癌症近年來一直都穩坐台灣十大死因之首位，而肝細胞癌更是所有癌症中發生率最高的，肝癌的最常見的治療一般有手術切除、酒精注射、動脈栓塞治療、消融治療等，射頻消融術則具有手術傷口較小且術後副作用少等優點，所以是近年來最常見肝腫瘤治療術，治療方式是在超音波的精確導引下，將消融針插入肝腫瘤中並放出射頻電波，而組織會受到電波激盪擾動使溫度上升，進而將腫瘤細胞燒灼及破壞掉，但在臨床應用常因為徒手插入消融針的精準度低且超音波引導不易，造成手術消融不全，進而導致術後復發率上升。所以本研究為了輔助外科醫生更準確地進行射頻消融術，因此開發一套雙機械手臂輔助超音波引導射頻消融手術系統。在該系統中，以超音波影像為主要引導並以電腦斷層影像作為輔助判斷，引導機械手臂將消融針準確地插入腹部假體中，高系統精準度是本研究的重點。研究中分成硬體校正及手術系統開發，硬體校正部分主要有雙機械手臂整合校正、超音波影像空間校正，手術消融針定位註冊。手術系統操作是根據實際手術流程設計，主要有超音波掃描、手術路徑規劃、超音波引導消融針插入。在驗證實驗結果中，雙機械手臂的重複精準度為0.314±0.052mm，超音波影像定位精準度為0.759 ± 0.296 mm，最終以超音波影像引導機械手臂插入消融針至腹部假體中的精準度為1.867 ± 0.436 mm。實驗證明，硬體校正和系統設計的準確性對機器人輔助 RFA 系統有很大影響。未來在實際臨床應用中如果可在系統中加入即時超音波影像辨識、超音波及電腦斷層影像的融合、機械手臂即時補償等功能，系統將會更加完善，更適合臨床應用。

Cancer has been the top 10 causes of death in Taiwan in recent years, and hepatocellular carcinoma (HCC) is common among all cancers. The common treatments for liver cancer include surgical resection, alcohol injection, arterial embolization, and thermal ablation. Radiofrequency ablation (RFA) is one of the most common treatments for liver tumors in recent years because of its smaller incision size and fewer postoperative side effects. RFA treatment involves inserting an ablation probe into the liver tumor and emitting radiofrequency waves under ultrasound guided. The radiofrequency waves will generate ion agitation and friction heating for the tissue to destroy the tumor. Due to the low accuracy of the freehand insertion of the ablation probe and the difficulty of ultrasound guided, incomplete surgical ablation in clinical practice might lead to the potential increase of postoperative recurrence rate. Therefore, to assist surgeons in performing RFA more accurately, a dual robotic arm assisted ultrasound-guided radiofrequency ablation system was developed in this study. In this system, we used ultrasound images as the main guidance and computed tomography images as auxiliary judgment to guide the robotic arm to insert the ablation needle into the abdominal phantom accurately. This study was divided into the hardware calibration and the surgical system development. The hardware calibration includes the integrated calibration of dual robotic arms, the spatial calibration of ultrasound images, and the registration of surgical ablation probes. The operation of the surgical system was designed according to the actual surgical procedures, mainly including ultrasound scanning, surgical path planning and ultrasound guided ablation probe insertion. Our verification experiment showed that repeatable accuracy of the dual robotic arm was 0.314±0.052mm, the positioning accuracy of the ultrasound image was 0.759 ± 0.296mm, and the accuracy of the insertion of the ablation needle into the abdominal phantom guided by ultrasound image was 1.867 ± 0.436mm. The accuracy of the hardware calibration and system design was proven to greatly influence the accuracy of robot-assisted RFA system. In the future, the system will be applied for clinical application with inclusion of real-time ultrasound image identification, a fusion of ultrasound and computed tomography, and instant compensation of robotic arm.

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