目的 本研究旨在建立基于数字图像相关技术的非接触式力学测试评估平台，明确其在经脐入路腹腔镜手术操作评估中的可靠性。方法 用腹腔镜模拟训练箱和SILS Port组建经脐入路腹腔镜手术操作平台。分析基于数字图像相关技术评估平台得到的位移与应变分量改变与客观标准——万能材料试验机水平牵引载荷改变的相关性。结果 本实验中8次重复实验的研究结果均显示，由数字图像相关技术得到的位移与应变分量改变与万能材料试验机牵引实验载荷改变呈强相关，且相关系数有统计学意义(P<0.001)。结论 基于三维数字图像相关技术的非接触式力学测试方法反映了器械进行操作时SILS port 发生的综合性力学参数改变，方法可靠，适用于经脐入路腹腔镜手术器械与操作方法评估。
Objective Analysis of mechanical measurements in laparo-endoscopic single-site surgery (LESS) is an important instrument design and surgical simulator.Aims of this study was to set up and evaluate the reliability and stability of noncontacting mechanical measurement system for instrument of LESS in company with digital image correlation technology.Methods The noncontacting mechanical measurement system was connected to a digital image correlation devices and a LESS manipulation platform (set up with a SILS Port and an inanimate laparoscopic trainer box).The correlation between the changes of deformation measurements (displacement and strain calculated by digital image correlation technology) and the change of workload (workout by the universal material testing machine)were evaluated.The experiment was repeated 8 times.Results A strong correlation was noticed between the changes of deformation measurements and the change of workload.The correlation coefficient was statistical significant (P<0.001).A high stability was well shown in all repetitions.Conclusions A noncontacting mechanical measurement system has been developed for LESS.Comprehensive mechanical parameters of SILS port can be obtained precisely by the digital image correlation technology.It is reliable and stable for the evaluation of instruments and manipulations in laparo-endoscopic single-site surgery by this system.
[1] Zhu JF.Scarless endoscopic surgery:NOTES or TUES[J].Surg Endosc,2007,21(10):1898-1899.
[2] Zhu JF.Transumbilical endoscopic surgery:History,present situation and perspectives[J].World J Gastrointest Endosc,2011,3(6):107-109.
[3] Kommu SS,Kaouk JH,Rane A.Laparo-endoscopic single-site surgery:preliminary advances in renal surgery[J].BJU Int,2009,103(8):1034-1037.)
[4] Joseph RA,Goh AC,Cuevas SP,et al.Chopstick surgery:a novel technique improves surgeon performance and eliminates arm collision in robotic single-incision laparoscopic surgery[J].Surg Endosc,2010,24(6):1331-1335.
[5] Botden S,Strijkers R,Fransen S,et al.The use of curved vs.straight instruments in single port access surgery on standardized box trainer tasks[J].Surg Endosc,2011,25(8):2703-2710.
[6] Stolzenburg JU,Kallidonis P,Oh MA,et al.Comparative assessment of laparoscopic single-site surgery instruments to conventional laparoscopic in laboratory setting[J].J Endourol,2010,24(2):239-245.
[7] Zhu JF,Xu An An.Can cross-handed approach improve maneuver in transumbilical laparoscopic surgery?[J].Surg Endosc,2013,27 ( 4 ):1444-1445.
[8] Dongsheng Zhang,S Mao,C Lu,Elaine Romberg,et al.Dehydration and the Dynamic Dimensional Changes within Dentin and Enamel[J].Dental Materials,2009,25(7):937-945.
[9] Nazari A,Bajaja D,Zhang D,Romberg E,et al.Aging and the reduction in fracture toughness of human dentin[J].Journal of the Mechanical Behavior of Biomedical Materials,2009,2(5):550-559.
