Robot-assisted Surgery System Research Articles

Robot-assisted surgery: an emerging platform for human neuroscience research.

Classic studies in human sensorimotor control use simplified tasks to uncover fundamental control strategies employed by the nervous system. Such simple tasks are critical for isolating specific features of motor, sensory, or cognitive processes, and for inferring causality between these features and observed behavioral changes. However, it remains unclear how these theories translate to complex sensorimotor tasks or to natural behaviors. Part of the difficulty in performing such experiments has been the lack of appropriate tools for measuring complex motor skills in real-world contexts. Robot-assisted surgery (RAS) provides an opportunity to overcome these challenges by enabling unobtrusive measurements of user behavior. In addition, a continuum of tasks with varying complexity—from simple tasks such as those in classic studies to highly complex tasks such as a surgical procedure—can be studied using RAS platforms. Finally, RAS includes a diverse participant population of inexperienced users all the way to expert surgeons. In this perspective, we illustrate how the characteristics of RAS systems make them compelling platforms to extend many theories in human neuroscience, as well as, to develop new theories altogether.

Cost-Benefit Performance of Robotic Surgery Compared with Video-Assisted Thoracoscopic Surgery under the Japanese National Health Insurance System

Medical economics have significant impact on the entire country. The explosion in surgical techniques has been accompanied by questions regarding actual improvements in outcome and cost-effectiveness, such as the da Vinci(®) Surgical System (dVS) compared with conventional video-assisted thoracic surgery (VATS). To establish a medical fee system for robot-assisted thoracic surgery (RATS), which is a system not yet firmly established in Japan. This study examines the cost benefit performance (CBP) based on medical fees compared with VATS and RATS under the Japanese National Health Insurance System (JNHIS) introduced in 2012. The projected (but as yet undecided) price in the JNHIS would be insufficient if institutions have less than even 200 dVS cases per year. Only institutions which perform more than 300 dVS operations per year would obtain a positive CBP with the projected JNHIS reimbursement. Thus, under the present conditions, it is necessary to perform at least 300 dVS operations per year in each institution with a dVS system to avoid financial deficit with current robotic surgical management. This may hopefully encourage a downward price revision of the dVS equipment by the manufacture which would result in a decrease in the cost per procedure.

Effects of realistic force feedback in a robotic assisted minimally invasive surgery system

Background: Robotic assisted minimally invasive surgery systems not only have the advantages of traditional laparoscopic procedures but also restore the surgeon's hand-eye coordination and improve the surgeon's precision by filtering hand tremors. Unfortunately, these benefits have come at the expense of the surgeon's ability to feel. Several research efforts have already attempted to restore this feature and study the effects of force feedback in robotic systems. The proposed methods and studies have some shortcomings. The main focus of this research is to overcome some of these limitations and to study the effects of force feedback in palpation in a more realistic fashion. Material and methods: A parallel robot assisted minimally invasive surgery system (PRAMiSS) with force feedback capabilities was employed to study the effects of realistic force feedback in palpation of artificial tissue samples. PRAMiSS is capable of actually measuring the tip/tissue interaction forces directly from the surgery site. Four sets of experiments using only vision feedback, only force feedback, simultaneous force and vision feedback and direct manipulation were conducted to evaluate the role of sensory feedback from sideways tip/tissue interaction forces with a scale factor of 100% in characterising tissues of varying stiffness. Twenty human subjects were involved in the experiments for at least 1440 trials. Friedman and Wilcoxon signed-rank tests were employed to statistically analyse the experimental results. Results: Providing realistic force feedback in robotic assisted surgery systems improves the quality of tissue characterization procedures. Force feedback capability also increases the certainty of characterizing soft tissues compared with direct palpation using the lateral sides of index fingers. Conclusion: The force feedback capability can improve the quality of palpation and characterization of soft tissues of varying stiffness by restoring sense of touch in robotic assisted minimally invasive surgery operations.

Microfabrication of Three-Axis Tactile Feedback Actuator for Robot-Assisted Surgery

In this paper, we propose and demonstrate a three-axis tactile feedback actuator using pneumatic balloons for human perception applications such as robot-assisted surgery systems. A tactile actuator is composed of a center structure having four balloons, sidewalls with one lateral balloon on each sidewall, and a bottom structure supporting the center structure. We fabricated the proposed device using flexible poly(dimethylsiloxane) and hard polyurethane with final dimensions of 18 ×18 ×18 mm3. The four balloons on the center structure produce normal tactile display during pneumatic-pressure-assisted inflation. The lateral movement of the center structure driven by sidewall balloons generates a shear tactile display on fingertips. The center deflections of the circular and rectangular balloons were calculated and measured experimentally.

Automation Highlights from the Literature

Automation Highlights from the Literature

Research on Displacement Compensation Algorithm of Tactile Sensor on the Beating Heart

In robot-assisted surgery system, the method of compensating the relative motion between the surgical site on the heart and the surgical instruments was introduced by using tactile sensor in this paper. Three-dimensional space coordinate systems were established, including the world coordinate system, surgical instruments and tactile sensor coordinate system. Space coordinate was transformed between the three coordinate systems through the way of mathematical theory. Compensation algorithm theory formulas about the beating heart were derived, including the rotation matrixes of the coordinate system, the equations, etc. According the data of the tactile sensor, the relative displacement of the surgical instruments coordinate system was calculated compared with the world coordinate system. Finally, Conclusion is obtained by compensation example analysis.

A Robot-Assisted Surgery Positioning Method for Artificial Cervical Disc Replacement

Robotic–assisted surgery is a new trend in medicine. To overcome problems in artificial cervical disc replacement surgery, a robot-assisted surgery system which consists of an active 6-UPS parallel robot and its control system, a surgical planning system and an optical tracking system was developed to replace the cumbersome mechanical positioning device. A positioning method for robot-assisted cervical disc replacement surgery will be studied. Firstly, the robot-assisted surgery system is described. Secondly, the coordinate transformation method for robot-assisted surgery positioning is given. Then, a preoperative position and pose planning method is given. Finally, a robot-assisted surgery positioning by using the method in this paper is carried out. The result shows that the robot-assisted surgery positioning method in this paper is an effective method for artificial cervical disc replacement surgery.

A vision guided hybrid robotic prototype system for stereotactic surgery

Robot-assisted surgery (RAS) systems help surgeons performing accurate operations, but a number of drawbacks render them not yet suitable for clinical theaters and procedures. In this paper, a novel vision guided robotic system is proposed to facilitate navigation procedures. A vision guided hybrid robotic system is designed, consisting of a passive serial arm and an active parallel frame. Navigation is accomplished in three steps: approaching, aiming and insertion. First, the target is safely approached with the passive arm. Second, the trajectory is automatically aligned using the parallel frame. And then the target is reached by manual insertion. A stereo camera is used to position fiducials, the robot and the surgical tool. It also provides working area images for professional surgeons at a remote site. The prototype system accomplished phantom and animal trials with satisfactory accuracy. The robot can easily be adjusted to avoid obstacles and quickly set up on an optimal 'approaching' place. The surgical tool is automatically aligned with the trajectory. The system can withdraw from the working area and restore the aiming posture freely. With the help of the working area images, some important navigation steps can be handled remotely. A novel vision guided robotic system is proposed and validated. It enables surgeons to fit the system to the clinical theater. System safety and feasibility are enhanced by multi-step navigation procedures and remote image monitoring. The system can be operated easily by general clinical staff.

Status and prospects in clinical application of robotic assisted surgery system

Robotic assisted surgery system as an advanced technique gains particular attention over the world.We hereby introduce the history of Robotic assisted surgery system, and induce the advantage or existing problems of this technique. We also compared the new technique with traditional surgery and laparoscopic surgery. The future of this novel technique is assessed with the recent development application at home and abroad. Key words: Robot-assisted surgical system; Minimally invasive surgery; Laparoscope

A novel knot‐tying approach for minimally invasive surgical robot systems

In robot-assisted minimally invasive surgery (MIS), knot-tying is an important but challenging task for surgeons when performing surgery by manipulating a master-slave robot system. Knot-tying in the conventional way is restricted by a confined workspace, which may cause the suture loop to be unstable and make knot-tying difficult and time-consuming in robot-assisted MIS. A knot-tying approach named 'bending-twisting knot-tying' (BTKT) has been developed for robot-assisted surgery systems operating in a confined workspace. The non-linear deformation of sutures during knot-tying is qualitatively described using knot theory. The length ratio of a knot (LoK) and the feasible coefficient (Fc) are introduced to evaluate the quality of BTKT knots. Simulations and experiments are performed based on finite segment dynamic models and the MicroHand surgical system, respectively, to describe the dynamic behaviours of the knots. Sensitive parameters, including the length of a suture (L), the distance between two ends (d) and the angle between tangents of the two ends (alpha) are analysed based on the model. For a terylene suture, the length of the suture L and the distance between the two ends d should satisfy 1.12d< or =L< or =14.4d. When L and alpha are constant, the smaller d is, the larger are LoK and Fc relative to different sutures. A knot of high quality can be tied with a small alpha. Simulation and experimental results show that BTKT requires a smaller workspace and can form more stable loops compared to conventional methods.

Laserbasierte Qualitätssicherung für die robotergestützte Fräsabtragung an der Schädelbasis

Implanting active hearing devices in the lateral base of the skull requires high-precision, secure fixation of the electromagnetic transducer and long-life anchorage using osteosynthetic fixation plates referred to as mountain brackets. Nonlinear distortion in the acoustic signal path and consecutive implant loosening can only be avoided by exact osseous milling to create the necessary cavity bed while avoiding excessive milling. Robot technology is ideal for high-precision milling. However, safety measures are necessary in order to prevent errors from occurring during the reduction process. Ideally, a robot should be guided by a navigation system. However, robotic systems so far available do not yet have an integrated global navigation system. We used an animal model under laboratory conditions to examine the extent to which the semiautomatic ROBIN assistant system developed could be expected to increase osseous milling accuracy before implanting active electronic hearing devices into the recipient tissue in the cranium. An existing prototype system for robot-assisted skull base surgery was equipped with laser sensors for geometric measurement of the operation site. The three-dimensional measurement data was compared with CT simulation data before, during, and after the robot-assisted operation. The experiments were conducted on test objects as well as on animal models. Under ideal conditions, the operation site could be measured at a spatial resolution of better than 0.02 mm in each dimension. However, reflections and impurities in the operation site from bleeding and rinsing fluids did have a considerable effect on data collection, necessitating specialised registering procedures. Using an error-tolerant procedure specifically developed, the effective registering error could be kept under 0.3 mm. After milling, the resulting shape matched the intended form at an accuracy level of 0.8 mm. The results show that robot systems can reach the accuracy required for reliable microsurgery on the cranial base. High-resolution laser-based geometric measurement of the operation site enables head registration without additional artificial landmarks. During the navigated operation, the procedure can be used to ensure that the resulting cavity matches the intended shape as determined in the preoperative planning phase. This will enable quantitative analysis of, and improvement in the quality of robot-assisted surgery in the future.

Robot-Assisted Craniotomy

In the Special Research Centre 414 of the German Research Funding (DFG, Bonn) a system for robot-assisted cranial surgery was developed. It is designed for the accurate and safe execution of craniotomies and repositioning of bone pieces. The system is intended for use in the surgical therapy of craniosynostosis. Preoperatively, CT imaging is performed. In a computerized planning system the position and shape of the intended craniotomy is intuitively planned on a virtual model of the patient's skull. Intraoperatively, after conventional removal of the covering soft tissue, the robot performs the craniotomy autonomously. Extensive testing in phantom studies and animal tests confirmed the reliability and accuracy of the system. A thorough risk analysis of the system was performed. In this paper, the first clinical use of the system on a patient is described and the clinical importance is discussed.

Morphometric Study of the Human Lumbar Spine for Operation–Workspace Specifications

The anatomy of the lumbar vertebrae of 55 patients was measured by use of data provided by computed tomography. On the basis of these measurements, the location of puncture points and the orientation of the surgical instruments for pedicle, vertebral body, and disc entry points were calculated for open as well as percutaneous surgery. Normal anatomic variations of the lumbar spine were investigated to define the workspace for several spinal procedures and to define the workspace of a robot designed to guide the physician during those procedures. Several comprehensive studies of vertebrae dimensions have been conducted in the past, but they lack several dimensions that are needed to determine the exact location of the entry point and orientation of the tool, in particular when a computerized guidance system is used. Fifty-five spinal columns (L1-L5, total 250 vertebrae) were measured by computed tomography. These data provide geometric relations that determine entry points and tool orientations for different spinal interventions. The workspace for spinal operations was defined on the basis of anatomic data taken from computed tomography scans. The data included 15 measurements for each vertebra that defined its shape. The processed data provided puncture points for several spinal procedures in both open and percutaneous surgery. This study provides additional information on vertebral structure needed to calculate accurately the entry point and tool orientation in various spinal procedures. These statistical data are also valuable for model and implant designs and for workspace specifications for a robot-assisted surgery system.

Robot-assisted surgery system with kinesthetic feedback.

The better understanding of the systems of the human body and their specific functions has led to minimally invasive and microsurgical procedures being carried out on an ever smaller scale. New therapies will require precision of 10 microm or better, which will only be achievable with robotic teleoperators. Experience with existing robot-assisted surgery systems shows that the human-machine interface is a critical component for acceptance of this technology, but no universally satisfactory interface has yet been found. Therefore, this article investigates a new concept based on kinesthetic motion feedback and presents details of the implementation of a first prototype.

Robot-Assisted Surgery System with Kinesthetic Feedback

The better understanding of the systems of the human body and their specific functions has led to minimally invasive and microsurgical procedures being carried out on an ever smaller scale. New therapies will require precision of 10 fim or better, which will only be achievable with robotic teleoperators. Experience with existing robot-assisted surgery systems shows that the human-machine interface is a critical component for acceptance of this technology, but no universally satisfactory interface has yet been found. Therefore, this article investigates a new concept based on kinesthetic motion feedback and presents details of the implementation of a first prototype.