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As shown in Figure 1, during the operation, the surgeon needs to hold a micro-syringe through the anterior segment and vitreous body under the visual field of the posterior segment of the microscope and then position it above the blocked retinal vein. However, retinal intravenous injection puts forward higher requirements for surgeons’ operations ( Ahmad et al., 2020 Mishra and Ashraf, 2020). Surgeons inject thrombolytic drugs into the blocked retinal vein to dissolve the thrombus, which is expected to restore blood circulation in the retinal vein ( Kadonosono et al., 2018 Kadonosono, 2020). In recent years, retinal vein cannulation (RVC) has been proposed as an innovative procedure ( Peng et al., 2017). Today, there is no clinically effective treatment for this disease. Due to the complexity, high precision, and importance of the anatomical structure and function of the retina, retinal surgery is considered a very challenging and difficult surgical operation. It manifests as thrombus formation in the center or branch blood vessels of the retinal vein, resulting in severe loss of vision and even blindness ( Ip and Hendrick, 2018). Retinal vein obstruction (RVO) is an important cause of vision loss in the elderly worldwide, affecting approximately 16.4 million people ( Rogers et al., 2010). Furthermore, 20 groups of experimental measurements on chicken embryo blood vessels with diameters of 150–500 μm showed that the piercing force was 4.02∼23.4 mN, with an average value of 12.05 mN. The experimental data of 15 groups of porcine eyeball retinal veins with diameters of 100–200 μm showed that the piercing force of surgical instruments and blood vessels is 5.95∼12.97 mN, with an average value of 9.98 mN. Based on the layout of three FBG sensors on the hollow outer wall of the nested needle tube in a circular array of nickel-titanium alloys, the real-time sensing of the contact force between the intraoperative instrument and the blood vessel was realized. Additionally, the robot-assisted real-time three-dimensional micro-force-sensing method for retinal vein injection was proposed.
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In this paper, a 3-DOF automatic drug injection mechanism was designed for microscopic image guiding robot-assisted needle delivery and automatic drug injection.
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Surgeons’ limited operation and force-sensing accuracy make it difficult to perform precise and stable drug injection operations on the retina in a magnified field of image vision. However, the retina organization is complex, fine, and weak, and the operation scale and force are small. Retinal vein injection guided by microscopic image is an innovative procedure for treating retinal vein occlusion.
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