目的:通过构建超远程机器人手术的实验动物模型,验证超远程机器人辅助腹腔镜输尿管损伤修复术的安全性.方法:采用国产民用多孔腔镜手术机器人MP1000,其主从系统分别放置在北京和三亚(两地间距约3000公里并跨越琼州海峡),建立下段输尿管完全离断的动物模型,采用超远程机器人辅助腹腔镜输尿管膀胱再植术修复损伤.记录单次手术操作时间(分钟)、单次手术出血量(毫升)、网络环境指标如带宽、延迟、丢帧等.然后通过技术手段动态将带宽限制在不同区间内进行手术,并采用问卷调查反馈操作感受.结果:所有8台超远程机器人输尿管膀胱再植手术均顺利完成.单次手术操作时间30~45分钟,平均(37.5±4.5 min);单次手术出血量1~5毫升,平均(2.8±1.2 ml).实验动物生命体征平稳.在手术过程中,未发生机器和器械故障.在正常网络环境下数据传输稳定;人为动态限制带宽后,手术视野清晰度有所降低,但术者在精细操作上需要花费更多时间和精力,但不会损失关键信息,能够保证手术的正常进行.结论:本研究证实超远程机器人辅助腹腔镜输尿管损伤修复术在动物模型中是安全可行的,为后续人体超远程手术的实施提供理论和实践基础.
Objective:To verify the safety of ureteral injury repair by constructing an experimental animal model of robotic telesurgery.Methods:The domestic endoscopic surgery robot MP1000 was used,and its master-slave sys-tems were placed in Beijing and Sanya,respectively.The distance between the two places which crossed the Qiong-zhou Strait,was about 3000 km.The animal model of complete amputation of lower ureter was established.Ureteral bladder replantation was performed.Key parameters including single operation time(minutes),single operation bleeding volume(ml),and network indicators were recorded.The bandwidth of network was then dynamically limit-ed in different intervals through technical means.,After completing the operation,the surgeon filled in a questionnaire to feedback the feeling of the operation.Results:All 8 robotic ureteral bladder replantation were completed success-fully.The operation time were 30-45 minutes,(37.5±4.5 min).The blood loss were 1-5 ml,(2.8±1.2 ml).The vi-tal signs of experimental animals were stable.During the operation,there was no mechanical failure.Under the nor-mal network environment,the data transmission was stable.After dynamic limitation of bandwidth,the operation vi-sual field is blurred,however the key visual information is intact,which can ensure the normal proceeding of surgery.But the surgeon needed to be more discreet on subtle maneuver.Conclusion:This study confirms that the animal model construction and robotic telesurgery for ureteral injury repair is safe and feasible,which provides a theoretical and practical basis for the follow-up human surgery.