软组织吻合器手术缝钉排列优化设计

doi:10.3969/j.issn.0258-8021. 2015. 06.015

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摘要缝钉排列是影响吻合器缝合手术效果的重要因素之一。针对吻合器与软组织交互作用对机械缝合手术质量的影响，提出一种基于缝钉排列方式的机械缝合手术优化模型。首先,对缝钉与软组织交互作用进行力学分析，并在力学模型的基础上建立简化的有限元模型;然后,以血管机械缝合手术为例，建立以缝钉排数和排间距为设计参量、缝合面软组织径向应力大小及应力分布为目标函数的优化模型;最后,通过有限元仿真实验，运用统计学分析方法，获得组织径向应力值及应力分布规律，采用分层序列优化方法确立目标函数与设计参量之间的响应关系。优化结果表明，当缝钉排数为3、排间距为1.25 mm时，缝合面组织径向应力平均值为0.056 3 MPa，组织径向应力分布差值为0.138 5 MPa，血管机械缝合手术效果达到最优。此外，通过乳胶管泄露压实验，初步验证优化结果的有效性。此研究结果可为减少机械缝合手术术后并发症以及吻合器的优化设计提供重要参考。

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	李进华¹ 杨英侃¹张林安^2*李建民¹王树新¹

关键词 ：吻合器, 机械缝合, 缝钉排列, 优化设计, 有限元仿真

Abstract：Staple configuration is one of the important factors that have impacts on the effects of stapling anastomosis. According to staplertissue interaction on the surgery with stapling technology, we proposed an optimized model based on the staple configuration in this study. Firstly, the mechanical model of stapletissue interaction was analyzed, and the simplified finite element model was established based on the mechanical model. Furthermore, the optimized model was established in the case of vascular stapling surgery, and staple row and row space were chosen to be design variables, and the magnitude and distribution of radial stress on the surface of soft tissue were regarded as objective function. At last, the regularities of radial stress magnitude and distribution of soft tissue were obtained by the statistical methods based on finite element simulation experiments. Results showed that when staple row was 3 and row space was 1.25 mm, the average of radial stress was 0.056 3 MPa and the difference of stress distribution was 0.138 5 MPa,and the vascular stapling surgery achieved the optimal effect. The results provide important reference for decreasing complications of stapling surgery and optimal design of staplers.

Key words： stapler mechanical suture staple configuration optimization finite element simulation

基金资助:国家自然科学基金（51275335）

引用本文:

李进华¹ 杨英侃¹张林安^2*李建民¹王树新¹. 软组织吻合器手术缝钉排列优化设计[J]. 中国生物医学工程学报, 2015, 34(6): 743-751.
Li Jinhua¹Yang Yingkan¹Zhang Linan^2*Li Jianmin¹Wang Shuxin^1
. Staple Configuration Optimal Design of Soft Tissue Anastomosis with Stapler. journal1, 2015, 34(6): 743-751.

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http://cjbme.csbme.org/CN/10.3969/j.issn.0258-8021. 2015. 06.015 或 http://cjbme.csbme.org/CN/Y2015/V34/I6/743

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