臺灣博碩士論文加值系統

在本論文中關節鏡手術訓練模擬系統是應用虛擬實境技術發展出一套高效率、低成本、高品質虛擬訓練且符合醫師手術訓練需求之模擬系統。關節鏡手術的優點包含傷口小、流血少、復原快，因此成為外科手術的主流。然而其技術層次高，需經過長期的訓練，才能成為關節鏡手術之主治醫師。
基於經驗式的虛擬手術訓練系統相較於傳統訓練方式具有高效率學習與低成本的優點。因此本論文提出一個經驗式的虛擬膝關節鏡檢查訓練系統，該系統藉由追蹤有經驗醫師3D操作軌跡做經驗記錄關節鏡的軌跡，這些軌跡與三維虛擬膝關節模型相符合，此外搭配力回饋系統有效地導引操作者逐步完成檢查，該系統亦開放評估操作者的訓練表現，操作者可依據分數來檢視自己的學習效果，並藉由反覆練習發展經驗來達到實際臨床檢查的熟練性與穩定性。
實驗顯示本系統透過導引力跟隨有經驗醫師的軌跡，可有效率的縮短年輕醫師的學習曲線。反覆訓練操作本系統可以發展出關節鏡手術的技巧以及減少在實際手術中對病患的風險。

In this thesis, knee arthroscopic surgery training system-an application of virtual reality technology, is developed to perform efficient, low-cost, high-quality virtual training that meets the requirements of doctors’ training needs. The advantages of knee arthroscopic surgery include small wound, less bleeding, faster recovery, etc, so it becomes the mainstream surgical approach at present. However, it requires high technical level and long-term training to become a chief physician of the arthroscopic surgery.
Experience-based virtual surgery training system, compared to traditional training methods, has the advantages of high efficiency learning and low cost. Therefore, this thesis presents an experience-based virtual knee arthroscopic training system that records experiences by tracking the 3D operation trajectories of the experienced physicians. These trajectories are matched with the three-dimensional virtual model of the knee that is established from the patient’s medical images. In addition, with force feedback, the system can effectively guide the operator step by step to complete the inspection. The system is also open to evaluating the performance of the operator being trained. The operator can view their scores based on the study results, and develop experience by repeated practices to achieve proficiency and stability in the actual clinical examination.
Experiments show that the proposed system, through the guided force to follow trajectories of the experienced physicians, can efficiently shorten the learning curves of the young doctors. Repeated training using this system can develop the skills required for arthroscopic surgery and can reduced the patient’s risk in the actual surgery.

摘要 i
Abstract ii
目錄 iii
圖目錄 vi
表目錄 xii
第一章 緒論 1
1.1 前言 1
1.2 研究動機 2
1.3 研究目的 3
1.4 文獻回顧 4
1.4.1關節鏡檢查 4
1.4.1.1 膝關節構造 4
1.4.1.2 關節鏡入口選擇 6
1.4.2虛擬手術 8
1.4.3力回饋技術 14
1.4.4攝影機校正與追蹤技術 19
1.5 研究方法 20
1.5.1硬體 21
1.5.2軟體 22
第二章 虛擬力回饋系統 25
2.1 力回饋系統 26
2.2 系統架構 28
2.3 虛擬環境設定 29
2.4 力回饋計算 31
第三章 攝影機校正 34
3.1 攝影機模型 34
3.2 攝影機介紹 38
3.3 校正模板 39
3.4 畸變(Distortion)運算 40
3.5 透視參數運算 42
第四章 關節鏡手術之追蹤定位 44
4.1 平板標誌 44
4.2 影像處理 45
4.3 空間定位之矩陣轉換 46
4.4 平面標誌與關節鏡之轉換關係 48
4.4.1關節鏡校正 48
4.4.2關節鏡定位 55
4.5 軌跡處理 58
第五章 導引式膝關節鏡訓練 62
第六章 研究成果分析與討論 74
6.1 結果分析與討論 74
6.1.1虛擬模型 74
6.1.2系統介面 76
6.1.3攝影機校正 77
6.1.4關節鏡之追蹤定位 78
6.1.5軌跡處理 82
6.1.6導引力分析 83
6.2 成果展示 86
6.2.1基本介面介紹 87
6.2.2讀檔 89
6.2.3膝關節鏡檢查 90
第七章 結論與未來展望 93
7.1 結論 93
7.2 未來展望 95
參考文獻 97

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