Essential techniques and current research situation in robotic endovascular systems
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1.Department of Vascular Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China;2.the Institute of Vascular Diseases, Central South University, Changsha 410011, China;3.Department of Vascular Surgery, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China

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R654.3

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    Abstract:

    As a minimally invasive treatment, endovascular therapy has been widely used in different disciplines such as vascular surgery, both interventional cardiology and cardiovascular surgery as well as neurosurgery. There are some problems in sustainability and accuracy in traditional vascular interventional surgery that is operated by manipulation of the catheter and guide wire with hands under X-ray fluoroscopy, meanwhile the operators are at high risk of occupational hazards from long-term X-ray exposure and the burden of the lead apron. The robotic system for endovascular intervention has the advantages of significantly reducing the exposure of the operators to radiation, accurate imaging positioning, as well as precise and stable operation. It not only reduces the contact between the instrument and the vessel wall and minimizes the uncontrolled tremors, but also increases the operator's sensation of comfort, which has currently become the research hotspot of medical robot. Here, the authors introduce some key techniques of endovascular intervention robot system, such as image navigation, structure of mechanical arm, force feedback and safety performance, and describe the progress of endovascular intervention robot system at home and abroad, and also illustrate the importance of these techniques through their clinical applications, and then discuss the development trend of these key techniques. Although the progress of technology has greatly promoted the development of robotic endovascular system, it should be noted that there are still many deficiencies. For example, the lack of haptic feedback limits its application in complex and difficult lesions, such as calcified lesions and chronic occlusive lesions. At the same time, there is a lack of endovascular intervention instruments applicable for the currently commercialized guide wires, catheters, balloons and stents. Frequent replacement of interventional devices will lead to an increase in surgical time and further reduce the controllability of surgery. The rapid development of artificial intelligence and 5G communication technology will provide a more accurate and standardized development direction for endovascular intervention robot system. Furthermore, on the basis of artificial intelligence, the integration of robotic endovascular system with endovascular imaging equipment and the application of virtual reality technology provides a broader prospect for precise vascular interventional surgery, and points out the future research direction. The development of endovascular intervention robot system complies with the present trend of precision medicine, and provides protections for vascular interventional physicians. However, this technology still needs some more time for improvement and perfection, and defining the indications and contraindications, as well as establishing a standard procedure, and assessing the long-term efficacy by a number of clinical trials, so that it can be used more widely.

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HE Hao, YE Zijian, SHU Chang. Essential techniques and current research situation in robotic endovascular systems[J]. Chin J Gen Surg,2021,30(12):1477-1484.
DOI:10.7659/j. issn.1005-6947.2021.12.012

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History
  • Received:April 02,2021
  • Revised:October 25,2021
  • Adopted:
  • Online: January 07,2022
  • Published: