Report On ROBOTICS IN MEDICAL APPLICATIONS

Submitted By:

Guided By:

RAUNAK JOSHI B.tech IV (2008-12) Production Engg. U08PR807
raunakrjoshi@gmail.com

Mr. ANIL .K.MAHTO Assistant Professor Mechanical Engg. Dept

CERTIFICATE This is to certify that ―Mr. 7th has satisfactorily completed his report on ―ROBOTICS IN MEDICAL APPLICATIONS‖ Signature of guide: . RAUNAK JOSHI‖ of B Tech IV sem.

CONTENT    INTRODUCTION WHAT IS ROBOTICS ROBOTICS IN MEDICAL FIELD  THE DA VINCI Surgical System  Nano Robotics  Hospital Robots APPLICATIONS CRITICSM CONCLUSION    .

developed at Imperial College London. The ROBODOC from Integrated Surgical Systems was introduced in 1992 to mill out precise fittings in the femur for hip replacement. In computer-controlled systems the surgeon uses a computer to control the robotic arms and its end-effectors. In 1988. indeed the surgeon could be anywhere in the world. and robotically-assisted surgery are terms for technological developments that use robotic systems to aid in procedures. was used to place a needle for a brain biopsy using CT guidance. Robotically-assisted surgery was developed to overcome both the limitations of minimally invasive surgery or to enhance the capabilities of surgeons performing open surgery. the surgeon uses one of two methods to control the instruments . was used to perform prostatic surgery. though these systems can also still use telemanipulators for their input. feedback-controlled motions than could ever be achieved by a human hand. the PROBOT. the PUMA 560. The main object of such smart instruments is to reduce or eliminate the tissue trauma traditionally associated with open surgery without requiring more than a few minutes' training on the part of surgeons. instead of directly moving the instruments. One advantage of using the computerised method is that the surgeon does not have to be present. leading to the possibility for remote surgery. that minimally invasive techniques have so failed to supplant. autonomous instruments (in familiar configurations) replace traditional steel tools. A telemanipulator is a remote manipulator that allows the surgeon to perform the normal movements associated with the surgery whilst the robotic arms carry out those movements using endeffectors and manipulators to perform the actual surgery on the patient. ZEUS is no longer being actively marketed. performing certain actions (such as rib spreading) with much smoother.) . either a direct telemanipulator or by computer control. In the case of robotically assisted minimally invasive surgery. particularly cardio-thoracic. This approach seeks to improve that lion's share of surgeries. In 1985 a robot. In the case of enhanced open surgery. Further development of robotic systems was carried out by Intuitive Surgical with the introduction of the da Vinci Surgical System and Computer Motion with the AESOP and the ZEUS robotic surgical system. (Intuitive Surgical bought Computer Motion in 2003. computer-assisted surgery.INTRODUCTION Robotic surgery.

semi-autonomous or remotely controlled. construction. structural disposition. typically by remote control. In practice a robot is usually an electro-mechanical machine that is guided by computer and electronic programming. whether domestically. mechanics mechatronics. a robot may convey a sense that it has intent or agency of its own. Industrial robots.WHAT IS ROBOTICS ? A robot is a mechanical or virtual intelligent agent that can perform tasks automatically or with guidance. Robotics is related to the sciences of electronics. commercially. and build new robots that serve various practical purposes. ―ROBOTICS‖ is the branch of technology that deals with the design. The concept and creation of machines that could operate autonomously dates back to classical times. manufacture and application of robots. . Robots can be autonomous. mobile and servicing robots. By mimicking a lifelike appearance or automating movements. Robots range from humanoids such as ASIMO and TOPIO to Nano robots. robotics is a rapidly growing field. and software. engineering. medicine or militarily. Swarm robots. as we continue to research. Today. but research into the functionality and potential uses of robots did not grow substantially until the 20th century. design. operation.

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it turned out to be more useful for minimally invasive on-site surgery. Although the telesurgical robot was originally intended to facilitate remotely performed surgery in battlefield and other remote environments. It is commonly used for prostatectomies and increasingly for cardiac valve repair and gynecologic surgical procedures The da Vinci Surgical System comprises three components: a surgeon’s console. The da Vinci senses the surgeon’s hand movements and translates them electronically into scaled-down micromovements to manipulate the tiny proprietary instruments.000 procedures in 2006 and sells for about $1. Michler.2 million. and is used in more than 800 hospitals in the Americas and Europe. . Cardiothoracic Surgery. It also detects and filters out any tremors in the surgeon's hand movements. The first robotic surgery took place at The Ohio State University Medical Center in Columbus. Robert E. 2009 currently sells for $1.The da Vinci Surgical System Da Vinci Surgical System The Da Vinci Surgical System is a robotic surgical system made by Intuitive Surgical and designed to facilitate complex surgery using a minimally invasive approach. a patient-side robotic cart with 4 arms manipulated by the surgeon (one to control the camera and three to manipulate instruments). The patents for the early prototype were sold to Intuitive Surgical in Mountain View. The new da Vinci HD SI released in April. so that they are not duplicated robotically.75 million. The original telesurgery robotic system that the da Vinci was based on was developed at SRI International in Menlo Park with grant support from DARPA and NASA. and a highdefinition 3D vision system. Professor and Chief. The da Vinci System was used in 48. Ohio under the direction of Dr. Articulating surgical instruments are mounted on the robotic arms which are introduced into the body through cannulas. The camera used in the system provides a true stereoscopic picture transmitted to a surgeon's console. California. hysterectomy and mitral valve repair. The system is controlled by a surgeon from a console. The da Vinci System is FDA cleared for a variety of surgical procedures including surgery for prostate cancer.

Like any developing scientific field. nanoids. Nanorobots are at the brink of revolutionizing the medical world. An example is a sensor having a switch approximately 1. manipulation and swarm behavior at nano scale • Bio nanorobots – Nanorobots designed (and inspired) by harnessing properties of biological materials (peptides. Following the microscopy definition even a large apparatus such as an atomic force microscope can be considered a nanorobotic instrument when configured to perform nanomanipulation. macroscale robots or microrobots that can move with nanoscale precision can also be considered nanorobots. nanites. More specifically. Once they are created. which could be used to identify and destroy cancer cells. capable of counting specific molecules in a chemical sample. their designs and functionalities. • Nanorobots could propose solutions at most of the nanomedicine problems. These are inspired not only by nature but machines too. nanorobots will treat and find disease. Each one ranges from 0. The NanoRobotic Concept • Nanorobots would constitute any ―smart‖ structure capable of actuation. with devices ranging in size from 0. Nanorobotics is the emerging technology field of creating machines or robots whose components are at or close to the microscopic scale of a nanometer (10−9 meters). Nanomachines are largely in the research-and-development phase. . Nanorobots will be able to monitor neuro-electric signals and stimulate bodily systems. With nanorobotics. Rice University has demonstrated a single-molecule car developed by a chemical process and including buckyballs for wheels. Recently.Nanorobotics Medical robots that get under the skin. but some primitive molecular machines have been tested. Other nanoparticles may be used to starve cancer. DNAs). and the measurement of their concentrations. DIAGNOSTICS: Tiny nanorobotic probes may be the future of diagnosis. or can manipulate with nanoscale resolution. scientists believe tiny nanorobots will be the answer to many serious conditions and diseases. nanorobotics refers to the nanotechnology engineering discipline of designing and building nanorobots. It is actuated by controlling the environmental temperature and by positioning a scanning tunneling microscopetip. instead of the description of nanorobots as molecular machine.1 to 100 nanometers in size. Another definition is a robot that allows precision interactions with nanoscale objects. there are objections about side effects and ethical concerns. and restore lost tissue at the cellular level. But that can't begin to describe the size of a nano. providing an alternative to chemotherapy. in the environment. Monitoring. A nanometer is one-billionth of a meter. But the eventual medical advantages are unmistakable. Such devices are more related to Microscopy or Scanning probe microscopy. The word. TARGETED DRUG DELIVERY: Nano-sized machines have a future in drug delivery. specific areas can be targeted with nanobullets or treated with smart bombs. sensing. intelligence. Small enough to slip into the blood stream. diagnosing and fighting sickness will be the work of microscopic agents. The first useful applications of nanomachines might be in medical technology. The names nanobots. Another potential application is the detection of toxic chemicals. nanomachines or nanomites have also been used to describe these devices currently under research and development.5 nanometers across. information processing.1-10 micrometers and constructed of nanoscale or molecular components. For this perspective. nano is Greek for dwarf. signaling.

From dispensing medication. to making deliveries and visiting patients. They stepin to handlenursing and support staff shortages and streamlinemany tediousadministrative tasks. It sorts half a billion medications error free per year.the number of doses a ROBOT-Rx can store. 25. McKesson ROBOT-Rx This automated system stores and dispenses single doses of drugs for entire hospitals. The Numbers:    1/3 of the medium and large pharmacies in U.hospitals own a ROBOT-Rx. all the while keeping track of all medication. the robot collects the dosage by scanning the barcodes on the medications. This robotic system ensures that the right medicine reaches the right patient.HOSPITAL ROBOTS Robots are the newest members of the hospital support and nursing staff. The Advantage of ROBOT-Rx:       Prevents medication errors Manages dispension numbers Eliminates the tedious task of sorting medicine Works 24-hours a day Keeps track of stocking needs Saves money/time . Pharmacists enter prescriptions into the computer.000 . Robots are helping doctors reach patients across distance. and bags them.S. robots are improving the way hospitals function.

Doctors operate them using a joystick and wireless technology. Mobile robots such as the In Touch Health Remote Presence (RP-6 and RP-7s) are facilitating faster service and doctor-patient face time. with computer screens for heads and real-time video cameras for eyes and ears. and linens throughout the hospital. Another advantage to these robots is saving staff from cross-infection. The RobotCart travels a set path and prevents collisions by using sonar. These robots are fully mobile.Mechanized Couriers Robots are efficient messengers. . They transport materials like food. The HelpMate and Aethon TUG are other mechanized couriers work to create better hospital environments. x-rays. Robot Doctors kiwi-robot-doctor In New Zealand Doctors are examining patients from continents away with interactive robots and hi-tech visuals.

making for less pain and faster recovery. heal hearts. THE ROBOTIC LEECH It is a revolutionary robotic tool not only can it inject drugs. . Doctors control the entire operation from another room. and work with great precision. Unlike human hands. a tiny camera. doctors can perform operations in rural communities or dangerous settings without having to be present. The MRI provides a clear. and connect pacemakers. Surgical Systems are other robotic operating systems. Doctors will use the neuroArm and MRI technology to perform risky surgical procedures with dexterity and precision. robotic tools take up little room. The AESOP and Zeus R. Whether the patient is located in a remote location or on a battlefield. OTHER SURGERIES Lung surgeries and difficult procedures such as kidney transplants have been performed successfully with robot assistance. They are voice-controlled. 3-D image of the entire process. LONG-DISTANCE SURGERIES With robot-assisted surgery. but it is also engineered to destroy damaged tissue. using handles to control every movement of the robotic arms and gauge pressure and texture. With shorter recovery times and non invasive keyhole procedures. and miniature tools. Not only will health care have a greater reach. There is no longer any need for long incisions. The new software makes stopping or slowing the heart during the procedure unnecessary because the robotic arm is able to work in synch with the movement of the heart. doctors can operate with less risk to the patient and more accuracy. physicians hope surgeries will grow in popularity. surgeons can control the operation without traveling or endangering themselves. but it can take place earlier.APPLICATIONS BRAIN SURGERY: The Neuro Arm robot performs brain surgery Canadian scientists have designed a robot that operates on the brain. With only a few tiny cuts. HEART SURGERY The da Vinci robot and new software from the UK are making major heart surgery easier and better.

gynecologists can perform hysterectomies. pancreatectomy. Other gastrointestinal procedures including colon resection. The need for large abdominal incisions is virtually eliminated. The Hansen Medical Sensei robotic catheter system uses a remotely operated system of pulleys to navigate a steerable sheath for catheter guidance. proven to reduce contrast usage and access tortuous anatomy unreachable by manual navigation. removing 60% of the patient's liver. commensurate with higher procedural complications. including bariatric surgery. Surgeons at various universities initially published case series demonstrating different techniques and the feasibility of GI surgery using the robotic devices.GENERAL SURGERY In early 2000 the field of general surgical interventions with the daVinci device was explored by surgeons at Ohio State University. This includes the use of the da Vinci surgical system in benign gynecology and gynecologic oncology. and female cancers. GASTRO-INTESTINAL SURGERY Multiple types of procedures have been performed with either the 'Zeus' or da Vinci robot systems. At present. . led by Prof. reported a pancreatectomy and also the Midwests fully robotic Whipple surgery. ovarian tumors. esophagectomy and robotic approaches to pelvic disease have also been reported. The Sensei has been associated with mixed acute success rates compared to manual. CARDIOLOGY AND ELECTROPHYSIOLOGY The Stereotaxis Magnetic Navigation System (MNS) has been developed to increase precision and safety in ablation procedures for arrhythmias and atrial fibrillation while reducing radiation exposure for the patient and physician. and the system utilizes two magnets to remotely steerable catheters. In 2007. Reports were published in esophageal and pancreatic surgery for the first time in the world and further data was subsequently published by Horgan and his group at the University of Illinois and then later at the same institution by others. Specific procedures have been more fully evaluated. In April 2008. the University of Illinois at Chicago medical team. Robotic surgery can be used to treat fibroids. and lymph node biopsies. pelvic prolapse. GYNECOLOGY Robotic surgery in gynecology is one of the fastest growing fields of robotic surgery. in very good condition. endometriosis. Furthermore the patient can also leave with less pain than a usual surgery due to the four puncture holes and not a scar by a surgeon. it is expected that the applications of robots in cardiovascular surgery will expand. Coronary artery bypass — rerouting of blood supply by bypassing blocked arteries that provide blood to the heart. As surgical experience and robotic technology develop. longer procedure times but lower fluoroscopy dosage to the patient. These three surgery types are:    Atrial septal defect repair — the repair of a hole between the two upper chambers of the heart. myomectomies. the same team of surgeons performed the world's first fully minimally invasive liver resection for living donor transplantation. and MNS has also been used in interventional cardiology for guiding stents and leads in PCI and CTO procedures. The system allows for automated 3-D mapping of the heart and vasculature. It allows precise and more forceful positioning of catheters used for 3-D mapping of the heart and vasculature. The system provides doctors with estimated force feedback information and feasible manipulation within the left atrium of the heart. specifically esophageal fundoplication for the treatment of gastroesophageal reflux and Heller myotomy for the treatment of achalasia. Using the robotic system. Mitral valve repair — the repair of the valve that prevents blood from regurgitating back into the upper heart chambers during contractions of the heart. yet allowing him to leave the hospital just a couple of days after the procedure. abnormal periods. three types of heart surgery are being performed on a routine basis using robotic surgery systems. Pier Cristoforo Giulianotti.

It has been most extensively applied for excision of prostate cancer because of difficult anatomical access. kasai portoenterostomy. MD Robotic's NeuroArm is the world’s first MRI-compatible surgical robot. nissen fundoplication. Mounted on the robot is a compact X-band linac that produces 6MV Xray radiation. The system uses a German KUKA KR 240. RADIO SURGERY Stereotactic Radio surgery CyberKnife Robotic Radiosurgery System uses image guidance and computer controlled robotics to treat tumors throughout the body by delivering multiple beams of high-energy radiation to the tumor from virtually any direction. congenital diaphragmatic hernia repair. surgeons at Children's Hospital of Michigan in Detroit performed the nation's first advanced computer-assisted robot-enhanced surgical procedure at a children's hospital. especially in the United States. PEDIATRICS Surgical robotics has been used in many types of pediatric surgical procedures including: tracheoesophageal fistula repair. the first robot-assisted laparoscopic radical prostatectomy was performed.Also usedfor knee replacement operations. a robot that constrains a bone cutting tool to a pre-defined volume. ORTHOPEDICS ROBODOCIntegrated Surgical Systems. cholecystectomy.NEURO SURGERY Several systems for stereotactic intervention are currently on the market. total knee replacement and anterior cruciate ligament reconstruction. . steerable flexible needles for use in prostate brachytherapy. which enables the system to deliver radiation from many different directions without the need to move both the patient and source as required by current gantry configurations. 2002. Mounting the radiation source on the robot allows very fast repositioning of the source. UROLOGY Robotic surgery in the field of urology has become very popular. New minimally invasive robotic devices include ultrasound probes for selective excisions of kidney tumors. In 2000. and others. It is also utilized for kidney cancer surgeries and to lesser extent surgeries of the bladder. Inc. morgagni's hernia repair. sells the "Acrobot Sculptor". Used for total hip replacement. On January 17.CUREXO Technology CorporationThe Acrobot Company Ltd.

However. Finally. Because patient recovery after robot-assisted heart surgery is quicker. Further advantages are articulation beyond normal manipulation and threedimensional magnification. critics point out that studies that indicate that long-term results are superior to those after laparoscopic surgery are lacking. On average patients leave the hospital two to five days earlier than patients who have undergone traditional open-heart surgery and return to work and normal activity 50% more quickly. The robotic system does not come cheap and has a learning curve. minimally invasive surgery and unmanned surgery. Robotic techniques are also associated with reduced duration of hospital stays. While the use of robotic surgery has become an item in the advertisement of medical services. transfusions. smaller incisions. and quicker healing time. and brain surgery: When it comes to complex surgical procedures.ADVANTAGES OF ROBOTICS IN MEDICAL APPLICATIONS Heart operations. kidney transplants. Advantages of this technique are that the incisions are small and patient recovery is quick. smaller scars Shortened recovery period . Some major advantages of robotic surgery are precision. the overall cost of hospital stays. they also reduce the number of staff needed during surgery. the surgeon makes a ten to twelve-inch incision. Compared with other minimally invasive surgery approaches. nursing care required after surgery. Data is absent that proves the increased costs can be justified. these may not be representative of surgeons with lesser experience. This approach can be associated with postoperative infection and pain. and prolonged time to complete recovery. and risky. while increasing accuracy. surgeons no longer have to stand throughout the surgery and do not tire as quickly. less pain. therefore. decreased blood loss. and use of pain medication. . THE ADVANTAGES OF ROBOT-ASSISTED SURGERY For the Patient:      Less pain Smaller incisions Fewer. Robots are making operations less painful. robot-assisted surgery gives the surgeon better control over the surgical instruments and a better view of the surgical site. the hospital stay is shorter. the surgical robot can continuously be used by rotating surgery teams.days instead of weeks Fewer infections. The patient is then placed on a heart-lung machine and the heart is stopped for a period of time during the operation. then gains access to the heart by splitting the sternum (breast bone) and spreading open the rib cage. Naturally occurring hand tremors are filtered out by the robot’s computer software. doctors are looking to robotics.Reduced recovery times are not only better for the patient. In addition. and. very experienced surgeons tend to publish their results with robotic systems. resulting in improved ergonomics. In traditional open-heart surgery. blood loss. invasive. In medical literature. miniaturization. complications For the Surgeon:    Greater precision Steady instruments Less invasive procedures Major advances aided by surgical robots have been remote surgery.

engineers.200. Data are absent to show that these increased costs can be justified. critics point out a lack of studies that indicate long-term results are superior to results following laparoscopic surgery. At present the negative impact is only on menial and repetitive jobs. and there is actually a positive impact on the number of jobs for highly skilled technicians. and specialists. These. . however. although the manufacturers of such systems provide training on this new technology. improved outcomes.500 per procedure. shortening length-of-stay in the hospital and reducing recovery times. there is no question that some procedures that have traditionally been performed with large incisions can be converted to "minimally invasive" endoscopic procedures with the use of the Da Vinci. minimally invasive operations can take up to twice as long as traditional surgery.000 dollars and disposable supply costs of $1. Patient surveys indicate they chose the procedure based on expectations of decreased morbidity. But because of the hefty cost of the robotic system it is not clear that it is cost-effective for hospitals and physicians despite any benefits to patients since there is no additional reimbursement paid by the government or insurance companies when the system is used. And there is a steep learning curve for surgeons who adopt use of the system. leading to operating room tie ups and surgical staffs keeping patients under anesthesia for longer periods. Higher expectations may explain higher rates of dissatisfaction and regret. As it stands. these highly skilled jobs are not sufficient in number to offset the greater decrease in employment among the general population. Moreover during the training phase. Numerous feasibility studies have been done to determine whether the purchase of such systems are worthwhile. Robots and other forms of automation will ultimately result in significant unemployment unless the economy is engineered to absorb them without displacing humans. Another problem is that in the medical literature very experienced surgeons tend to publish their results. Surgeons report that. On the other hand.CRITICSM While the use of robotic surgery has become an item in the advertisement of medical services. reduced blood loss and less pain. may not be representative of surgeons with lesser experience. the cost of the procedure is higher. opinions differ dramatically. Additional surgical training is needed to operate the system. With the cost of the robot at $1. However. as machines begin to match and exceed the capability of workers to perform most jobs. causing structural unemployment in which overall (net) unemployment rises. the learning phase is intensive and surgeons must operate on twelve to eighteen patients before they adapt.

integrating imaging modalities into the OR.CONCLUSION Robotic technology has successfully produced valuable tools for rehabilitation. providing functional replacements for lost limbs. surgery. Future applications of robotic technology will continue to provide advances in these and other areas of medicine. . such as enabling new micro surgery procedures by providing high-dexterity access to small anatomical structures. and enabling new human machine interfaces and techniques for delivering neuro-rehabilitation therapy. and medical training. as well as new and improved prosthetics and assistive devices for people with disabilities. The most significant role of medical robot will most likely be to perform tasks that are otherwise impossible.

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