Directing at the difficulties of reverse shoulder replacement surgery, such as long surgical planning time, low efficiency, unreliable prosthesis fixation screw paths, and high requirements for doctors' clinical experience, our team proposed an automatic planning algorithm for prosthesis fixation screw paths based on bone density assessment and conical spatial path integral, and developed related automatic surgical planning software. The tests show that the proposed algorithm and software can efficiently and accurately realize the automatic preoperative planning of reverse shoulder replacement surgery, which has a broad clinical application prospect in the future.

Directing at the problem of compatibility between anti-(nerve) damage localization and occlusal orientation in complex cavity drilling in dental implant surgery planning, our team proposes key technologies such as path planning based on multi-planar reconstruction and curved surface reconstruction, and develops a computer-aided surgical planning system for oral implantation, which solves the difficulty of spatial path planning in the complex surgical environment, effectively reduces the difficulty of surgical planning, and enhances the efficiency of surgical planning, and is effectively applied and popularized in dental implantation surgeries.

Our team has proposed innovative key algorithms for medical image segmentation and alignment, high-precision real-time tracking, non-invasive spatial alignment, surface alignment based on unmarked points, spatial search based on image recognition, calibration of surgical instruments, and accuracy detection, which have solved a bunch of key technologies for surgical navigation. At the same time, the team has developed the first “Craniomaxillofacial Surgery Navigation System” in China, which has successfully completed more than 100 cases of clinical trials, won the National Medical Device Registration Certificate (Class III) and the European Union CE certification, and is being promoted in the domestic and international markets by an enterprise. The surgical navigation system developed by the team has won the Second Prize of National Prize for Progress in Science and Technology, the Second Prize of Shanghai Award for Scientific and Technological Advancement, and the Award for Scientific and technological Advancement of Zhejiang Province.

Directing at the difficulty of accurate segmentation of tumor eroded mandibles in mandibular reconstruction surgery due to artifact interference, contiguous areas, different morphologies, and unbalanced categories, our team proposes an automatic segmentation algorithm for conventional mandibles based on DenASPP and Attention gates, and a multi-convolutional module combination and boundary supervision based automatic 3D segmentation network for tumor eroded mandibles. These algorithms allow accurate and automatic segmentation of tumor eroded and non-tumor-eroded mandibles in mandibular reconstruction surgery. Meanwhile, our team developed intelligent planning software for mandibular reconstruction surgery integrating the above algorithms and conducted relevant experiments, which effectively improved the planning efficiency and accuracy of mandibular reconstruction surgery and has a broad clinical application prospect in the future.

Directing at the difficulties in the design of surgical guides and implants in the complex clinical space environment, complicated and cumbersome processes, low degree of intelligence, and high requirements for clinical experience, our team proposes relevant algorithms such as personalized implant automatic design based on artificial intelligence, implant hole refinement design, and intelligent guide plate design, and develops an intelligent software system integrating the above key algorithms, realizing highly efficient and reliable automatic implants design. Some of the algorithms and software have been clinically applied and popularized in complex surgeries such as craniomaxillofacial surgery. Among them, the smart implant design was applied in animal experiments of craniozygomatico-orbital prosthetic surgery and generated good results, and the smart guide plate design was effectively applied and popularized in orthognathic and dental implant surgery.

Directing at the clinical challenges of intra-operative preoperative planning failure caused by intra-operative soft tissue deformation and hand-eye discordance of the surgeons during surgery, our team proposes an ultrasound image-guided intra-operative soft tissue deformation tracking method. Real-time segmentation of intra-operative ultrasound images was realized using lightweight convolutional neural networks, the correspondence between pre-operatively reconstructed soft tissue models and intra-operative soft tissue morphology was established using optical navigation equipment, and the deformation field was updated by calculating the a posteriori shape probability, which ultimately realized the real-time dynamic tracking of intra-operative soft tissue deformation. Furthermore, the soft tissue deformation algorithm was integrated into the pre-developed head, neck, craniomaxillofacial surgery mixed-reality surgical robotic system. The system's accuracy and real-time were tested through model and animal experiments, and the results showed that the surface average distance error of soft tissue deformation tracking was 1.04±0.27 mm, and the navigation distance error was 1.52±0.43 mm, which has a large potential for clinical application.

Directing at difficult and high-risk surgical operations, this product combines the key technologies of intelligent surgical planning and navigation proposed above, and proposes a force sensing information guidance based human-robot interaction technology, which utilizes the intra-operative virtual soft tissue morphology to compute the interference relationship between the prohibited area of the surgical robot and the pre-operative planning path, and assesses the safety of the operation in real time. Ultimately, an intelligent surgical robot system was developed, which effectively enhances the precision, minimally invasiveness and safety of surgeries, and has been applied and promoted in cranio-maxillofacial, orthopedic, pulmonary and other complex clinical operations.