Recently, the three-day 2024 China University Science and Technology Achievement Fair was held in Nanjing. More than 2,700 scientific research achievements from 425 universities across the country participated in the transaction, of which 241 universities carried out on-site display and trading with key promotion results, attracting nearly 3,000 enterprises to come to exchange and negotiate. Nanjing Medical University's project "Operational Minimally Invasive Orthopedic Surgical Robot System" has attracted widespread attention.
Li Liang, the project leader and a teacher from the School of Biomedical Engineering and Information Science of Nanjing Medical University, introduced that this project innovatively designed a robotic operation scheme with programmable screwing of multi-layer surgical tools in minimally invasive orthopedic surgery, and overcame a number of key technologies such as automatic surgical planning, operation slip prediction and perception, and autonomous bone cutting state recognition. It can meet the clinical needs of automatic needle placement, bone cement insertion, nerve stimulation, bone biopsy and other aspects, and can significantly improve the efficiency and operation safety of minimally invasive orthopedic surgery.
"The previous generation of navigation robots has been able to accurately guide the path of surgical instruments, but doctors still need to do it manually in operation, such as minimally invasive bone channel establishment, bone forming, etc. This requires a lot of effort on the part of the doctor. Li Liang introduced, "Our operational orthopedic robot not only requires precision, but also completes the strength work for doctors. The doctor is responsible for thinking, and the robot is responsible for execution. Before surgery, image modeling combined with optical tracking system ensures high-precision tracking, so as to ensure the accuracy of the operation. "
Bone tissue is hard, and the mechanical properties of bone tissue vary greatly from patient to patient. Unlike working with soft tissue, the hard and irregular shape of the bones, especially in the spine area, often causes surgical instruments to slip when they touch their surfaces. To this end, the project team set out to conduct research on slip perception and applied for various scientific research projects to explore in depth the measurement method of slip and how to effectively control the robot to reduce or avoid slippage during surgery.
Doctors need to rely on hand to operate during surgery, just like when digging with a shovel, they can feel the resistance and changes of the soil, if they are replaced by an excavator to dig the soil, due to the lack of feel, it may not be able to perceive the underground water pipes, which can easily lead to the water pipes being dug up, and similarly, in the operation, if the robot is allowed to operate without giving it the corresponding perception ability, it may easily damage the nerves or blood vessels of the surgical patient. Therefore, "giving robots the ability to perceive the end of the operation, so that they can perceive resistance and changes during surgery like a doctor." Li Liang explained, "At the end of the surgical position, we are equipped with a power system with end-sensing function, which can control the operation of the instruments and ensure that the instruments can accurately reach the surgical area predetermined by the doctor."
Talking about technological innovation, Li Liang said: "In the past, doctors had to manually plan surgery on a computer based on experience when facing images. But now, we are looking at common clinical cases, such as spine surgery, and we find that the path often follows a certain paradigm, always passing through several key anatomical structures. Therefore, we hope to use AI technology to train doctors on the data of manually planned surgeries, so that they can recommend the optimal location of surgery when new images are given. This location may not be the best, but in any case, it is far more efficient than in the past, when it was all planned manually by doctors. "
At the same time, he also emphasized that "although the current AI technology is very advanced and robots can give valuable advice, they still cannot completely replace the judgment and decision-making of doctors."