新生兒的頭骨尚未癒合，未覆蓋區域由軟組織「囟門」所組成，柔軟的囟門可用超音波進行顱內檢查，稱為顱內超音波（ICU），這對保溫箱內的新生兒是例行性檢查與臨床監測。因ICU新生兒患者是在保溫箱內，使得該檢查步驟變得困難，近來遠端ICU檢查技術已受到關注，但仍未有新生兒ICU檢查之遠端操作系統。本計畫旨在設計一遠端超音波技術，可對新生兒執行遠端超音波檢查之醫療機器人，協助醫生對遠距離新生兒患者進行超音波檢查。本研究所提出的機器人機構將以一個雙自由度（DoF）縮放儀機構為基礎設計概念，然後再將此概念擴張為六自由度的創新設計，並模擬臨床動作的動力與力度分析作為機構設計與最佳化設計基礎。本研究將設計一觸覺控制裝置與一力回饋系統，使醫師得以遠端控制醫療機械人，運用主動式力回饋系統感測操醫師的臨床操作，並回饋至觸覺控制裝置中，並產生相同的運動感知且可精準控制施加於囪門的力度。此外，規劃一系列實驗，透過運動捕捉系統與外部力感測裝置，以測試此一主從式醫療機械人系統的運動軌跡與力回饋控制。臨床實驗將使用新生兒假人模型，結合本研究發展的醫療協同系統，驗證應用於ICU檢驗的可行性。本計畫具有高度創新性與發展性，發展第一個專用於保溫箱內新生兒的超音波遠端醫療機械人與創新性機構與結構的設計。此外，本計畫所發展的架構，包含遠端通訊、操控等，可為各種遠端超音波醫療的應用範例。 ;Newborn children before the age of 9 to 18 months have an anatomical particularity: their skull is composed of several separated bones leaving a zone of soft tissues: fontanelle. These bones are subject to an ossification that progressively closes the skull. The softness of the fontanelle tissues allows the propagation of ultrasonic waves, which makes possible the use of ultrasound for intracranial examination. This specific medical care is called Intracranial Ultrasound (ICU) examination. This task is performed in large number in Taiwan, as a routine exanimation or as critical clinical monitoring where the patients are often place inside neonatal incubator. The objective of this project is to design the first robotic manipulator being able to perform remote ICU examinations on newborn patients. The specific medical robotic application that allows a doctor to provide ultrasound examination to a distant patient, namely the tele-echography, has been subject to many attentions by medical robotic research since the nineties. However, a tele-operated system dedicated to the examination of newborn’s fontanelle has never been proposed. This project will focus on the mechanical design of the robotic manipulator that holds the ultrasound probe and the haptic control mechanism device that allows the operator to control the system. The ICU examination through the fontanelle is a delicate procedure as the tissues in contact with probe are fragile. Moreover, the patient is located inside an incubator. This makes the present procedure very challenging to robotize. A new mechanism based on a common pantographic architecture of two Degree of Freedom (DoF) is proposed for the design of the manipulator. Specific architectural improvements are implemented to enhance it into a six-DoF mechanism (three linear and three angular). The definition and the medical-oriented optimization of this mechanism will be based on the result of kinematic and force analysis of the clinical task gesture through experimentations. In order to complete the robotic system, a haptic control device will be design to allow the pediatric doctor to remotely control the manipulator. An active force feedback system will generate to operator the same kinesthetic sensations of a real examination. It will also allow the operator to accurately control the force to apply on the fontanelle tissues. A series of experimentation are planned to be carried out to test and to validate the motion trajectory and force feedback system of the global “Master-Slave” robotic system. They will respectively rely on motion capture system and external force sensor method. Final clinical simulation experiments using newborn phantom models will be performed with our medical collaborator to validate the robotic system for ICU examination. This project will bring significant outcomes in terms of innovations: the first medical robotic system dedicated to pediatric patients, the development of a robotic arm able to operate inside an incubator and the definition innovative mechanical architecture. Also, it will generate a demonstrator for further multidisciplinary tele-echography project involving tele-manipulation, communication, control, etc.
