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A Study on Dual SMART System for Bimanual Microsurgery

A Study on Dual SMART System for Bimanual Microsurgery
Translated Title
바이매뉴얼 미세수술을 위한 듀얼 스마트 시스템에 대한 연구
Park, Hyun Cheol
DGIST Authors
Park, Hyun Cheol; Song, Cheol; Hwang, Jae Youn
Song, Cheol
Hwang, Jae Youn
Issue Date
Available Date
Degree Date
2016. 2
Optical coherence tomographybimanual surgeryPZT motorball lensdual SMART systemhorizontal scissorshorizontal forceps광 단층 촬영 장치바이매뉴얼 수술PZT 모터볼렌즈듀얼 스마트 시스템수평 가위수평 폴셉
Manual micro-surgical tasks are fundamentally divided into grasping, cutting and injecting maneuvers performed on biological tissues. Efficient dissection of fibrous tissue from the retina often requires grasping and cutting maneuvers which are carried out simultaneously. True bimanual surgery requires that the surgeon overcomes the hand tremor of both hands at once as well as unpredicted patient’s movement. In this study, we develop and evaluate a dual SMART micro-surgical system for bimanual surgery. The dual SMART system is composed of two common-path swept source optical coherence tomography (CP SS-OCT) distance sensor with a ball lens, two piezoelectric (PZT) motor and customized horizontal scissors and forceps. The ball lens coupled OCT distance sensor could detect the unintended tremor in both hands at tilted angle from 90 to 45 degree. Also, high numerical aperture (NA) of the ball lens coupled OCT sensor has 1.3 times higher signal-to-noise-ratio (SNR) than bare fiber based OCT sensor. In order to achieve efficient bimanual dissection, each end-effector’s desired height could be controlled by the dual SMART system. Total feedback control rate of the system is nearly 500 Hz which is enough to compensate the hand tremor of 6-12 Hz. Additionally, customized horizontal scissors and forceps contribute to accessibility of surgical area compared to commercial vertical scissors and forceps. Results of hand tremor cancellation demonstrate that the ball lens coupled dual SMART system could compensate unpredictable tremor in various tilt angles even in water. The dual SMART system could precisely dissect an egg membrane compared to freehand. The root mean square error (RMSE) of dual SMART is about 10 times smaller than freehand one. Furthermore, dissected surface of the membrane by the system was uniformed. The system with high SNR proved that it could compensate the tremor in a porcine eye compared to freehand. The improved dual SMART system will be useful for bimanual vitrectomy with minimized iatrogenic damage. In the future, durability of the dual SMART system should be improved for the stable microsurgery. ⓒ 2016 DGIST
Table Of Contents
1. INTRODUCTION 1-- 1.1 Objectives and Motivations 1-- 1.2 Background and information 3-- 1.2.1 History of microsurgery 3-- 1.2.2 Bimanual vitrectomy 4-- 2. PRINCIPLE OF OPTICAL COHRENCE TOMOGRAPHY (OCT) 5-- 2.1 Chapter Overview 5-- 2.1.1 Optical coherence tomography (OCT) 6-- 2.1.2 Interference signal using monochromatic source 7-- 2.1.3 Interference signal using broadband source 8-- 2.1.4 Swept source OCT (SS-OCT) 11-- 2.1.5 Common-path OCT in SMART system 13-- 3. DESIGN OF DUAL SMART SYSTEM 14-- 3.1 SMART horizontal micro-forceps and scissors 14-- 3.1.1 System specification 14-- 3.1.2 Dual SMART system 16-- 3.2 Implementation of SMART horizontal scissors and forceps 19-- 3.2.1 SMART horizontal micro-scissors system 19-- 4. EXPERIMENTS 23-- 4.1 Hand tremor cancellation in water 23-- 4.2 Bimanual dissection using a biological membrane 24-- 4.3 Bimanual tasks using a porcine eye 26-- 5. CONCLUSION 28-- REFERENCES 30-- --
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