面向方舱医院应急场景的多链路远程手术机器人系统创新设计与验证

Innovative design and validation of a multi-link telesurgical robotic system for emergency scenarios in square pod hospitals

  • 摘要: 背景 既往复杂战创伤背景下,前沿救治场所因无装备、无设备、无场地开展确定性手术。如何将高端医疗技术前伸战场一线、将后方专家的救治能力快速部署至前方救治单元,是有效提升战创伤救治能力,减少因伤致死、致残的重要手段。目的 探讨在方舱医院手术组模块开展基于多链路聚合传输系统的远程机器人辅助交互式手术技术突破与应用前景。方法 分析2024 年12 月20 日首台在方舱医院手术组模块内采用远程机器人辅助交互式手术行股骨颈骨折闭合复位内固定术的相关技术性指标,包括远程手术的延迟时间、手术置钉时间及出血量等。结果 1 名51 岁男性患者,因外伤所致右侧股骨颈骨折,前线军医依托专家远程指导、远程规划及远程监视下精准完成手术操作。远程中心建立在解放军总医院某医学中心(网络通讯距离为2 652 km),手术方式为股骨颈骨折闭合复位微创螺钉置入。该手术整体总延迟为85 ms,未出现数据包丢失现象;专家远程规划时间10 min;机器人辅助置入三枚螺钉,平均每枚时间为10 min;术中出血量10 mL;在术中透视验证取得良好的复位效果,术后无切口感染等术后并发症。结论 在方舱医院场景下第一次实现骨折创伤的远程机器人辅助交互式手术,该系统基于多链路聚合传输系统所构建,整合方舱医院内各类信息系统,可综合诊疗伤员,提升救治效果。

     

    Abstract: Background Under the complex circumstances of combat trauma, forward medical facilities often lack the necessary equipment, facilities, or space to perform definitive surgical procedures. Extending advanced medical technologies to frontline battlefields and rapidly deploying rear-area specialists' treatment capabilities to forward treatment units constitute crucial approaches for effectively enhancing combat trauma care capabilities while reducing mortality and disability rates caused by battlefield injuries. Objective To explore the technological breakthroughs and application prospects of remote robot-assisted interactive surgery based on multi-link aggregation transmission system in the surgical team module of the Square Cabin Hospital. Methods The technical indicators related to the first closed reduction and internal fixation of femoral neck fracture using telerobotic-assisted interactive surgery within the surgical group module of the Cube Hospital on 20 December 2024 were analyzed, including the delay time of telerobotic surgery, surgical pinning time, and bleeding volume. Results A 51-year-old male patient with fracture of the right femoral neck due to a traumatic injury was operated precisely by frontline military doctors relying on expert tele-guidance, tele-planning and tele-surveillance. The remote center was established at a Medical Center of Chinese PLA General Hospital (network communication distance: 2 652 km), and the surgical procedure was performed via closed reduction and minimally invasive screw fixation for femoral neck fracture. The overall total delay of the surgery was 85 ms, with no packet loss. The expert remote planning took 10 minutes; the robotic system assisted in the insertion of three screws, with an average time of 10 minutes per screw. The intraoperative blood loss was 10 mL, and intraoperative fluoroscopy confirmed satisfactory reduction. The patient did not experience postoperative complications such as incision infection. Conclusion The first remote robotic-assisted interactive surgery for fracture trauma in mobile cabin hospital settings have been achieved successfully. The system, built on a multi-link aggregation transmission framework, integrates various information systems within the mobile cabin hospital to enable comprehensive diagnosis and treatment of injured personnel, significantly enhancing treatment efficacy.

     

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