WO2022067608A1 - 一种远程手术指导和教学装置及其方法与医疗设备 - Google Patents

一种远程手术指导和教学装置及其方法与医疗设备 Download PDF

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Publication number
WO2022067608A1
WO2022067608A1 PCT/CN2020/119178 CN2020119178W WO2022067608A1 WO 2022067608 A1 WO2022067608 A1 WO 2022067608A1 CN 2020119178 W CN2020119178 W CN 2020119178W WO 2022067608 A1 WO2022067608 A1 WO 2022067608A1
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Prior art keywords
remote
guidance
teaching
surgical
marking line
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PCT/CN2020/119178
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English (en)
French (fr)
Inventor
邵鹏飞
张帆
刘鹏
李晨梦
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中国科学技术大学
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Application filed by 中国科学技术大学 filed Critical 中国科学技术大学
Priority to PCT/CN2020/119178 priority Critical patent/WO2022067608A1/zh
Publication of WO2022067608A1 publication Critical patent/WO2022067608A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B5/00—Electrically-operated educational appliances
    • G09B5/02—Electrically-operated educational appliances with visual presentation of the material to be studied, e.g. using film strip
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/67—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation

Definitions

  • the present invention relates to the technical field of medical equipment, and more particularly, to a remote operation guidance and teaching device, a method thereof, and medical equipment.
  • Telemedicine devices can help medical experts conduct distance teaching instruction. Through the use of telemedicine devices, inexperienced surgeons on the surgical site can share each other's perspectives with surgical experts on the remote site, overcoming barriers of distance, enabling interactive knowledge transfer and guided instructional interventions to enable experienced surgeons to Teach complex surgical procedures interactively.
  • the traditional telemedicine device is based on the teleconferencing system.
  • the telemedicine marks and guides the operation according to the surgical scene pictures captured by the on-site camera.
  • the teleconference system transmits the guidance mark to the monitor in the operating room, and cooperates with the voice to provide intraoperative guidance.
  • the operator's perspective must be switched back and forth between the monitor and the operating area, which brings great inconvenience to the surgical process, not only wastes a lot of precious operating time, but also makes it difficult to determine the actual size and location of the label.
  • Such remote guidance is very effective. limited.
  • the present invention provides a remote surgery guidance and teaching device, method and medical equipment, which effectively solve the technical problems existing in the prior art and improve the quality of remote surgery guidance and teaching.
  • a remote surgical guidance and teaching device comprising a surgical terminal and a remote guidance terminal
  • the operating end includes: an operating bed; a collection and projection device arranged above the operating table, the collection and projection device is used to collect real-time images of the area to be operated on, and is used for performing an operation aligned with the area to be operated.
  • the marking line is projected to the area to be operated, and the surgical marking line includes a remote guidance marking line and a teaching marking line;
  • the real-time image is transmitted to the remote guidance terminal through the Internet, and is used for receiving the remote guidance marking line sent by the remote guidance terminal through the Internet, for storing the real-time image, and for retrieving and displaying
  • the stored real-time image is inputted corresponding to the teaching marking line;
  • the remote guidance terminal includes: a remote guidance terminal interaction device associated with the surgical terminal interaction device through the Internet, and the remote guidance terminal interaction device is used for receiving the real-time image and displaying it, and for inputting all the input data.
  • the remote guidance and marking line is transmitted to the surgical terminal interactive device through the Internet.
  • the surgical end further includes: a positioning and tracking device electrically connected to the acquisition and projection device and the surgical-end interactive device, and the positioning and tracking device is used to locate the location of the to-be-operated area according to the real-time image. position, and adjust the surgical marking line projected by the acquisition and projection device to align with the to-be-operated area.
  • a positioning and tracking device electrically connected to the acquisition and projection device and the surgical-end interactive device, and the positioning and tracking device is used to locate the location of the to-be-operated area according to the real-time image. position, and adjust the surgical marking line projected by the acquisition and projection device to align with the to-be-operated area.
  • the remote guidance terminal interaction device is further configured to store the real-time image.
  • the collection and projection device includes:
  • a collection element arranged on the reflected light path of the beam splitter, the collection element is electrically connected to the surgical end interaction device;
  • a projection element disposed on the transmitted light path of the beam splitter, the projection element is electrically connected to the surgical terminal interactive device;
  • an absorption filter disposed on the side of the beam splitter away from the collection element.
  • the collection element includes a CCD camera or a CMOS camera.
  • the projection element includes a projector or a scanning galvanometer.
  • both the surgical terminal interaction device and the remote guidance terminal interaction device further include audio equipment.
  • the present invention also provides a remote surgery guidance and teaching method, which is applied to the above-mentioned remote surgery guidance and teaching device, wherein the remote surgery guidance method includes:
  • the acquisition and projection device acquires a real-time image of the to-be-operated area, and transmits it to the operation-end interactive device;
  • the operating terminal interactive device transmits the real-time image to the remote guidance terminal interactive device through the Internet;
  • the remote guidance terminal interactive device transmits the remote guidance marking line to the surgical terminal interactive device through the Internet;
  • the operating-end interactive device transmits the remote guidance and marking line to the acquisition and projection device; the acquisition and projection device aligns and projects the remote guidance and marking line to the area to be operated on, and the surgeon according to the remote Guide the marked line for surgery;
  • the teaching doctor performs a teaching operation on the to-be-operated area, and at the same time, the acquisition and projection device collects a real-time image of the to-be-operated area, and transmits it to the operation-end interactive device for storage;
  • the teaching doctor retrieves and displays the stored real-time image through the operating terminal interactive device, inputs the corresponding teaching marking line according to the real-time image, and stores it on the operating terminal. interactive device;
  • the trained doctor retrieves and displays the stored real-time image through the operating-end interactive device, and the operating-end interactive device transmits the teaching marking line to the acquisition and projection device;
  • the acquisition and projection device aligns and projects the teaching marking line onto the to-be-operated area.
  • the teaching doctor when the teaching doctor inputs the corresponding teaching marking line according to the real-time image, the teaching doctor also inputs a voice marking and stores it in the operating-end interactive device.
  • the present invention also provides a medical device, which includes the above-mentioned remote surgery guidance and teaching device.
  • the technical solution provided by the present invention has at least the following advantages:
  • the invention provides a remote operation guidance and teaching device, method and medical equipment, including an operation end and a remote guidance end;
  • the operation end includes: an operation bed; a collection and projection device arranged above the operation bed, the The collection and projection device is used to collect real-time images in the area to be operated, and is used to project the surgical mark line aligned with the area to be operated to the area to be operated, the surgical mark line includes remote guidance mark lines and teaching marks and, a surgical terminal interactive device electrically connected with the acquisition and projection device, the surgical terminal interactive device is used for transmitting the real-time image to the remote guidance terminal through the Internet, and for receiving the The remote guidance marking line sent by the remote guidance terminal is used for storing the real-time image, and for retrieving and displaying the stored real-time image and inputting the corresponding teaching marking line;
  • the remote guidance terminal includes: and The operating terminal interactive device is connected to the remote guidance terminal interactive device through the Internet, and the remote guidance terminal interactive device is used for receiving the real-time image and displaying it, and for passing the input
  • the technical solution provided by the present invention can directly project the remote guidance line input by the guidance doctor to the area to be operated during the remote operation guidance process, so that the surgeon can more intuitively understand the operation area to be operated. Therefore, the problem in the prior art that the surgeon needs to frequently switch the viewing angle between the monitor and the diseased part repeatedly is solved.
  • the technical solution provided by the invention can improve the accuracy of surgical positioning, reduce surgical damage, optimize the surgical path and improve the success rate of surgery; improve the accuracy of remote surgical guidance, without the need for additional complicated registration algorithms, and improve the speed of remote surgery.
  • the teaching marking line input by the teaching doctor can also be directly aligned and projected to the area to be operated, so that the trainee doctor can intuitively understand the surgical process of the teaching doctor.
  • the technical scheme provided by the present invention improves the quality of remote surgery guidance and teaching.
  • FIG. 1 is a schematic structural diagram of a remote surgery guidance and teaching device according to an embodiment of the present invention
  • FIG. 2 is a schematic structural diagram of another remote surgery guidance and teaching device provided by an embodiment of the present invention.
  • FIG. 3 is a flowchart of a remote surgery guidance method provided by an embodiment of the present invention.
  • FIG. 4 is a flowchart of a teaching method provided by an embodiment of the present invention.
  • the traditional telemedicine device is based on the teleconferencing system.
  • the telemedicine marks and guides the operation according to the surgical scene pictures captured by the on-site camera.
  • the teleconference system transmits the guidance mark to the monitor in the operating room, and cooperates with the voice Intraoperative guidance, because the operator’s perspective must be switched back and forth between the monitor and the operating area, which brings great inconvenience to the surgical process, not only wastes a lot of precious operating time, but also difficult to determine the actual size and location of the annotation, Such remote guidance is very limited.
  • the embodiments of the present invention provide a remote surgery guidance and teaching device, method and medical equipment, which effectively solve the technical problems existing in the prior art and improve the quality of remote surgery guidance and teaching.
  • FIG. 1 it is a schematic structural diagram of a remote surgery guidance and teaching device according to an embodiment of the present invention, wherein the remote surgery guidance and teaching device includes a surgical terminal 100 and a remote guidance terminal 200 .
  • the operating end 100 includes: an operating bed 110; a capture and projection device 120 disposed above the operating bed 110, the capture and projection device 120 is used to capture a real-time image of the area to be operated on, and is used to compare the data with the to-be-operated area.
  • the area-aligned surgical marking line is projected onto the area to be operated on, and the surgical marking line includes a remote guidance marking line and a teaching marking line;
  • the operating terminal interaction device 130 is used for transmitting the real-time image to the remote guidance terminal 200 through the Internet 300, for receiving the remote guidance marking line sent by the remote guidance terminal 200 through the Internet 300, for storage
  • the real-time image is used to retrieve and display the stored real-time image and input the corresponding teaching marking line.
  • the remote guidance terminal 200 includes: a remote guidance terminal interaction device 210 associated with the surgical terminal interaction device 130 through the Internet 300, and the remote guidance terminal interaction device 210 is used for receiving and displaying the real-time image, and using it.
  • the inputted remote guidance marking line is transmitted to the operating terminal interactive device 130 through the Internet 300 .
  • the operating bed provided by the embodiment of the present invention is used for placing a patient or a surgical phantom, wherein the to-be-operated area is an area where the patient or the surgical phantom needs to be operated.
  • the acquisition and projection device provided by the embodiment of the present invention may be supported by a support frame, wherein the support frame may be fixed to the floor, or the support frame may be fixed to an operating bed, which is not specifically limited by the present invention.
  • both the operation terminal interaction device and the remote guidance terminal interaction device provided by the embodiments of the present invention are equipped with a synchronous display system.
  • the remote guidance terminal interactive device provided by the present invention is also used to store the real-time image, so that after the remote guidance operation is completed, the guidance doctor at the remote guidance terminal can also retrieve the real-time operation process. Images for subsequent surgical analysis and other operations.
  • the surgical terminal interaction device and the remote guidance terminal interaction device provided by the embodiment of the present invention both include audio equipment, that is, the surgical terminal interaction device and the remote guidance terminal interaction device provided by the embodiment of the present invention include a microphone and a remote guidance terminal interaction device. Audio equipment such as speakers, and then can realize voice interaction through audio equipment.
  • the technical solution provided by the embodiment of the present invention can directly project the remote guidance line input by the guidance doctor to the area to be operated during the remote operation guidance process, so that the surgeon can more intuitively understand the operation in the area to be operated.
  • the circuit of the operation further solves the problem in the prior art that the surgeon needs to repeatedly switch the viewing angle between the monitor and the diseased part.
  • the technical solutions provided by the embodiments of the present invention can improve the accuracy of surgical positioning, reduce surgical damage, optimize the surgical path, and improve the success rate of surgery; improve the accuracy of remote surgical guidance, do not require additional cumbersome registration algorithms, and improve the speed of remote surgery .
  • the teaching marking line input by the teaching doctor can also be directly aligned and projected to the area to be operated, so that the trainee doctor can intuitively understand the surgical process of the teaching doctor.
  • the technical solutions provided by the embodiments of the present invention improve the quality of remote surgery guidance and teaching.
  • the optional remote operation guidance may be remote operation guidance of radical excision of skin lesions and skin flap transplantation, and the teaching operation may be medical education and training of surgical suturing, which is not specifically limited in the present invention.
  • the operating terminal interactive device and the remote guidance terminal interactive device provided by the embodiment of the present invention may be implemented by a terminal such as a computer, and the terminal such as a computer may include functions such as touch;
  • the surgical marking line can be obtained by moving the corresponding drawing line in the displayed real-time image through a mouse or a stylus.
  • the surgical end provided by the embodiment of the present invention further includes: a positioning and tracking device electrically connected to the acquisition and projection device and the surgical end interactive device.
  • the positioning and tracking device is used to locate the position of the to-be-operated area according to the real-time image, and to adjust the alignment of the surgical marking line projected by the acquisition and projection device with the to-be-operated area.
  • the surgical end provided by the embodiment of the present invention further includes a positioning and tracking device, wherein the positioning and tracking device can, when the position of the to-be-operated area shakes and/or the acquisition projection device shakes and other positional deviations or deformations, according to the collected data.
  • Real-time images and related positioning algorithms can track and locate the position of the to-be-operated area, and then adjust the position of the surgical marking line projected by the acquisition and projection device according to the tracked and positioned position of the to-be-operated area, so that the to-be-operated area and the surgical marking line can be accurately aligned. bit.
  • the positioning and tracking device provided in the embodiment of the present invention may be integrated into the surgical terminal interactive device, or the positioning and tracking device may be an independent device, which is not specifically limited by the present invention.
  • FIG. 2 it is a schematic structural diagram of another remote surgery guidance and teaching device provided by an embodiment of the present invention, wherein the acquisition and projection device 120 includes:
  • Beam splitter 121 Beam splitter 121 .
  • the collection element 122 disposed on the reflected light path of the beam splitter 121 is electrically connected to the operation terminal interaction device 130 .
  • the projection element 123 disposed on the transmitted light path of the beam splitter 121 is electrically connected to the operation terminal interactive device 130 .
  • the absorption filter 124 is disposed on the side of the beam splitter 121 away from the collecting element 122 .
  • the beam splitter, the collection element and the projection element provided by the present invention are arranged in a coaxial optical path, the optical axis of the projection element can be arranged in the vertical direction, and the optical axis of the collection element can be arranged in the horizontal direction,
  • the beam splitter can be arranged at an angle of 45 degrees with both the optical axis of the projection element and the optical axis of the collection element.
  • the distance D1 between the beam splitter and the vertex of the optical axis of the projection element provided by the embodiment of the present invention is the same as the distance D2 between the beam splitter and the fixed point of the optical axis of the collecting element.
  • the beam splitter provided by the embodiment of the present invention includes a reflection light path and a transmission light path.
  • the reflection beam path of the beam splitter reflects the image to the collecting element; and the transmission beam path of the beam splitter
  • the surgical marking line projected by the projection element is transmitted to the area to be operated on, wherein the projection element needs to perform matching analysis on the size and position of the surgical marking line, so as to adjust the surgical marking line to the line corresponding to the actual size of the area to be operated, and then carry out the matching analysis of the size and position of the surgical marking line. Alignment projection of the surgical area.
  • the absorption filter provided in the embodiment of the present invention is arranged on the side of the beam splitter away from the collection element, so that the stray light on the side away from the collection element can be passed through the absorption filter beam splitter to avoid the collection element from stray light. Then the acquisition will affect the real-time image quality.
  • the acquisition element provided by the embodiment of the present invention is used to collect a real-time image of the area to be operated, and transmit the real-time image to an electrically connected surgical-end interactive device; and the projection element is used to align the surgical marking line transmitted by the surgical-end interactive device. Projected to the area to be operated on.
  • the collection element provided in the embodiment of the present invention includes a CCD camera or a CMOS camera.
  • the projection element provided by the embodiment of the present invention includes a projector or a scanning galvanometer.
  • an embodiment of the present invention further provides a remote surgery guidance and teaching method, which is applied to the remote surgery guidance and teaching device provided by any of the above embodiments, wherein the remote surgery guidance and teaching device provided by the embodiment of the present invention Surgical guidance methods include:
  • the acquisition and projection device acquires a real-time image of the to-be-operated area, and transmits it to the operation-end interactive device.
  • the acquisition and projection device can be fixed at a distance of 500-700 mm from the surface of the patient's area to be operated on, and then the acquisition and projection device can be adjusted so that it can acquire clear images, and the acquired The real-time image is transmitted to the surgical terminal interactive device.
  • the operating terminal interactive device transmits the real-time image to the remote guidance terminal interactive device through the Internet.
  • the interactive device on the surgical end and the interactive device on the remote guidance end realize data interaction through the Internet, wherein when the interactive device on the surgical end receives the real-time image sent by the acquisition and projection device, it synchronously transmits the real-time image to the interactive device on the remote guidance end through the Internet.
  • the instructing doctor inputs the remote guidance marking line according to the real-time image displayed by the remote guidance terminal interactive device.
  • the guiding doctor on the remote guidance terminal through the real-time image displayed by the remote guidance terminal interactive device, learns the corresponding situation of the to-be-operated area, and then controls the remote-guidance terminal interactive device to input the remote guidance line corresponding to the to-be-operated area.
  • the guidance doctor can realize the input of the remote guidance marking line by means of mouse, touch, etc., which is not specifically limited in the present invention.
  • the remote guidance terminal interactive device transmits the remote guidance marking line to the surgical terminal interactive device through the Internet.
  • the remote guidance terminal interactive device While instructing the doctor to input the remote guidance marking line, the remote guidance terminal interactive device synchronously transmits the remote guidance marking line to the surgical terminal interactive device through the Internet.
  • the operating-end interactive device transmits the remote guidance and marking line to the acquisition and projection device.
  • the operating terminal interactive device When receiving the remote guidance marking line, the operating terminal interactive device transmits the remote guidance marking line synchronously to the acquisition and projection device, and the acquisition and projection device aligns and projects the remote guidance and marking line to the area to be operated.
  • the acquisition and projection device aligns and projects the remote guidance marking line to the to-be-operated area, and the surgeon performs the operation according to the remote guidance marking line.
  • the surgeon performs a series of surgical operations such as corresponding anesthetic injection and excision according to the remote guidance and marking lines projected to the area to be operated.
  • a series of surgical operations such as corresponding anesthetic injection and excision according to the remote guidance and marking lines projected to the area to be operated.
  • the surgeon injects the anesthetic according to the guidance of the remote guidance marking line at the position where the anesthetic needs to be injected, so as to realize the lesion in the area to be operated.
  • teaching method provided by the embodiment of the present invention includes:
  • the teaching doctor conducts teaching operations on the to-be-operated area, and at the same time, the acquisition and projection device collects a real-time image of the to-be-operated area, and transmits it to the operation-end interactive device for storage.
  • the acquisition and projection device can be fixed at a distance of 500-700 mm from the surface of the patient's area to be operated on, and then the acquisition and projection device can be adjusted so that it can perform clear image acquisition, while teaching doctors
  • the collection and projection device transmits the collected real-time images to the operation-side interactive device for storage.
  • the teaching doctor starts the teaching operation and simultaneously turns on the device provided by the embodiment of the present invention. Store in the interactive device of the surgical end.
  • the teaching doctor retrieves and displays the stored real-time image through the operating terminal interactive device, inputs the corresponding teaching line according to the real-time image, and stores it in the Surgical end interactive device.
  • the teaching doctor can retrieve and display the stored real-time image of the surgical process through the operating terminal interactive device. During the process of viewing the real-time image, the teaching doctor can use the mouse, touch, etc.
  • the operation area alignment input teaching annotation line and stored in the operation terminal interactive device.
  • the teaching doctor provided by the present invention inputs the corresponding teaching marking line according to the real-time image, and at the same time, inputs voice marking and stores it in the operating terminal interactive device, so that the teaching doctor can use voice and teaching
  • the double operation of the label line improves the training effect.
  • the trained doctor retrieves and displays the stored real-time image through the operating-end interactive device, and the operating-end interactive device transmits the teaching marking line to the acquisition and projection device.
  • the trained doctor can retrieve and watch the real-time image with the teaching marking line displayed by the interactive device on the operating end.
  • the interactive device on the operating end can transmit the teaching marking line to the acquisition and projection device.
  • the acquisition and projection device aligns and projects the teaching marking line onto the to-be-operated area.
  • the acquisition and projection device provided by the embodiment of the present invention can simultaneously project the teaching marking line to the area to be operated while the interactive device at the operating end displays the real-time image, so that the trainee can intuitively understand the entire operation process and improve the training effect.
  • an embodiment of the present invention further provides a medical device, where the medical device includes the remote surgery guidance and teaching device provided by any one of the above embodiments.
  • Embodiments of the present invention provide a remote surgical guidance and teaching device, a method, and medical equipment, including a surgical end and a remote guidance end;
  • the surgical end includes: an operating bed; a collection and projection device disposed above the operating bed,
  • the acquisition and projection device is used to acquire real-time images at the area to be operated on, and is used to project a surgical mark line aligned with the area to be operated on to the area to be operated on, where the surgical mark line includes a remote guide mark line and Teaching marking line; and, a surgical terminal interactive device electrically connected with the acquisition and projection device, the surgical terminal interactive device is used for transmitting the real-time image to the remote guidance terminal through the Internet, for receiving through the Internet
  • the remote guidance marking line sent by the remote guidance terminal is used for storing the real-time image, and for retrieving and displaying the stored real-time image and inputting the corresponding teaching marking line;
  • the remote guidance terminal includes: : a remote guide terminal interactive device associated with the surgical terminal interactive device through the Internet, the remote
  • the technical solutions provided by the embodiments of the present invention can directly project the remote guidance annotation line input by the guidance doctor to the area to be operated during the process of remote surgical guidance, so that the surgeon can more intuitively understand the area to be operated on.
  • the line for performing the operation further solves the problem in the prior art that the surgeon needs to repeatedly switch the viewing angle between the monitor and the diseased part.
  • the technical solutions provided by the embodiments of the present invention can improve the accuracy of surgical positioning, reduce surgical damage, optimize the surgical path, and improve the success rate of surgery; improve the accuracy of remote surgical guidance, eliminate the need for additional cumbersome registration algorithms, and improve the speed of remote surgery .
  • the teaching marking line input by the teaching doctor can also be directly aligned and projected to the area to be operated, so that the trainee doctor can intuitively understand the surgical process of the teaching doctor.
  • the technical solutions provided by the embodiments of the present invention improve the quality of remote surgery guidance and teaching.

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Abstract

本发明提供了一种远程手术指导和教学装置及其方法与医疗设备，在远程手术指导过程中能够将指导医生输入的远程指导标注线直接对位投影至待手术区，以使手术医生更加直观的了解对待手术区进行手术的线路，进而解决了现有技术中手术医生需反复在显示器与病变部位间频繁切换视角的问题。本发明提供的技术方案能够提高手术定位精度、减少手术损伤、优化手术路径及提高手术成功率；提高了远程手术指导的准确度，无需额外繁琐的配准算法，提高了远程手术的速度。同时，在教学过程中同样能够将教学医生输入的教学标注线直接对位投影至待手术区，以使受训医生能够直观了解教学医生的手术过程。本发明提供的技术方案，提高了远程手术指导质量和教学质量。

Description

一种远程手术指导和教学装置及其方法与医疗设备 技术领域
本发明涉及医疗设备技术领域，更为具体地说，涉及一种远程手术指导和教学装置及其方法与医疗设备。
背景技术
目前由于我国人口较多，经济发展和医疗资源极不平衡，发达城市的医疗资源丰富，而较偏远、经济水平相对落后的城市医疗资源匮乏。此外，需要进行大型手术的病人要到大城市中才能进行，由于地域造成的就医困难，病人往往错过了最佳的手术时期。
远程医疗装置可以帮助医学专家进行远程教学指导。通过使用远程医疗装置，手术现场经验不足的外科医生可以与远程现场的手术专家分享彼此的观点，从而克服距离的障碍实现交互式知识传递和有指导的教学干预，以使经验丰富的外科医生能够以交互方式教授复杂的外科手术程序。
传统的远程医疗装置是基于远程会议系统，远程医生根据现场摄像头拍摄的手术场景画面进行标注指导手术，远程会议系统将指导标注传输给手术室的监视器，并配合语音进行术中指导，由于手术操作者的视角必须在监视器和手术区域来回切换，给手术过程带来极大的不便，不但浪费了大量宝贵的手术时间，而且很难确定标注的实际大小和位置，这样的远程指导效果十分有限。
发明内容
有鉴于此，本发明提供了一种远程手术指导和教学装置及其方法与医疗设备，有效解决了现有技术所存在的技术问题，提高了远程手术指导质量和教学质量。
为实现上述目的，本发明提供的技术方案如下：
一种远程手术指导和教学装置，包括手术端及远程指导端；
所述手术端包括：手术床；设置于所述手术床上方的采集投影装置，所述采集投影装置用于采集待手术区处的实时影像，用于将与所述待手术区对位的 手术标注线投影至所述待手术区，所述手术标注线包括远程指导标注线和教学标注线；以及，与所述采集投影装置电连接的手术端交互装置，所述手术端交互装置用于将所述实时影像通过互联网传输至所述远程指导端，用于通过所述互联网接收所述远程指导端发送的所述远程指导标注线，用于存储所述实时影像，以及用于调取并显示存储的所述实时影像而输入相应所述教学标注线；
所述远程指导端包括：与所述手术端交互装置通过所述互联网关联的远程指导端交互装置，所述远程指导端交互装置用于接收所述实时影像并显示，及用于将输入的所述远程指导标注线通过所述互联网传输至所述手术端交互装置。
可选的，所述手术端还包括：与所述采集投影装置及所述手术端交互装置电连接的定位追踪装置，所述定位追踪装置用于根据所述实时影像定位所述待手术区的位置，并调整所述采集投影装置投射的手术标注线与所述待手术区对位。
可选的，所述远程指导端交互装置还用于存储所述实时影像。
可选的，所述采集投影装置包括：
分光片；
设置于所述分光片的反射光路上的采集元件，所述采集元件与所述手术端交互装置电连接；
设置于所述分光片的透射光路上的投影元件，所述投影元件与所述手术端交互装置电连接；
以及，设置于所述分光片背离所述采集元件一侧的吸收型滤光片。
可选的，所述采集元件包括CCD摄像头或CMOS摄像头。
可选的，所述投影元件包括投影仪或扫描振镜。
可选的，所述手术端交互装置和所述远程指导端交互装置还均包括音频设备。
相应的，本发明还提供了一种远程手术指导和教学方法，应用于上述的远程手术指导和教学装置，其中，远程手术指导方法包括：
所述采集投影装置采集所述待手术区的实时影像，并传输至所述手术端交互装置；
所述手术端交互装置将所述实时影像通过所述互联网传输至所述远程指导端交互装置；
指导医生根据所述远程指导端交互装置显示的所述实时影像而输入所述远程指导标注线；
所述远程指导端交互装置将所述远程指导标注线通过所述互联网传输至所述手术端交互装置；
所述手术端交互装置将所述远程指导标注线传输至所述采集投影装置；、所述采集投影装置将所述远程指导标注线对位投影至所述待手术区，手术医生根据所述远程指导标注线进行手术；
以及教学方法包括：
教学医生对所述待手术区进行教学手术，同时所述采集投影装置采集所述待手术区的实时影像，并传输至所述手术端交互装置存储；
待所述教学手术完毕后，所述教学医生通过所述手术端交互装置调取并显示存储的所述实时影像，并根据所述实时影像输入相应所述教学标注线后存储至所述手术端交互装置；
受训医生通过所述手术端交互装置调取并显示存储的所述实时影像，且所述手术端交互装置将所述教学标注线传输至所述采集投影装置；
所述采集投影装置将所述教学标注线对位投影至所述待手术区。
可选的，所述教学医生根据所述实时影像输入相应所述教学标注线的同时，输入语音标注并存储至所述手术端交互装置。
相应的，本发明还提供了一种医疗设备，所述医疗设备包括上述的远程手术指导和教学装置。
相较于现有技术，本发明提供的技术方案至少具有以下优点：
本发明提供了一种远程手术指导和教学装置及其方法与医疗设备，包括手术端及远程指导端；所述手术端包括：手术床；设置于所述手术床上方的采集投影装置，所述采集投影装置用于采集待手术区处的实时影像，用于将与所述待手术区对位的手术标注线投影至所述待手术区，所述手术标注线包括远程指导标注线和教学标注线；以及，与所述采集投影装置电连接的手术端交互装置，所述手术端交互装置用于将所述实时影像通过互联网传输至所述远程指导端， 用于通过所述互联网接收所述远程指导端发送的所述远程指导标注线，用于存储所述实时影像，以及用于调取并显示存储的所述实时影像而输入相应所述教学标注线；所述远程指导端包括：与所述手术端交互装置通过所述互联网关联的远程指导端交互装置，所述远程指导端交互装置用于接收所述实时影像并显示，及用于将输入的所述远程指导标注线通过所述互联网传输至所述手术端交互装置。
由上述内容可知，本发明提供的技术方案，在远程手术指导过程中能够将指导医生输入的远程指导标注线直接对位投影至待手术区，以使手术医生更加直观的了解对待手术区进行手术的线路，进而解决了现有技术中手术医生需反复在显示器与病变部位间频繁切换视角的问题。本发明提供的技术方案能够提高手术定位精度、减少手术损伤、优化手术路径及提高手术成功率；提高了远程手术指导的准确度，无需额外繁琐的配准算法，提高了远程手术的速度。同时，在教学过程中同样能够将教学医生输入的教学标注线直接对位投影至待手术区，以使受训医生能够直观了解教学医生的手术过程。本发明提供的技术方案，提高了远程手术指导质量和教学质量。
附图说明
图1为本发明实施例提供的一种远程手术指导和教学装置的结构示意图；
图2为本发明实施例提供的另一种远程手术指导和教学装置的结构示意图；
图3为本发明实施例提供的一种远程手术指导方法的流程图；
图4为本发明实施例提供的一种教学方法的流程图。
具体实施方式
下面将结合本发明实施例中的附图，对本发明实施例中的技术方案进行清楚、完整地描述，显然，所描述的实施例仅仅是本发明一部分实施例，而不是全部的实施例。基于本发明中的实施例，本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例，都属于本发明保护的范围。
正如背景技术所述，传统的远程医疗装置是基于远程会议系统，远程医生根据现场摄像头拍摄的手术场景画面进行标注指导手术，远程会议系统将指导标注传输给手术室的监视器，并配合语音进行术中指导，由于手术操作者的视角必须在监视器和手术区域来回切换，给手术过程带来极大的不便，不但浪费了大量宝贵的手术时间，而且很难确定标注的实际大小和位置，这样的远程指导效果十分有限。
基于此，本发明实施例提供了一种远程手术指导和教学装置及其方法与医疗设备，有效解决了现有技术所存在的技术问题，提高了远程手术指导质量和教学质量。
为实现上述目的，本发明实施例提供的技术方案如下，具体结合图1至图4对本发明实施例提供的技术方案进行详细的描述。
参考图1所示，为本发明实施例提供的一种远程手术指导和教学装置的结构示意图，其中，远程手术指导和教学装置包括手术端100及远程指导端200。
所述手术端100包括：手术床110；设置于所述手术床110上方的采集投影装置120，所述采集投影装置120用于采集待手术区处的实时影像，用于将与所述待手术区对位的手术标注线投影至所述待手术区，所述手术标注线包括远程指导标注线和教学标注线；以及，与所述采集投影装置120电连接的手术端交互装置130，所述手术端交互装置130用于将所述实时影像通过互联网300传输至所述远程指导端200，用于通过所述互联网300接收所述远程指导端200发送的所述远程指导标注线，用于存储所述实时影像，以及用于调取并显示存储的所述实时影像而输入相应所述教学标注线。
所述远程指导端200包括：与所述手术端交互装置130通过所述互联网300关联的远程指导端交互装置210，所述远程指导端交互装置210用于接收所述实时影像并显示，及用于将输入的所述远程指导标注线通过所述互联网300传输至所述手术端交互装置130。
本发明实施例提供的手术床用于放置患者或者手术仿体，其中待手术区即为患者或手术仿体所需要进行手术的区域。以及，本发明实施例提供的采集投影装置可以通过支撑架进行支撑，其中支撑架可以固定与地板，或者支撑架可以固定于手术床，对此本发明不做具体限制。此外，由于手术端和远程指导端 需要同步进行，本发明实施例提供的手术端交互装置和远程指导端交互装置均安装有同步显示系统。
在本发明一实施例中，本发明提供的所述远程指导端交互装置还用于存储所述实时影像，进而在远程指导手术完毕后，远程指导端的指导医生等同样能够调取手术过程的实时影像进行后续手术分析等操作。
进一步的，本发明实施例提供的所述手术端交互装置和所述远程指导端交互装置还均包括音频设备，即本发明实施例提供的手术端交互装置和远程指导端交互装置包括有麦克风及扬声器等音频设备，进而能够通过音频设备实现语音上的交互。
可以理解的，本发明实施例提供的技术方案，在远程手术指导过程中能够将指导医生输入的远程指导标注线直接对位投影至待手术区，以使手术医生更加直观的了解对待手术区进行手术的线路，进而解决了现有技术中手术医生需反复在显示器与病变部位间频繁切换视角的问题。本发明实施例提供的技术方案能够提高手术定位精度、减少手术损伤、优化手术路径及提高手术成功率；提高了远程手术指导的准确度，无需额外繁琐的配准算法，提高了远程手术的速度。同时，在教学过程中同样能够将教学医生输入的教学标注线直接对位投影至待手术区，以使受训医生能够直观了解教学医生的手术过程。本发明实施例提供的技术方案，提高了远程手术指导质量和教学质量。可选远程手术指导可以为皮肤病损根治性切除与皮瓣移植术的远程手术指导等，及教学手术可以为手术缝合的医学教育与训练等手术，对此本发明不做具体限制。
在本发明一实施例中，本发明实施例所提供的手术端交互装置和远程指导端交互装置可以通过电脑等终端实现，电脑等终端可以包括触控等功能；进而在通过交互装置进行输入手术标注线时，可以通过鼠标或触控笔等在显示的实时影像中进行对应画线移动得到手术标注线。
进一步的，为了保证手术标注线与待手术区的精准对位，本发明实施例所提供的所述手术端还包括：与所述采集投影装置及所述手术端交互装置电连接的定位追踪装置，所述定位追踪装置用于根据所述实时影像定位所述待手术区的位置，并调整所述采集投影装置投射的手术标注线与所述待手术区对位。
可以理解的，本发明实施例提供的手术端还包括有一定位追踪装置，其中定位追踪装置能够在待手术区位置发生晃动和/或采集投影装置发生晃动等位置偏移或形变时，根据采集的实时影像及相关定位算法来追踪定位待手术区的位置，进而根据追踪定位的待手术区的位置来调整采集投影装置所投射的手术标注线的位置，使得待手术区和手术标注线能够精确对位。
可选的，本发明实施例提供的定位追踪装置可以集成于手术端交互装置中，或者定位追踪装置可以为独立的器件，对此本发明不做具体限制。
参考图2所示，为本发明实施例提供的另一种远程手术指导和教学装置的结构示意图，其中，所述采集投影装置120包括：
分光片121。
设置于所述分光片121的反射光路上的采集元件122，所述采集元件122与所述手术端交互装置130电连接。
设置于所述分光片121的透射光路上的投影元件123，所述投影元件123与所述手术端交互装置130电连接。
以及，设置于所述分光片121背离所述采集元件122一侧的吸收型滤光片124。
在本发明一实施例中，本发明所提供的分光片、采集元件和投影元件为同轴光路设置，投影元件的光轴可以沿垂直方向设置，而采集元件的光轴可以沿水平方向设置，其中分光片可以与投影元件的光轴和采集元件的光轴均呈45度角设置。本发明实施例提供的分光片距投影元件的光轴的顶点距离D1，与分光片距采集元件的光轴的定点的距离D2相同。
可以理解的，本发明实施例提供的分光片包括反射光路和透射光路，在将采集投影装置对准待手术区后，分光片的反射光路将图像反射至采集元件；及分光片的透射光路将投影元件投射的手术标注线透射至待手术区，其中投影元件需要进行手术标注线的大小和位置的匹配分析，以将手术标注线调整至与待手术区对应实际尺寸的线路后，进行与待手术区的对位投影。进一步的，本发明实施例提供的吸收型滤光片设置于分光片背离采集元件一侧，进而能够通过 吸收型滤光片分光片背离采集元件一侧的杂光，避免采集元件将这些杂光进而采集而影响实时影像质量。
本发明实施例提供的采集元件用于采集待手术区的实时影像，并将该实时影像传输至电连接的手术端交互装置；及投影元件用于将手术端交互装置传输的手术标注线对位投影至待手术区。可选的，本发明实施例提供的所述采集元件包括CCD摄像头或CMOS摄像头。以及本发明实施例提供的所述投影元件包括投影仪或扫描振镜。
下面结合具体远程手术指导方法和教学方法对本发明实施例提供的技术方案进行更为详细的描述。结合图3和图4所示，本发明实施例还提供了一种远程手术指导和教学方法，应用于上述任意一实施例提供的远程手术指导和教学装置，其中，本发明实施例提供的远程手术指导方法包括：
S11、所述采集投影装置采集所述待手术区的实时影像，并传输至所述手术端交互装置。
在开启本发明实施例提供的装置后，可以将采集投影装置固定在距离患者的待手术区表面的500-700mm处，而后进行采集投影装置的调节，使得其进行清晰的影像采集，并将采集的实时影像传输至手术端交互装置。
S12、所述手术端交互装置将所述实时影像通过所述互联网传输至所述远程指导端交互装置。
手术端交互装置与远程指导端交互装置通过互联网实现数据的交互，其中手术端交互装置接收到采集投影装置发出的实时影像时，同步将该实时影像通过互联网传输至远程指导端交互装置。
S13、指导医生根据所述远程指导端交互装置显示的所述实时影像而输入所述远程指导标注线。
在远程指导端的指导医生，通过远程指导端交互装置所显示的实时影像，了解到待手术区的相应情况后，通过操控远程指导端交互装置将对应待手术区的远程指导标注线输入。
其中根据远程指导端交互装置的类型，指导医生可以通过鼠标、触控等方式实现远程指导标注线的输入，对此本发明不做具体限制。
S14、所述远程指导端交互装置将所述远程指导标注线通过所述互联网传输至所述手术端交互装置。
在指导医生输入远程指导标注线的同时，远程指导端交互装置同步将远程指导标注线通过互联网传输至手术端交互装置。
S15、所述手术端交互装置将所述远程指导标注线传输至所述采集投影装置。
手术端交互装置在接收到远程指导标注线时，同步将远程指导标注线传输至采集投影装置，由采集投影装置将该远程指导标注线对位投影至待手术区。
S16、所述采集投影装置将所述远程指导标注线对位投影至所述待手术区，手术医生根据所述远程指导标注线进行手术。
手术医生根据投射至待手术区的远程指导标注线，进行相应麻药注射、切除等一些列的手术操作。如本发明提供的远程指导方法应用于皮肤病损根治性切除与皮瓣移植术手术中时，手术医生根据远程指导标注线的指导需要注射麻药的位置进行麻药注射，实现在待手术区的病变位组织周围进行局麻等操作；其次根据远程指导标注线的指导，使用美兰在皮肤表面划定要切除范围，手术医生根据指导使用电刀对切除范围处病变组织及逆行完全切除；指导医生划定进行皮瓣移植的远程指导标注线后，手术医生再次根据指导使用电刀进行相应皮肤的切除；最后手术医生根据远程指导标注线进行正确缝合等完成手术。
以及，本发明实施例提供的教学方法包括：
S21、教学医生对所述待手术区进行教学手术，同时所述采集投影装置采集所述待手术区的实时影像，并传输至所述手术端交互装置存储。
在开启本发明实施例提供的装置后，可以将采集投影装置固定在距离患者的待手术区表面的500-700mm处，而后进行采集投影装置的调节，使得其进行清晰的影像采集，同时教学医生对待手术区进行教学手术，采集投影装置将采集的实时影像传输至手术端交互装置进行存储。如教学医生进行手术缝合的教学手术，教学医生开始教学手术的同时开启本发明实施例提供的装置，采集投影装置同时将教学医生的缝合流程中探查、清创、缝合等操作的实时影像传输至手术端交互装置中进行存储。
S22、待所述教学手术完毕后，所述教学医生通过所述手术端交互装置调取并显示存储的所述实时影像，并根据所述实时影像输入相应所述教学标注线后存储至所述手术端交互装置。
教学手术完毕后，教学医生能够通过手术端交互装置调取并显示存储的手术过程的实时影像，在教学医生观看实时影像的过程中，能够通过鼠标、触控等方式，根据实时影像显示的待手术区对位输入教学标注线并存储在手术端交互式装置中。
在本发明一实施例中，本发明提供的所述教学医生根据所述实时影像输入相应所述教学标注线的同时，输入语音标注并存储至所述手术端交互装置，进而能够通过语音和教学标注线的双重操作，提高训练效果。
S23、受训医生通过所述手术端交互装置调取并显示存储的所述实时影像，且所述手术端交互装置将所述教学标注线传输至所述采集投影装置。
在受训医生进行训练时，可以通过手术端交互装置调取并观看其显示的带有教学标注线的实时影像，同时手术端交互装置能够将教学标注线传输至采集投影装置。
S24、所述采集投影装置将所述教学标注线对位投影至所述待手术区。
本发明实施例提供的采集投影装置在手术端交互装置显示实时影像的同时，能够将教学标注线对位投射至待手术区，进而能够使得受训医生直观的了解整个手术过程，提高训练效果。
相应的，本发明实施例还提供了一种医疗设备，所述医疗设备包括上述任意一实施例所提供的远程手术指导和教学装置。
本发明实施例提供了一种远程手术指导和教学装置及其方法与医疗设备，包括手术端及远程指导端；所述手术端包括：手术床；设置于所述手术床上方的采集投影装置，所述采集投影装置用于采集待手术区处的实时影像，用于将与所述待手术区对位的手术标注线投影至所述待手术区，所述手术标注线包括远程指导标注线和教学标注线；以及，与所述采集投影装置电连接的手术端交互装置，所述手术端交互装置用于将所述实时影像通过互联网传输至所述远程指导端，用于通过所述互联网接收所述远程指导端发送的所述远程指导标注 线，用于存储所述实时影像，以及用于调取并显示存储的所述实时影像而输入相应所述教学标注线；所述远程指导端包括：与所述手术端交互装置通过所述互联网关联的远程指导端交互装置，所述远程指导端交互装置用于接收所述实时影像并显示，及用于将输入的所述远程指导标注线通过所述互联网传输至所述手术端交互装置。
由上述内容可知，本发明实施例提供的技术方案，在远程手术指导过程中能够将指导医生输入的远程指导标注线直接对位投影至待手术区，以使手术医生更加直观的了解对待手术区进行手术的线路，进而解决了现有技术中手术医生需反复在显示器与病变部位间频繁切换视角的问题。本发明实施例提供的技术方案能够提高手术定位精度、减少手术损伤、优化手术路径及提高手术成功率；提高了远程手术指导的准确度，无需额外繁琐的配准算法，提高了远程手术的速度。同时，在教学过程中同样能够将教学医生输入的教学标注线直接对位投影至待手术区，以使受训医生能够直观了解教学医生的手术过程。本发明实施例提供的技术方案，提高了远程手术指导质量和教学质量。
对所公开的实施例的上述说明，使本领域专业技术人员能够实现或使用本发明。对这些实施例的多种修改对本领域的专业技术人员来说将是显而易见的，本文中所定义的一般原理可以在不脱离本发明的精神或范围的情况下，在其它实施例中实现。因此，本发明将不会被限制于本文所示的这些实施例，而是要符合与本文所公开的原理和新颖特点相一致的最宽的范围。

Claims (10)

  1. 一种远程手术指导和教学装置，其特征在于，包括手术端及远程指导端；
    所述手术端包括：手术床；设置于所述手术床上方的采集投影装置，所述采集投影装置用于采集待手术区处的实时影像，用于将与所述待手术区对位的手术标注线投影至所述待手术区，所述手术标注线包括远程指导标注线和教学标注线；以及，与所述采集投影装置电连接的手术端交互装置，所述手术端交互装置用于将所述实时影像通过互联网传输至所述远程指导端，用于通过所述互联网接收所述远程指导端发送的所述远程指导标注线，用于存储所述实时影像，以及用于调取并显示存储的所述实时影像而输入相应所述教学标注线；
    所述远程指导端包括：与所述手术端交互装置通过所述互联网关联的远程指导端交互装置，所述远程指导端交互装置用于接收所述实时影像并显示，及用于将输入的所述远程指导标注线通过所述互联网传输至所述手术端交互装置。
  2. 根据权利要求1所述的远程手术指导和教学装置，其特征在于，所述手术端还包括：与所述采集投影装置及所述手术端交互装置电连接的定位追踪装置，所述定位追踪装置用于根据所述实时影像定位所述待手术区的位置，并调整所述采集投影装置投射的手术标注线与所述待手术区对位。
  3. 根据权利要求1所述的远程手术指导和教学装置，其特征在于，所述远程指导端交互装置还用于存储所述实时影像。
  4. 根据权利要求1所述的远程手术指导和教学装置，其特征在于，所述采集投影装置包括：
    分光片；
    设置于所述分光片的反射光路上的采集元件，所述采集元件与所述手术端交互装置电连接；
    设置于所述分光片的透射光路上的投影元件，所述投影元件与所述手术端交互装置电连接；
    以及，设置于所述分光片背离所述采集元件一侧的吸收型滤光片。
  5. 根据权利要求4所述的远程手术指导和教学装置，其特征在于，所述采集元件包括CCD摄像头或CMOS摄像头。
  6. 根据权利要求4所述的远程手术指导和教学装置，其特征在于，所述投影元件包括投影仪或扫描振镜。
  7. 根据权利要求1所述的远程手术指导和教学装置，其特征在于，所述手术端交互装置和所述远程指导端交互装置还均包括音频设备。
  8. 一种远程手术指导和教学方法，其特征在于，应用于权利要求1-7任意一项所述的远程手术指导和教学装置，其中，远程手术指导方法包括：
    所述采集投影装置采集所述待手术区的实时影像，并传输至所述手术端交互装置；
    所述手术端交互装置将所述实时影像通过所述互联网传输至所述远程指导端交互装置；
    指导医生根据所述远程指导端交互装置显示的所述实时影像而输入所述远程指导标注线；
    所述远程指导端交互装置将所述远程指导标注线通过所述互联网传输至所述手术端交互装置；
    所述手术端交互装置将所述远程指导标注线传输至所述采集投影装置；、所述采集投影装置将所述远程指导标注线对位投影至所述待手术区，手术医生根据所述远程指导标注线进行手术；
    以及教学方法包括：
    教学医生对所述待手术区进行教学手术，同时所述采集投影装置采集所述待手术区的实时影像，并传输至所述手术端交互装置存储；
    待所述教学手术完毕后，所述教学医生通过所述手术端交互装置调取并显示存储的所述实时影像，并根据所述实时影像输入相应所述教学标注线后存储至所述手术端交互装置；
    受训医生通过所述手术端交互装置调取并显示存储的所述实时影像，且所述手术端交互装置将所述教学标注线传输至所述采集投影装置；
    所述采集投影装置将所述教学标注线对位投影至所述待手术区。
  9. 根据权利要求8所述的远程手术指导和教学方法，其特征在于，所述教 学医生根据所述实时影像输入相应所述教学标注线的同时，输入语音标注并存储至所述手术端交互装置。
  10. 一种医疗设备，其特征在于，所述医疗设备包括权利要求1-7任意一项所述的远程手术指导和教学装置。
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