Development of the airway management training system WKA-2 designed to reproduce different cases of difficult airway

摘要

The emerging field of medical robotics aims to introduce intelligent tools to assist a physician. The main challenges for developing efficient medical robotic training systems are simulating real-world conditions of the task and assuring training effectiveness. High anatomic fidelity has been achieved in current systems. However, those training systems are designed to reproduce specific conditions of the task (passive training). In this research, we are focusing in developing an airway management training systems designed to reproduce various cases of difficult airway. Such difficulties (i.e. restricted mouth opening, various shapes of oral cavity including tongue swallowing, etc) may provoke traumas on different organs of the patient during an emergency situation. For this purpose, the authors have proposed the development of more advanced training tools. For this purpose, we have focused in embedding sensors and actuators to a conventional patient model towards the development of a patient robot (in previous research, authors have presented the evaluation model which embeds sensors). In this paper, we present an airway training system which embeds actuators into a mannequin. In particular, the mechanism design of the Waseda Kyotokagaku Airway No.2 (WKA-2) is detailed. The WKA-2 is composed of twelve active and one passive degrees of freedom; which are designed to reproduce the various cases of difficult airway. For this purpose, the WKA-2 reproduces the human muscles around the upper airway based on a wire driving mechanisms (a total of sixteen wires are used). In particular, the head of the model is composed of a tongue and mandible with translational and rotational movements around kinematic axis. In addition, we present the details of the kinematic model of WKA-2 which enable the robot to reproduce the airway difficulties. Finally, we presented the design of a tension sensor designed to measure the applied tension on each of the wire driving mechanism of WKA-2. As preliminary experiments, we reproduce several cases of difficult airways using WKA-2.