Design of an Augmented Clamping Instrument for Advanced Aneurysm Surgery

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题名:	Design of an Augmented Clamping Instrument for Advanced Aneurysm Surgery
作者:	詹佩毓;Chan, Pei-Yu
贡献者:	機械工程學系
关键词:	機構設計;腦動脈瘤;夾閉手術;單點觸發機構;線傳動;Mechanical design;Cerebral aneurysm;Clipping surgery;Single point trigger mechanism;Cable transmission
日期:	2021-08-10
上传时间:	2021-12-07 13:27:23 (UTC+8)
出版者:	國立中央大學
摘要:	在腦動脈瘤的夾閉手術中，神經外科手術醫生需先將切開患者的一部分顱骨，再使用腦動脈瘤夾具將夾子夾在大腦的血管上。通往腦動脈瘤的路徑較窄，以及夾子要安裝的位置很小，此外，要安裝的動脈的方向不一致，即便外科手術醫生在操作過程中十分準確，因為傳統的手術夾具是使用剪刀狀的裝置，夾子的安裝和夾具的釋放有密切的關係，因此很難確保夾子在釋放時可以保持在中心線上，釋放夾子所需要的力也會影響醫生在操作上的準確性。本研究旨在設計一種機械裝置作為腦動脈瘤的新工具，不僅可以讓夾子的作用更穩定，也可以增加自由度，以便在患者腦中操作時有更好的導向。新的設計改變了夾具的外型，使它可以用於顱骨鑽孔手術，是一種對患者更加安全的手術，只需要鑽一個孔來取代移除大面積的顱骨。此設計藉由傳統滾球滑鼠的概念來控制所添加的球形關節之旋轉，另外，夾具的開合運用了單點觸發器的概念來取代傳統的剪刀外型，讓夾子在釋放時能更準確地保持在夾具的中心軸上。 ;In the aneurysm clipping surgery, the neurosurgeon needs to cut and remove a part of the patient’s skull first, and then use a surgical instrument to apply a clip on a blood vessel of the brain. The path leading the aneurysm is narrow and the location where the clip needs to be installed is small. In addition, the artery where it is installed can present itself in any orientation, even if the neurosurgeon operates very accurately during the procedure, the installation of the clip is associated with parasitic motion due the scissor shape and operation method of the traditional aneurysm instrument. Consequently, it is difficult to maintain the middle axis of the clip during its release, and the force required to release the clip is also altering the accuracy of the neurosurgeon’s gesture. This study aims to design a mechanical device as a new instrument of aneurysm. Not only its design will allow a more stable clip application, but it will present additional degrees of freedom to allow better navigation inside the patient’s brain. The change of shape given by the new design will allow its use in Burr hole surgery, which is a safer procedure of the patient as only drilling a hole will be necessary instead removing a large section of the skull. The design relies on traditional ancient ball mouse to control the rotation of an added spherical joint. Also, the opening and closing of the instrument clamp is performed using a single-point trigger as a replacement of the traditional cumbersome scissors shape. This allows a maintaining the instrument axis more accurately during the clip release.
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