Development Of Surgical Robot Research Articles

Accuracy of implant site preparation in robotic navigated dental implant surgery.

Modern technological advancements have led to increase in the development of surgical robots in dentistry, resulting in excellent clinical treatment outcomes. This study aimed to determine the accuracy of automatic robotic implant site preparation for different implant sizes by correlating planned and posttreatment positions, and to compare the performance of robotic and human freehand drilling. Seventy-six drilling sites on partially edentulous models were used, with three different implant sizes (Ø = 3.5 × 10 mm, 4.0 × 10 mm, 5.0 × 10 mm). The robotic procedure was performed using software for calibration and step-by-step drilling processes. After robotic drilling, deviations in the implant position from the planned position were determined. The angulation, depth, and coronal and apical diameters on the sagittal plane of sockets created by human and robotic drilling were measured. The deviation of the robotic system was 3.78° ± 1.97° (angulation), 0.58 ± 0.36 mm (entry point), and 0.99 ± 0.56 mm (apical point). Comparison of implant groups showed the largest deviation from the planned position for 5 mm implants. On the sagittal plane, there were no significant differences between robotic and human surgery except for the 5-mm implant angulation, indicating similar quality between human and robotic drilling. Based on standard implant measurements, robotic drilling exhibited comparable performance to freehand human drilling. A robotic surgical system can provide the greatest accuracy and reliability regarding the preoperative plan for small implant diameters. In addition, the accuracy of robotic drilling for anterior implant surgery can also be comparable to that of human drilling.

Development of Surgical Robots in Recent Years

To study the development of surgical robots at home and abroad in recent years. Through a large number of literature review and analysis, the qualification approval and technical function characteristics of domestic and foreign surgical robots from January 2019 to July 2022 were analyzed. The related situations of 39 surgical robots were analyzed and reported, and the shortcomings and future development direction of the current surgical robots were summarized. The development of surgical robots in China is now in a rapid development stage. At present, surgical robots generally have the disadvantages of high cost, lack of tactile feedback (force feedback), large size, large space occupation and difficult to move. In the future, it will develop towards intelligent, miniaturized, remote, open and low-cost.

Safe design of surgical robots- a systematic approach to comprehensive hazard identification.

Since the 1980s, robotic arms have been transferred from industrial applications to orthopaedic surgical robotics. Adverse events are frequent and often associated with the adopted powerful and oversized anthropomorphic arms. The FDA's 510(k) pathway encourages building on such systems, leading to the adoption of hazards, which is known as "predicate creep". Additionally, the methodology of hazard identification for medical device development needs improvement. We present an approach to enhance general hazard identification and prevent hazards of predicate creep by using the integrative, scenario-based and multi-perspective Point-of-View (PoV) approach. We also present the Catalogue of Hazards (CoH) as an approach for collecting and systematising hazards for future risk analysis and robot development. We applied seven predefined PoVs to the use case of robotic laminectomy and identified 133 hazards, mainly coming from HMI analysis and literature. By analysing the MAUDE and recalls databases of the FDA, we were able to classify historical hazards and adopt them into the use case. The combination of PoV approach and CoH is suitable for integrating multiple established hazard identification methods, increasing comprehensiveness, and supporting the systematic and hazard-based development of surgical robots.

A review on the techniques used in prostate brachytherapy

Prostate brachytherapy is a validated treatment for prostate cancer. During the procedure, the accuracy of needle placement is critical to the treatment’s effectiveness. However, the inserted needle could deflect from the preset trajectory because of the needle deflection, tissue shifting caused by the interaction between the needle and soft tissue, as well as the effects of pre-inserted needles. There are significant challenges in needle placement areas, especially in prostate brachytherapy, because multiple needles are required for the effectiveness of radiation. To overcome these limitations, relevant research is carried out in mechanical, computer science, and material science areas. With the development of surgical robotics, researchers are also exploring the possibilities of raising the accuracy of needle placement with surgical-assisted robotics. This study provides a review over the last 3 decades in each of the component research areas that constitutes a surgical robotics system, including needle steering approaches, needle-tissue deformation models, path planning algorithms and different automatic level surgical robotics systems used for prostate cancer treatment, especially prostate brachytherapy. Further directions for researchers are also suggested.

History of Skull Base Surgery

Skull base surgery is a surgical field that involves the cooperation of multiple surgical and medical specialties, including neurosurgery, head-neck surgery, plastic-reconstructive surgery, radiation oncology, as well as multiple medical supporting teams. This field has been developed with the collaborative efforts of these medical specialties, and its history can be divided into five phases: Beginning of surgery(Prior to 1940); Early skull base surgery driven by the ENT-HN surgery group(1940-70); Conventional skull base surgery development based on anatomical, physiological knowledge and microsurgical equipment and technique(1970-90); Reflection and consolidation of the surgical dimension(1995-2005); and Evolution of endoscopic and new skull base surgical techniques(2005-). Several topics and advancements have improved this surgical field, such as access to the cavernous sinus, petrosal-temporal bone, and foramen magnum; concepts of minimally invasive surgical techniques; advanced endoscopic instruments; knowledge of biological assessments; and development of surgical robotics. To achieve a safe and effective surgery for cases of difficult cranial base lesions, clinicians must understand the origin of the surgical field, the detailed anatomy and physiology of the skull base, and the basic microsurgical techniques.

Research progress and development trend of surgical robot and surgical instrument arm.

In recent years, surgical robots have become an indispensable part of the medical field. Surgical robots are increasingly being used in the areas of gynaecological surgery, urological surgery, orthopaedic surgery, general surgery and so forth. In this paper, the development of surgical robots in different operations is reviewed and analysed. In the type of master-slave surgical robotic system, the robotic surgical instrument arms were located in the execution terminal of a surgical robot system, as one of the core components, and directly contact with the patient during the operation, which plays an important role in the efficiency and safety of the operation. In clinical, the arm function and design in different systems varies. Furtherly, the current research progress of robotic surgical instrument arms used in different operations is analysed and summarised. Finally, the challenge and trend are concluded. According to the classification of surgical types, the development of surgical robots for laparoscopic surgery, neurosurgery, orthopaedics and microsurgery are analysed and summarised. Then, focusing on the research of robotic surgical instrument arms, according to structure type, the research and application of straight-rod surgical instrument arm, joint surgical instrument arm and continuous surgical instrument arm are analysed respectively. According to the discussion and summary of the characteristics of the existing surgical robots and instrument arms, it is concluded that they still have a lot of room for development in the future. Therefore, the development trends of the surgical robot and instrument arm are discussed and analysed in the five aspects of structural materials, modularisation, telemedicine, intelligence and human-machine collaboration. Surgical robots have shown the development trend of miniaturisation, intelligence, autonomy and dexterity. Thereby, in the field of science and technology, the research on the next generation of minimally invasive surgical robots will usher in a peak period of development.

Application and Prospect of Robotic Technology in Medical Clinic

<p class="18"><span lang="EN-US">In the process of gradually improving the level of clinical medical treatment and continuously developing industrial technology, the application of less invasive and non-invasive surgical methods in medical clinic is increasingly widespread. In the face of this situation, the inevitable trend of the development of surgery has been inclined to minimally invasive surgery. Under the background of a large number of new technologies in the clinical application of medicine, the application space of surgical minimally invasive surgery technology has become more and more extensive. The first successful laparoscopic cholecystectomy in 1987 is an important sign of the arrival of the era of minimally invasive surgery. The research and development of surgical robots based on this is a predictor of the gradual beginning of the era of surgical information processing. At this time, it will inevitably promote the qualitative improvement of surgical accuracy, and a new era of minimally invasive surgery will gradually open. At present, the latest “Da Vinci” surgical robot developed by ISRG company has been widely used in medical clinic.</span></p>

Development of Surgical Robots in University-originated Venture

Development of Surgical Robots in University-originated Venture

Tele-robotics and artificial-intelligence in stroke care

In the last forty years, the field of medicine has experienced dramatic shifts in technology-enhanced surgical procedures – from its initial use in 1985 for neurosurgical biopsies to current implementation of systems such as magnetic-guided catheters for endovascular procedures. Systems such as the Niobe Magnetic Navigation system and CorPath GRX have allowed for utilization of a fully integrated surgical robotic systems for perioperative manipulation, as well as tele-controlled manipulation systems for telemedicine. These robotic systems hold tremendous potential for future implementation in cerebrovascular procedures, but lack of relevant clinical experience and uncharted ethical and legal territory for real-life tele-robotics have stalled their adoption for neurovascular surgery, and might present significant challenges for future development and widespread implementation. Yet, the promise that these technologies hold for dramatically improving the quality and accessibility of cerebrovascular procedures such as thrombectomy for acute stroke, drives the research and development of surgical robotics. These technologies, coupled with artificial intelligence (AI) capabilities such as machine learning, deep-learning, and outcome-based analyses and modifications, have the capability to uncover new dimensions within the realm of cerebrovascular surgery.

Robotic Surgery: Anaesthesiologist's Contemplation.

Technological advances in the field of surgery and medicine have increased the demand for minimally invasive surgery manifold. Robot assisted surgery is gaining popularity, overcoming the flaws of laparoscopic techniques; with improved surgical precision. The conservative nature of anaesthesia care has to face the challenges with respect to patient positioning, bulkiness of the operating system and being positioned far and away from the patient. Anaesthesiologist’s commitment to be the ‘best man’ for the patient during the perioperative period mandates him to familiarise with these challenges of robot assisted surgical system and provide best possible anaesthetic care and ensure patient safety. In this article, a systematic review of the development of surgical robots and the consideration of unique anaesthetic concerns thereof have been undertaken as any new technology is known to be accompanied by its risks and technical perplexity.

Medical Service of Robots

Today, robots have not only penetrated to create microchips in electronics but also in medicine, where it helps to perform difficult operations, especially where precision is needed and the size is small and any human error could be fatal to the patient. Robots assist the doctor in heart, brain, kidney operations, not to mention bone implants and repair of damaged bones, cartilage and muscles. In this area, new materials adapted to the requirements of the human body also play an important role. The robotic systems used in today's operating blocks are very expensive and bulky and they need to be permanently adapted and prepared before a difficult operation, but in the end their help is unsurpassed because the operation takes place with the help of the machine and the computer, so they can perform a giant precision of hundredth of a millimeter, precision that stops the scalpel from cutting accidentally such as a nerve, a blood vessel, healthy tissue and anything else. Assisted operation brings infinitely more advantages than the disadvantage that the operator block is voluminous and costly. However, apart from the related space, the costs are amortized over time and the satisfaction of the successful operations is great for both the patients and the medical team. Surgery has taken advantage of this technology relatively late. Initial use of robots in surgery began in the late 1980s when an industrial robot was used to support instruments for stereotactic biopsy in neurosurgery. Also in the late 1980s, IBM built the first robot used in clinical practice, called Robo-doc. The first use of a robot in human surgery was for a transurethral prostate resection. In 1993, Computer Motion, Inc. introduced a voice-controlled arm, Automated Endoscopic System for Optimal Positioning (AESOPTM), used to support instruments, of optics in laparoscopic surgery. Its version, AESOPTM 2000 is the first human-controlled robot approved by the Food and Drug Administration of the United States. In 1998, Reichenspurner introduced the ZEUS Microsurgical Robotic System into Germany. Today, the most complex and efficient robot in use is the daVinci system. With the birth of laparoscopy and information technology, surgery went into a new era. The development of surgical robots is primarily motivated by their desire the need to increase the effectiveness of surgical medical interventions. Medical actions are chosen based on information from various sources, including patient-specific data (vital signs and images of human body tissues and organs), general medical knowledge (atlases of human anatomy) and medical experiences. First, a robot can usually do things much more accurate than a man. This provides the first motivation for using CAD/CAM systems. Robots can be used successfully if the patient has been radiated (e.g., with X-radiation), thus not endangering the health of the medical team. Since ancient times, the imagination of mankind has been concerned with the idea of making cars equipped with artificial intelligence to execute operations similar to those performed by man. Technicians have been used for many years in various fields other than medical, such as the automotive industry, the underwater environment, the alien space, or the areas at risk of nuclear radiation.

Medical Service of Robots

Today, robots have not only penetrated to create microchips in electronics but also in medicine, where it helps to perform difficult operations, especially where precision is needed and the size is small and any human error could be fatal to the patient. Robots assist the doctor in heart, brain, kidney operations, not to mention bone implants and repair of damaged bones, cartilage and muscles. In this area, new materials adapted to the requirements of the human body also play an important role. The robotic systems used in today's operating blocks are very expensive and bulky and they need to be permanently adapted and prepared before a difficult operation, but in the end their help is unsurpassed because the operation takes place with the help of the machine and the computer, so they can perform a giant precision of hundredth of a millimeter, precision that stops the scalpel from cutting accidentally such as a nerve, a blood vessel, healthy tissue and anything else. Assisted operation brings infinitely more advantages than the disadvantage that the operator block is voluminous and costly. However, apart from the related space, the costs are amortized over time and the satisfaction of the successful operations is great for both the patients and the medical team. Surgery has taken advantage of this technology relatively late. Initial use of robots in surgery began in the late 1980s when an industrial robot was used to support instruments for stereotactic biopsy in neurosurgery. Also in the late 1980s, IBM built the first robot used in clinical practice, called Robo-doc. The first use of a robot in human surgery was for a transurethral prostate resection. In 1993, Computer Motion, Inc. introduced a voice-controlled arm, Automated Endoscopic System for Optimal Positioning (AESOPTM), used to support instruments, of optics in laparoscopic surgery. Its version, AESOPTM 2000 is the first human-controlled robot approved by the Food and Drug Administration of the United States. In 1998, Reichenspurner introduced the ZEUS Microsurgical Robotic System into Germany. Today, the most complex and efficient robot in use is the daVinci system. With the birth of laparoscopy and information technology, surgery went into a new era. The development of surgical robots is primarily motivated by their desire the need to increase the effectiveness of surgical medical interventions. Medical actions are chosen based on information from various sources, including patient-specific data (vital signs and images of human body tissues and organs), general medical knowledge (atlases of human anatomy) and medical experiences. First, a robot can usually do things much more accurate than a man. This provides the first motivation for using CAD/CAM systems. Robots can be used successfully if the patient has been radiated (e.g., with X-radiation), thus not endangering the health of the medical team. Since ancient times, the imagination of mankind has been concerned with the idea of making cars equipped with artificial intelligence to execute operations similar to those performed by man. Technicians have been used for many years in various fields other than medical, such as the automotive industry, the underwater environment, the alien space, or the areas at risk of nuclear radiation.

Research and Development of Surgical Robot and Manimulator

Research and Development of Surgical Robot and Manimulator

Ultrasonic motor-induced geometric distortions in magnetic resonance images.

Ultrasonic motors (USMs) are common actuators that can be safely used in the magnetic resonance imaging (MRI) environment. However, lack of MRI compatibility results in issues such as image distortion. This fact led researchers to shift focus from USMs to pneumatic and hydraulic actuators in development of surgical robots. The aim is to quantify and compensate the geometric distortion of MR images as generated by the presence of USMs. An ultrasonic motor was positioned in three orientations with respect to the bore axis. The induced distortions were compared across four image sequences. To reduce the distortions, three artifact reduction methods were employed. Geometric distortion is the only artifact in image slices farther from the motor. The various motor orientations lead to different distortions, with the lowest distortion for the z orientation. The maximum measured distortion of ten pixels occurred. This maximal distortion is equal to a 1-cm displacement of the displayed points relative to their actual locations and it is beyond the acceptable level for medical display standards. Bandwidth reduction reduced the distortion, with a 50% reduction for a doubled bandwidth. In conclusion, USMs can be preferred alternative because accurate targeting of pathologies can occur in free distorted images.

Development of Surgical Robot Using the Bionic Humanoids Platform

Development of Surgical Robot Using the Bionic Humanoids Platform

Totally Endoscopic Robotic Mitral Valve Surgery

Mitral valve dysfunction can seriously impair patients’ lives and may require valve repair or replacement. Surgery can be performed using techniques including sternotomy; right thoracotomy with or without robot assistance; and the totally endoscopic robotic technique, which requires percutaneous techniques, femoral cannulation, and endovascular aortic cross-clamping. The totally endoscopic robotic technique has been facilitated by minimally invasive surgical techniques, the evolution of endoscopic techniques, and the development of surgical robots. These advances have enhanced the view of the surgical field and provide better exposure for the repair or replacement of the mitral valve and subvalvular apparatus. This article describes the totally endoscopic robotic approach to mitral valve surgery as performed at Temple University Hospital, Philadelphia, Pennsylvania.

Modeling and motion compensation of a bidirectional tendon-sheath actuated system for robotic endoscopic surgery

Recent study shows that tendon-sheath system (TSS) has great potential in the development of surgical robots for endoscopic surgery. It is able to deliver adequate power in a light-weight and compact package. And the flexibility and compliance of the tendon-sheath system make it capable of adapting to the long and winding path in the flexible endoscope. However, the main difficulties in precise control of such system fall on the nonlinearities of the system behavior and absence of necessary sensory feedback at the surgical end-effectors. Since accurate position control of the tool is a prerequisite for efficacy, safety and intuitive user-experience in robotic surgery, in this paper we propose a system modeling approach for motion compensation. Based on a bidirectional actuated system using two separate tendon-sheaths, motion transmission is firstly characterized. Two types of positional errors due to system backlash and environment loading are defined and modeled. Then a model-based feedforward compensation method is proposed for open-loop control, giving the system abilities to adjust according to changes in the transmission route configuration without any information feedback from the distal end. A dedicated experimental platform emulating a bidirectional TSS robotic system for endoscopic surgery is built for testing. Proposed positional errors are identified and verified. The performance of the proposed motion compensation is evaluated by trajectory tracking under different environment loading conditions. And the results demonstrate that accurate position control can be achieved even if the transmission route configuration is updated.

Recent advances in urologic laparoscopic surgeries: laparoendoscopic single‐site surgery, natural orifice transluminal endoscopic surgery, robotics and navigation

Laparoscopic surgery was developed at the end of the 1980s and has been utilized in almost all urologic surgical procedures. It offers the benefits of less invasiveness and earlier recovery than open surgery. The introduction of laparoendoscopic single-site surgery has offered reduced pain and improved cosmetic satisfaction to patients. Scarless nephrectomy has been realized with transvaginal natural orifice transluminal endoscopic surgery in women. The development of surgical robots has decreased the technical difficulty of complicated procedures, shortened the learning curve, and improved perioperative outcomes relative to laparoscopic surgery. Surgical navigation using real-time sonography, augmented reality, fluorescence, or radioisotope images will improve the quality of these surgeries.

Surgical Robotics Through a Keyhole: From Today's Translational Barriers to Tomorrow's “Disappearing” Robots

In the last century, engineering advances have transformed the practice of surgery. Keyhole surgical techniques offer a number of advantages over traditional open approaches including less postoperative pain, fewer wound complications, and reduced length of stay in hospital. However, they also present considerable technical challenges, particularly to surgeons performing new operative approaches, such as those through natural orifices. Advances in surgical robots have improved surgical visualization, dexterity, and manipulation consistency, thus greatly enhancing surgical performance and patient care. Clinically, however, robotic surgery is still in its infancy, and its use has remained limited to relatively few operations. In the paper, we will discuss the economic-, clinical-, and research-related factors that may act as barriers to the widespread utilization and development of surgical robots. In overcoming these barriers through a synergistic effort of both engineering and medicine, we highlight our future vision of robotic surgery, in both the short and long term.

Robotic invasion of operation theatre and associated anaesthetic issues: A review

A Robotic device is a powered, computer controlled manipulator with artificial sensing that can be reprogrammed to move and position tools to carry out a wide range of tasks. Robots and Telemanipulators were first developed by the National Aeronautics and Space Administration (NASA) for use in space exploration. Today’s medical robotic systems were the brainchild of the United States Department of Defence’s desire to decrease war casualties with the development of ‘telerobotic surgery’. The ‘master-slave’ telemanipulator concept was developed for medical use in the early 1990s where the surgeon’s (master) manual movements were transmitted to end-effector (slave) instruments at a remote site. Since then, the field of surgical robotics has undergone massive transformation and the future is even brighter. As expected, any new technique brings with it risks and the possibility of technical difficulties. The person who bears the brunt of complications or benefit from a new invention is the ‘Patient’. Anaesthesiologists as always must do their part to be the patient’s ‘best man’ in the perioperative period. We should be prepared for screening and selection of patients in a different perspective keeping in mind the steep learning curves of surgeons, long surgical hours, extreme patient positioning and other previously unknown anaesthetic challenges brought about by the surgical robot. In this article we have tried to track the development of surgical robots and consider the unique anaesthetic issues related to robot assisted surgeries.