Science子刊：成功率100%？头戴式手术机器人实现眼科手术"动态零误差"

Core Viewpoint - The article discusses the challenges of retinal injections for genetic therapies and presents a novel solution involving a head-mounted surgical robot that improves precision and success rates in these procedures [1][11]. Group 1: Challenges in Retinal Injections - Retinal injections for genetic therapies, such as Luxturna, are difficult due to precision issues, as the retina is only 300 micrometers thick, requiring exact placement of the needle [2][3]. - Stability is a significant concern, as maintaining the needle's position during slow injections (0.18 ml per minute) is nearly impossible due to patient movement [2][3]. - Patient head movement can cause needle misalignment, with studies showing that even with the head fixed, movements can reach 2 to 5 millimeters, leading to potential complications [3]. Group 2: Innovative Design of the Head-Mounted Robot - The research team from the University of Utah developed a head-mounted surgical robot that moves with the patient's head, addressing the challenge of head movement during procedures [6][7]. - The robot, weighing only 0.8 kilograms, utilizes piezoelectric actuators for positioning accuracy better than 1 micrometer, significantly reducing the impact of human hand tremors [7]. - A hybrid experimental method was employed to simulate real surgical conditions, using a pig's eye mounted on a special headset worn by a volunteer [7][9]. Group 3: Success Rates and Technical Breakthroughs - The system achieved a 100% success rate in 21 injection attempts, compared to a combined success rate of 63.6% for manual injections, highlighting the effectiveness of the robotic system [9][11]. - Key factors contributing to this success include the head-mounted design, high-precision robot, real-time optical coherence tomography (OCT) imaging, and slow injection rates allowing for adjustments [9][10]. - The use of a flexible 38-gauge polymer needle helped compensate for minor movements, maintaining stability during the injection process [9]. Group 4: Implications for Clinical Applications - The head-mounted surgical robot could significantly enhance the success rates of retinal injections, potentially allowing more physicians to perform these complex procedures [11]. - The system's ability to operate under local anesthesia reduces risks associated with general anesthesia, particularly for elderly patients [11]. - Future applications may extend beyond ophthalmology to other high-precision surgeries, such as neurosurgery and ENT procedures, benefiting from this innovative design [12].