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机器人变身骨科医生 精准辅助外科手术

2017-09-20 15:02:22   中国青年网

羊城晚报讯 记者郑诚,通讯员张键怡、冯灿报道:16日上午,佛山市中医院成功利用骨科手术机器人,为一名股骨颈骨折患者完成骨折闭合复位内固定术,这也是华南首例机器人辅助骨折固定术。据介绍,通过机器人的智能辅助、精准定位,医生将空心螺钉准确打入骨折部位,精度达到亚毫米级,手术时间缩短了大约一半,减少了对病人的二次损伤以及术中辐射,大大提高手术效率和质量。

患者陈先生(化名)近日不慎跌倒导致股骨颈骨折,需要进行闭合复位内固定术。9月16日上午,手术如期进行,主刀医生由佛山市中医院院长刘效仿担任,医院多位医疗技术骨干也参与了手术。而手术室里的新面孔——骨科手术机器人也已提前进场准备就绪。

医生首先为患者针对性地实施“单侧腰麻+静脉全麻”,患者仰卧于牵引床。随后对患者骨折部位实施手法复位,复位满意后,继而进入空心螺钉内固定环节。此时,骨科手术机器人派上用场。它由三部分组成,包括光学跟踪相机、六轴机械臂和机器人操作系统。手术现场,患者的骨折影像通过C型臂X光机被同步传输至机器人操作系统。刘效仿开始在系统屏幕上设计空心螺钉的植入路线和位置规划。做好规划后,机器人在接收到指令后开始运行,根据设计好的进钉路线,机械臂自动伸展并将安装在“手臂”末端的套筒精准定位到患者皮肤表面、空心螺钉导针轴线位置。随后刘效仿沿着套筒向患者骨折部位钻入2.8毫米导针,之后通过X光影像扫描检验导针位置与前期规划是否完全一致。

在确认准确无误后,机器人再次运转,定位到第二根导针进入的位置。医生在机器人的引导下,钻入第二根导针。经过扫描,两根导针进入的深度和角度均与前期规划完全一致,最终,两枚直径7.3毫米的空心螺钉顺着导针的指引被准确拧进骨折部位,顺利实现微创内固定。整个手术实际只花了20分钟,是传统手术耗时的一半左右。

据介绍,这台骨科手术机器人名叫“天玑”,是目前国际上唯一能开展脊柱全节段、骨盆骨折及四肢骨折手术的骨科机器人。通过骨科手术机器人开展手术,精确度达到0.8毫米,减少术中辐射70%以上,并具有减少失血量和术中软组织创伤等优势。如今该机器人已经在北京积水潭医院等国内30多家医院配合医生顺利完成了3200多例手术。佛山市中医院此次实施的为华南地区首例,应用的“天玑”是第三代、也是最新一代机器人。

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