MEDICAL ROBOTICS

Overview
 Introduction
 Classification
 Application of Medical Robotics
 Design of Robotic Telesurgery
 Historic Companies and Systems
 Existing surgical systems
 Strengths and Limitations
 Ethical and Safety Considerations
 Challenges, Future and Conclusion
Introduction(1)
 Definition: Robotic systems for
surgery
 There are computer-integrated surgery (CIS)
systems first, and “medical robots” second.
The robot itself is just one element of a larger
system designed to assist a surgeon in
carrying out a surgical procedure..” [Taylor,
2003]
Introduction(2)
 CIS

 Information flow in CIS

Application of Medical Robotics(1)
 Laboratory Robots
◦ For pre-programmed tasks
◦ High repetitions
◦ Perform multiple-tests in parallel
◦ Manufacturers include, Thermo Electron Corp,
Hamilton Co, Central Research Laboratories
(CRL), A Dover Diversified Co etc.
Application of Medical Robotics(2)
 Telesurgery
◦ Surgeon sits at a
console
◦ Has controls to
move the robotic
arms
◦ Does not operate on
the patient directly
◦ Mainly used in
minimally invasive
surgeries
Application of Medical Robotics(3)
 Surgical Training
◦ Robots used as
surgical training
simulators
◦ Used for medical
resident students
◦ Residents lack  The Second Generation Robotic
Telesurgical System for
expertise and this Laparoscopy during tests in the
helps in avoiding legal, Experimental Surgery Lab at UC
social and economic San Francisco
problems
Application of Medical Robotics(4)
 Rehabilitation
◦ Assistive robots
◦ Wheelchair with
intelligent
navigational
control system
Application of Medical Robotics(5)
 Remote surgery
◦ Surgeon can be anywhere in the world
◦ Remotely controls the robotic surgical system
◦ Very useful for treating wounded people in
battlefields
Application of Medical Robotics(6)
 Laparoscopic Surgery
◦ Performed in the abdominal cavity using MIS
◦ Abdomen cavity is expanded using CO2
◦ Uses Laparoscopic instrument
 Fiber optic channels to illuminate the inside of abdominal
cavity
 Lens optics to transmit image
 CCD camera at the outer end
 Image displayed on high resolution TV
Design of Robotic Telesurgery
 The Concept

 Telesurgical system concept

Design of Robotic Telesurgery
 Considerations:
◦ Compatibility
◦ Backdrivabilit
◦ Actuator’s impedance
◦ Actuators receive tool-to-tissue force
◦ Loss of power can lead to dropping of a heavy
tool and undesirable high accelerations in the
actuator
Design of Robotic Telesurgery
 Considerations:
◦ Human-Machine Interface
◦ Video system used to capture images inside
the patient
◦ Backlash-loss of motion between a set of
movable parts
 Choose the appropriate mechanism for the
required transmission
◦ Choose passive gravity balance over active
gravity balance
Historic Companies and Systems
 First Robotic assisted surgery 1988
◦ – PUMA 560
◦ – Light duty industrial robotic arm to guide laser/needle for sterostactic
brain surgery
 First Robotic urological surgery 1992
◦ – PROBOT-assisted TURP in Guy’s Hospital in London leaded by
Wickham
 First commercially available robotic system, 1992
◦ – ROBODOC for orthopaedic hip surgery
 First RCT of transatlantic telerobotics surgery
◦ – Between Guy’s and John Hopkins Hospitals
◦ – PAKY-RCM percutaneous access robot (Kavoussi group developed in
1996)
Existing surgical systems(1)
 AESOP
Existing surgical systems(2)
 ZEUS (Computer Motion)
◦ – Marketed in 1998
Existing surgical systems(3)
 Da Vinci (Intuitive Surgical)
◦ – Initially developed by US Department of
Defence in 1991
◦ – Intuitive Surgical acquired the prototype and
commercialized the system
◦ – Approved by FDA in July 2000
Existing surgical systems(4)
 Da Vinci Surgical® system by Intuitive
Surgical, Inc.
Existing surgical systems(5)
 Advantages of Da Vinci Surgical®:
◦ Technically
 – Patented Endowrist: 6 degrees of movement
 – 3-D vision (Dual channel endoscopy) and
magnified view (x12)
 – Tremor suppression and scaling of movement
Surgeon
 – Ergonomic advantage
 – Shorter learning curve
◦ Patient
 – Better outcome
Existing surgical systems(7)
 6 degree movements

 Advantages:
Strengths and Limitations(1)
 Strengths:
◦ Physical separation
◦ Wrist action
◦ Tremor elimination
◦ Optional motion scaling
◦ Three-dimensional stereoscopic image
◦ Electronic information transfer (Telesurgery)
Strengths and Limitations(2)
 Limitation
◦ Reluctance to accept this technology (trust)
◦ Additional training
◦ Fail proof?
◦ Most of the sensors use IR transmission
◦ Highly efficient visual instruments are needed
◦ Cannot be pre-programmed
◦ Task-specific robots are required
◦ Latency in transmission of mechanical
movements by the surgeon
◦ Longer operating time
Ethical and Safety Considerations
 When there is a marginal benefit from
using robots, is it ethical to impose
financial burden on patients or medical
systems?
 If a robot-assisted surgery fails because of
technical problems, is it the surgeon who
is responsible or others?
Challenges, Future and Conclusion
 Haptic feedback
 A safe, easy sterilizable, accurate, cheap
and compact robot
 Reliable telesurgical capabilities
 Compatibility with available medical
equipment and standardizing
 Autonomous robot surgeons
Reference
 Robotics in surgery: history, current and future applications.
New York: Nova Science Pub-. lishers; 2007
 J.E. Speich, J. Rosen, 'Medical Robotics,' In Encyclopedia of
Biomaterials and Biomedical Engineering, pp. 983-993,
Marcel Dekker, New York, 2004.
 http://robotics.eecs.berkeley.edu/medical/laparobot.html
 http://biomed.brown.edu/Courses/BI108/BI108_2005_G
roups/04/index.html
 http://faculty.cs.tamu.edu/dzsong/teaching/fall2005/cpsc6
89/
Thanks!