Minimal invasive surgery (MIS) has developed for almost two decades. Due to it causes smaller scars, lower blood loss, shorter hospital stay, and lower morbidity rates. Nowadays, open surgery is gradually replaced by MIS, which is mainly applied to cholecystectomy, splenectomy, nephrectomy, and hepatectomy.Despite the MIS has lots of advantages, it still could not fully replace the open surgery. The first reason is the limitation of the view of laparoscopy. Surgeons can only observe the surface of the organs through laparoscopy, without seeing the distribution of vessels and tumors. The view of laparoscopy is usually focused on a local but not global area in a patient’s abdomen. The second reason is the limitation of workspace in abdominal cavity. Surgeons could only operate MIS by inserting the instruments into patient’s body through ports on the abdomen. If the ports are set inappropriately, surgeons might not be able to carry out the medical plan. Moreover, surgeons lost the sense of touch as indirectly contacting with the target of surgery in MIS. This subproject will integrate the achievements of other subprojects to develop an augmented reality minimal invasive surgical system. The achievements are the solutions to break the limitations in MIS. Finally, the system with augmented reality for MIS is established, thus help the surgeon to break the two limitations of the MIS.The purpose in the first year is to reconstruct a three-dimensional abdominal model, and secondly arrange the port placement and plan the instrument locations by considering the three-dimensional abdominal model, the biomedical limitation, and the fluency of surgery. The purpose in the second year is to design the display and operation interface of an augmented reality minimal invasive surgical system. The purpose in the third year is to integrate the information from other subprojects. In addition, we will develop an information integration and treatment planning for mini-invasive surgical system, and verify its accuracy and stability by in-vivo experiments.The achievement of the subproject will provide more sufficient information of anatomy in MIS. With enhancing the instruments’ degree of freedom and force feedback, MIS will be simpler. Thus the safety and the therapeutic effect in MIS will be enhanced.微創手術腹腔鏡手術肝臟切除手術穿刺套管位置資訊整合Minimally Invasive SurgeryHepatectomyPort PlacementComputer-Assisted Surgery SystemInformation Integration