腔镜手术机器人研发的关键问题及解决对策

doi:10.3877/cma.j.issn.1674-6899.2025.03.001

中华腔镜外科杂志(电子版) ›› 2025, Vol. 18 ›› Issue (03) : 129 -133. doi: 10.3877/cma.j.issn.1674-6899.2025.03.001

专家论坛

腔镜手术机器人研发的关键问题及解决对策

张恭¹, 杨叶蓁², 王斐¹, 张卓超¹, 张修平¹, 史靖², 邢元², 刘荣¹^,^†(

)

¹100853　北京，中国人民解放军总医院第一医学中心肝胆胰外科医学部
²300072　天津大学医疗机器人与智能系统研究院

收稿日期:2025-04-03 出版日期:2025-06-30
通信作者: 刘荣
基金资助:
北京市AI＋健康协同创新培育(Z221100003522005); 天津市科技局，京津冀协同创新项目(24YFXTHZ00220)

Critical challenges and mitigation strategies in endoscopic surgical robotic system research and development

Gong Zhang¹, Yezhen Yang², Fei Wang¹, Zhuochao Zhang¹, Xiuping Zhang¹, Jing Shi², Yuan Xing², Rong Liu¹^,^†()

¹Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing 100853, China
²Institute of Medical Robotics and Intelligent Systems, Tianjin University, 300072, China

Received:2025-04-03 Published:2025-06-30
Corresponding author: Rong Liu

全文 ( ) 下载PDF ( ) 导出引用

目的

系统分析当前国产腔镜手术机器人研发面临的核心挑战，并提出相应的解决对策，以推动国产系统的技术突破与战略转型。

方法

聚焦国产腔镜手术机器人研发中普遍存在的"多模态操作数据融合难题""狭小空间多臂协同避障挑战"以及"力反馈缺失风险"三大关键问题及其解决策略。

结果

围绕上述三大挑战寻求解决方案，国产系统在技术替代进程中已取得显著进展。

结论

国产腔镜手术机器人的未来发展应着力于专科器械创新、远程手术功能实现以及智能化决策支持，以此突破核心技术瓶颈。推动系统从三级甲等医院向基层医疗体系普及，最终实现从技术替代到原创引领的战略升级。

关键词: 腔镜手术机器人, 技能评价框架, 虚拟夹具, 力反馈机制, 多臂协同

Objective

To systematically analyze the core challenges in the current research and development of domestic laparoscopic surgical robots and propose corresponding solutions to promote technological breakthroughs and strategic transformation for domestic systems.

Methods

Focusing on the three key problems prevalent in the research and development of domestic laparoscopic surgical robots-the challenge of multi-modal operational data fusion, the challenge of multi-arm collaborative obstacle avoidance in confined spaces, and the risk posed by the lack of force feedback-along with their solution strategies.

Results

Significant progress has been made in the technological substitution process of domestic systems while seeking solutions around the aforementioned three major challenges.

Conclusion

The future development of domestic laparoscopic surgical robots should focus on specialized instrument innovation, the realization of remote surgery functionality, and AI-powered decision support to overcome core technical bottlenecks. This will expand access from top-tier Class A tertiary hospitals to grassroots healthcare systems, ultimately achieving a strategic transformation from technological substitution to original innovation leadership.

Key words: Endoscopic surgical robotic systems, Skill evaluation framework, Virtual fixture, Force feedback mechanism, Multi-arm collaboration

图1 机器人辅助微创外科手术操作技能综合评价方法框架^[5,6,7,8]

图2 碰撞干涉检测模型^[15]

图3 术前规划算法流程图

图4 几种力测量装置

图5 不同经验受试者施加力注：A.新手受试者施加力；B.中级受试者施加力；C.专家受试者施加力^[21]

1	Guthart GS, Salisbury JK. The Intuitive/sup TM/telesurgery system: overview and application; proceedings of the Proceedings 2000 ICRA Millennium Conference IEEE International Conference on Robotics and Automation Symposia Proceedings (Cat No 00CH37065), F, 2000[C]. IEEE.
2	McLeod IK, Melder PC. Da Vinci robot-assisted excision of a vallecular cyst: a case report [J]. Ear, nose & throat journal, 2005, 84(3): 170-172.
3	Hardon SF, Horeman T, Bonjer HJ, et al. Force-based learning curve tracking in fundamental laparoscopic skills training [J]. Surgical endoscopy, 2018, 32: 3609-3621.
4	Mathis R, Watanabe Y, Ghaderi I, et al. What are the skills that represent expert-level laparoscopic suturing? A Delphi Study [J]. Surgical endoscopy, 2020, 34: 1318-1323.
5	Jiang J, Xing Y, Wang S, et al. Evaluation of robotic surgery skills using dynamic time warping[J]. Comput Methods Programs Biomed, 2017, 152:71-83.
6	Liang K, Xing Y, Li J, et al. Motion control skill assessment based on kinematic analysis of robotic end-effector movements[J]. Int J Med Robot, 2018, 14(1).
7	Xing Y, Liang K, Wang S, et al. Safety oriented evaluation (SOE) of robot-assisted minimally invasive surgery (MIS) performance skill; proceedings of the 2014 IEEE International Conference on Robotics and Biomimetics (ROBIO 2014), F, 2014 [C]. IEEE.
8	Peng W, Xing Y, Liu R, et al. An automatic skill evaluation framework for robotic surgery training[J]. Int J Med Robot, 2019, 15(1):e1964.
9	彭文佳. 单孔手术机器人安全操作导引方法 [D]. 天津大学，2018.
10	Wang Z, Yan Z, Xing Y, et al. Real-time trajectory prediction of laparoscopic instrument tip based on long short-term memory neural network in laparoscopic surgery training[J]. Int J Med Robot, 2022, 18(6):e2441.
11	江竞宇. 基于安全性的手术机器人机构与手术技巧评价 [D]. 2018.
12	Rosenberg LB. Virtual fixtures: perceptual tools for telerobotic manipulation; proceedings of the Proceedings of IEEE virtual reality annual international symposium, F, 1993 [C]. Ieee.
13	Kikuuwe R, Takesue N, Fujimoto H. A control framework to generate nonenergy-storing virtual fixtures: Use of simulated plasticity [J]. IEEE Transactions on Robotics, 2008, 24(4): 781-793.
14	梁科. 面向手术安全性的腹腔镜微创手术机器人性能评价与实验研究[D]. 天津大学，2020.
15	Gao L, Xing Y, Bian Y, et al. Preoperative planning and experimental validation for robot-assisted minimally invasive surgery based on a clinical evaluation system[J]. Int J Med Robot, 2025, 21(1):e70042.
16	Montoya-Alvarez S, Minor-Martínez A, Ordorica-Flores RM, et al. Construct validity of the SurgForce system for objective assessment of laparoscopic suturing skills [J]. Surgical endoscopy, 2020, 34: 5188-5199.
17	Tang B, Hanna G, Cuschieri A. Analysis of errors enacted by surgical trainees during skills training courses [J]. Surgery, 2005, 138(1): 14-20.
18	Wee J, Azzie G, Drake J, et al. Proof of concept study: investigating force metrics of an intracorporeal suturing knot task[J]. J Laparoendosc Adv Surg Tech A, 2018, 28(7):899-905.
19	Cundy TP, ThangarajE, Rafii-Tari H, et al. Force-Sensing Enhanced Simulation Environment (ForSense) for laparoscopic surgery training and assessment [J]. Surgery, 2015, 157(4): 723-731.
20	唐逸博. 微创外科手术缝合操作技能的安全性评价研究 [D]. 天津大学，2024.
21	Tang Y, Chen M, Xing Y, et al. Validation of a training system for laparoscopic longitudinal suturing in lesion[J]. Int J Med Robot, 2023, 9:e2594.
22	挑战不可能：现实版"科幻大片"！医生挑战5G远程缝合鸡蛋膜 [Z]. 北京；央视网. 2020-1-28

No related articles found!

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Critical challenges and mitigation strategies in endoscopic surgical robotic system research and development

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Critical challenges and mitigation strategies in endoscopic surgical robotic system research and development