机械设计制造及自动化专业外文翻译--外科手术机器人的现状临床应用和技术挑战(编辑修改稿)

机械设计制造及自动化专业外文翻译--外科手术机器人的现状临床应用和技术挑战(编辑修改稿)内容摘要：

s review article highlights the state of the art of medical robotics across several clinical areas. In this review, we will focus on robots that play an active role during a surgical intervention. These systems are not meant to replace the physician, but rather to augment the capabilities of the physician. There are other categories of medical robotics, such as robotics for rehabilitation or miniature robots that might be placed inside the body, but these will not be discussed here. This review is not intended to be prehensive, but rather to give an overview of the field, with a focus on key historical developments and on current work. Several other medical robotics review articles with a focus on surgical procedures have also been written. Davies [2] describes the history of surgical robotics and gives one classification for the types of robot systems studied by researchers. Taylor [3] discusses several taxonomies for surgical robotics and presents a different classification. Troccaz [4] gives a historical review and describes passive, semiactive, and active robotic systems. Howe [5] overviews applications in imagebased procedures, orthopedic surgery, and neurosurgery, among others. Specialized reviews also exist, such as the article by Caddedu on urology robotics [6]. The paper is organized as follows. Section 2 gives a brief historical review, followed by a table of clinical applications in Section 3. Each of these clinical applications is then described. Section 4 presents technology challenges and research areas. Conclusions are given in Section 5. Historical Review Medical robotics is a relatively young field, with the first recorded medical application of a robot occurring in 1985 [7]. In this case, the robot was a simple positioning device to orient a needle for biopsy of the brain. A 52yearold man was put on a CT scanner table, the target was identified on the CT images, and the robot was used to orient a guide tube through which a needle was inserted. Unfortunately, the robot used was a PUMA 560 industrial robot, and safety issues concerning the operation of the robot in close proximity to people prevented this work from continuing [2]. Shortly thereafter, research groups in Europe, Asia, and the United States began investigating medical applications of robotics. In Europe, a group at Imperial College in London under the direction of Davies began developing a robot for prostate applications [8]. At Grenoble University Hospital in France, Benabid, Lavallee, and colleagues started work on neurosurgical applications such as biopsy [9]. In Asia, Dohi at Tokyo University developed a prototype of a CTguided needle insertion manipulator [10]. In the ., Taylor and associates at IBM began developing the system later known as ROBODOC [11]. Currently, there are several mercial ventures and a handful of research laboratories active in the field of medical robotics. These early research efforts have led to some mercial products. For example, the work at Grenoble University Hospital led to the NeuroMate robot of Integrated Surgical Systems as described in Section . Clinical Applications There are several ways to classify the use of robots in medicine. One scheme, as developed by Taylor [3], is to classify robots by the role they play in medical applications. Taylor stresses the role of robots as tools that can work cooperatively with physicians to carry out surgical interventions and identifies five classes of systems: 1. Intern replacements 2. Telesurgical systems 3. Navigational aids 4. Precise positioning systems 5. Precise path systems While this classification is technology oriented, we have chosen to divide the field by clinical application in this paper. Clinical applications are more interesting to the enduser, and a list of seven clinical areas where robotics have been applied is shown in Table 1. This table is not meant to be inclusive, but representative research groups and mercial vendors in several areas have been selected to give the reader an overview of the field. The column labeled “Studies” refers to whether human trials, animal studies, cadaver studies, or other studies have been done. Neurosurgery As mentioned in the historical review, neurosurgery was the first clinical application of robotics and continues to be a topic of current interest. Neurosurgical stereotactic applications require spatial accuracy and precision targeting to reach the anatomy of interest while minimizing collateral damage. This section presents three neurosurgical robotic systems. 1. Minerva from the University of Lausanne in Switzerland 2. NeuroMate from Integrated Surgical Systems in the . 3. An MRI patible robot developed by Dohi and colleagues in Japan Minerva One of the earliest robotic systems developed for precise needle placement was the neurosurgical robot Minerva [13], designed for stereotactic brain biopsy. A special purpose robot was constructed which was designed to work within the CT scanner so that the surgeon could follow the position of the instruments on successive CT scans. NeuroMate The NeuroMate is a sixaxis robot for neurosurgical applications that evo。