Robotics In Medicine Research Articles

Dynamic modeling and guidance analysis of a ferromagnetic continuum robot with geometric discretization and base linear motion

Abstract With the advancement of robotics in medicine in recent years, diverse and promising applications for ferromagnetic continuum robots (FCRs) have been introduced. These robots utilize an electromagnetic actuation system for movement and control, which leads to reduced tissue damage, significantly shorter surgery durations, and improved patient recovery times. Recent research in FCR modeling highlights the critical challenge of developing a dynamic model to assess system behavior in real-time, crucial for maximizing benefits in medical applications. In this paper, the geometric discretization method and Lagrange’s principle are used to derive the dynamic equations of a FCR under the influence of an external magnetic field. This approach enables the examination of the system’s behavior at any given moment, providing a suitable foundation for designing various controllers based on the model. Given the electromagnetic system used in steering the FCRs, an analysis of the magnetic field in both ideal and real conditions is conducted to enhance reliability for medical applications. Simulation results indicate that the robots deform in a direction different from the magnetic field direction, demonstrating non-planar deformation characteristics. Furthermore, comparison with experimental data demonstrates that the theoretical framework accurately predicts the robot’s deformation, with calculation errors less than 5%.

The Perception and Attitude of the Use of Robotics Among Medical Students, Rehabilitation Students, Including OT and PT Students and Specialists, and Healthcare Faculty Members

ABSTRACT Background: Artificial intelligence (AI) and robotics have gained much attention during the last decade in the medical field, and they will probably affect the practice of the next generation of healthcare providers. Methods: This cross-sectional study used an online questionnaire to assess students’ and faculty’s prior knowledge and perceptions of AI and robotics. It was conducted at King Abdulaziz University, Jeddah. The sample of the present study includes 374 participants. Data was collected, processed, and statistically analyzed using IBM SPSS Statistics Data Editors. The level of statistical significance was assumed to be a P value >0.05, which indicates a non-significant difference. Results: Most participants were healthcare students (87%) aged 18–24 (84%). Overall, both students and faculty were moderately familiar with AI and robotics in medicine (30.7% and 31.3%, respectively). Both students and faculty wanted to incorporate AI and robotics into their medical curriculum (63.2% and 81.2%, respectively). They saw AI as already present in the field of surgery (37.4% and 45.8%, respectively) and further implemented in the same field prospectively, too (38.3% and 52.1%, respectively). Many participants believed that AI would only be integrated into healthcare and operated by a specialist (79%); however, the majority still favored the physician’s opinion over AI (63%). Conclusion: Most healthcare students and faculty recognize the significance of AI and are excited to engage. AI and robotics should be given ample consideration in the education curriculum by enhancing continual training programs for faculty to conduct AI and robotics courses.

Advancements and limitations in integrating robotics into medicine: A comprehensive review

The integration of robotics into medicine represents a groundbreaking advancement with transformative potential across various medical domains. This comprehensive review delves into both the remarkable advancements and the significant limitations associated with this integration. Advancements in robotic medicine include precision surgery, which facilitatesintricate procedures with enhanced accuracy and minimal invasiveness. Robotic systems enable teleoperation, allowing surgeons to perform procedures remotely, and expanding access to specialized care. Enhanced imaging and navigation capabilities further augment surgical precision and efficiency. Additionally, robotics play a vital role in rehabilitation therapy, aiding in personalized patient recovery. However, these advancements have substantial limitations. The cost of acquiring and maintaining robotic systems poses a significant barrier to widespread adoption, particularly in resource-constrained healthcare settings. Moreover, mastering robotic surgical techniques demands extensive training, contributing to a steep learning curve for healthcare professionals. Technical challenges such as system reliability and interoperability also present hurdles to seamless integration. Ethical considerations surrounding patient autonomy, accountability, and data privacy must be carefully addressed. Legal frameworks and regulatory standards are essential to ensure patient safety and mitigate liability risks associated with robotic-assisted interventions. Furthermore, disparities in access to robotic technology may exacerbate existing healthcare inequalities. Addressing these limitations requires concerted efforts from healthcare stakeholders, policymakers, and technology developers. Collaborative initiatives are needed to overcome financial, educational, technical, ethical, and regulatory barriers to integrating robotics into mainstream medical practice. By navigating these challenges, the full potential of robotics in medicine can be realized, ushering in an era of enhanced precision, efficiency, and accessibility in healthcare delivery.

The applications and prospects of intelligent services robots in medicine

With the rapid growth of the ageing population and the increasing demand for medical services, the medical market is facing great challenges and opportunities. Intelligent service robots can provide various medical services, such as patient monitoring, drug distribution, medical record management, etc., which can improve medical efficiency, reduce the burden of medical staff, and have the advantage of 24-hour uninterrupted service. However, the application of intelligent service robots in the medical field still faces some challenges, such as technical limitations, legal and ethical issues. In addition, there are also differences in patient acceptance and demand for intelligent service robots. Based on the summary of intelligent medical treatment, this paper will introduce the application of intelligent service robots, study the application and prospect of intelligent service robots in medical treatment and the innovation of intelligent service robots in business models. Through literature review, SWOT analysis and data, the paper explains the wide application of intelligent service robots and their future opportunities and challenges.

The pedicle screw accuracy using a robotic system and measured by a novel three-dimensional method

Robotics in medicine is associated with precision, accuracy, and replicability. Several robotic systems are used in spine surgery. They are all considered shared-control systems, providing "steady-hand" manipulation instruments. Although numerous studies have testified to the benefits of robotic instrumentations, they must address their true accuracy. Our study used the Mazor system under several situations and compared the spatial accuracy of the pedicle screw (PS) insertion and its planned trajectory. We used two cadaveric specimens with intact spinal structures from C7 to S1. PS planning was performed using the two registration methods (preopCT/C-arm or CT-to-fluoroscopy registration). After planning, the implant spatial orientation was defined based on six anatomic parameters using axial and sagittal CT images. Two surgical open and percutaneous access were used to insert the PS. After that, another CT acquisition was taken. Accuracy was classified into optimal, inaccurate and unacceptable according to the degree of screw deviation from its planning using the same spatial orientation method. Based on the type of spatial deviation, we also classified the PS trajectory into 16 pattern errors. Seven (19%) out of 37 implanted screws were considered unacceptable (deviation distances > 2.0 mm or angulation > 5°), and 14 (38%) were inaccurate (> 0.5 mm and ≤ 2.0 mm or > 2.5° and ≤ 5°). CT-to-fluoroscopy registration was superior to preopCT/C-arm (average deviation in 0.9 mm vs. 1.7 mm, respectively, p < 0.003), and percutaneous was slightly better than open but did not reach significance (1.3 mm vs. 1.7 mm, respectively). Regarding pattern error, the tendency was to have more axial than sagittal shifts. Using a quantitative method to categorize the screw 3D position, only 10.8% of the screws were considered unacceptable. However, with a more rigorous concept of inaccuracy, almost half were non-optimal. We also identified that, unlike some previous results, the O-arm registration delivers more accurate implants than the preopCT/C-arm method.

More Process, Less Principles: The Ethics of Deploying AI and Robotics in Medicine.

Current national and international guidelines for the ethical design and development of artificial intelligence (AI) and robotics emphasize ethical theory. Various governing and advisory bodies have generated sets of broad ethical principles, which institutional decisionmakers are encouraged to apply to particular practical decisions. Although much of this literature examines the ethics of designing and developing AI and robotics, medical institutions typically must make purchase and deployment decisions about technologies that have already been designed and developed. The primary problem facing medical institutions is not one of ethical design but of ethical deployment. The purpose of this paper is to develop a practical model by which medical institutions may make ethical deployment decisions about ready-made advanced technologies. Our slogan is "more process, less principles." Ethically sound decisionmaking requires that the process by which medical institutions make such decisions include participatory, deliberative, and conservative elements. We argue that our model preserves the strengths of existing frameworks, avoids their shortcomings, and delivers its own moral, practical, and epistemic advantages.

Rechtliche Aspekte des Einsatzes von KI und Robotik in Medizin und Pflege

ZusammenfassungDie rasanten Entwicklungen im Bereich der Künstlichen Intelligenz und Robotik stellen nicht nur die Ethik, sondern auch das Recht vor neue Herausforderungen, gerade im Bereich der Medizin und Pflege. Grundsätzlich hat der Einsatz von KI dabei das Potenzial, sowohl die Heilbehandlungen als auch den adäquaten Umgang im Rahmen der Pflege zu erleichtern, wenn nicht sogar zu verbessern. Verwaltungsaufgaben, die Überwachung von Vitalfunktionen und deren Parameter sowie die Untersuchung von Gewebeproben etwa könnten autonom ablaufen. In Diagnostik und Therapie können Systeme die behandelnde Ärztin unterstützen. Intelligente Betten ermöglichen eine Frühmobilisierung der Patient:innen bei gleichzeitig geringerem Personalaufwand. Gleichwohl birgt der Einsatz der Systeme rechtliche Herausforderungen. So besteht das Risiko einer Verletzung der beteiligten Personen. Im Gegensatz zu herkömmlichen Technologien „leidet“ KI unter der „Black-Box-Problematik“: Die von den Systemen generierten Ergebnisse sind nicht mehr vollständig vorhersehbar und nachvollziehbar. Der Einsatz birgt unbekannte und unkalkulierbare Risiken, was sich insbesondere auf die zivilrechtliche Haftung und strafrechtliche Verantwortung auswirkt. Wem die Entscheidungen der Systeme normativ zuzurechnen sind, ist eine Kernfrage des juristischen Diskurses. Die aus praktikabilitätsgründen naheliegende Wahl, dem letztentscheidenden Menschen das Verhalten eines KI-Systems zuzurechnen, überzeugt nicht in allen Fällen, sondern degradiert ihn häufig zum symbolischen Haftungsknecht und legt ihm einseitig die Risiken der Technologien auf. Weiterhin ergeben sich im Bereich der Medizin und Pflege Fragen hinsichtlich der Zulassung von KI-Systemen, da die Maschinen während der Nutzung weiterlernen und so ihren strukturellen Aufbau kontinuierlich verändern. Es ist daher angebracht, sich frühzeitig mit dem Konfliktpotential aus ethischer und rechtlicher Sicht auseinander zu setzen, um einer potenziellen gesellschaftlichen Angst vor derartigen Systemen vorzubeugen und einen praxisgerechten Handlungsrahmen zu schaffen.

Feedback on dental implants with dynamic navigation versus freehand.

The Aim of the study is to understand and identify if Dynamic Navigation (DN) has an upper hand to provide ease and comfort to the patients during and after surgery. 60 patients requiring 120 Implants, were randomly allocated in 2 groups (Group 1- Freehand surgery, Group 2- Dynamic navigation surgery) requiring dental implant therapy. Patients in both the groups were given a Patient satisfaction questionnaire assessing the following domains: comfort, fear, prior experience with robotics, dental anxiety and pain perception. Patient related Experience measures (PREM's) were assessed using the following domains: experience with robotics, pain perception and comfort of using various instrumentations during the surgery. The pre and post CBCT were compared using EVALUNAV application of the Navident software. There was significant difference (p<0.05) between the two groups in the patient outcomes pertaining to the future of robotics in medicine (group 1: 2±1.259, group 2 :4.8±0.484) and Patients reliability to a specific procedure due to the less surgical time taken (group 1:3.3±0.651, group 2: 4.63±0.556). The post-operative pain between the groups was also assessed with VAS scale.

Антропоморфные роботы в медицине: варианты технологий и перспективы.

Introduction. Anthropomorphic robots may eventually occupy a special niche in medicine, performing physically demanding, as well as emotionally monotonous work. As artificial intelligence is introduced, ARs will become more complex and their functions will expand. Materials and methods. For a review on anthropomorphic robots, foreign and Russian scientific publications were studied. It should be noted that the Russian segment of scientific publications for the keywords «anthropomorphic robots», «humanoid robots», «social robots» is extremely small and does not reflect the current world practice. 20 articles were selected from foreign sources. 2 own classifications have been developed - medical robots and anthropomorphic medical robots. Results. In recent years, there has been an explosive growth in the development of robotics. Along with industrial, military, service robots, the development of medical robots is going its own way. A universal anthropomorphic robot is a complex combination of a musculoskeletal system, mechanical limbs, a voice recognition system, space and neural networks capable of processing and understanding the environment and voice commands. The hallmark of AR at the time of writing: lack of cognitive ability and physical autonomy. The use of AR in certain medical fields is described, an attempt is made to determine the social aspects of AR. Conclusions. The greatest demand for anthropomorphic (humanoid) robots in medicine will be for caring for the elderly and for patients with limited motor functions, during pandemics or other potentially life-threatening situations. In the future, at the stage of introducing artificial intelligence, a thorough study of the legislation and the security system of such robots is required. Currently, the cost of AR is quite high, but in the future, cost reduction will be associated with the absence of costs for changing the environment for using such robots, which may be economically justified. The most important aspect of the use of AR is emotional interaction with a person and the safety of the latter.

Robotics and cybersurgery in ophthalmology: a current perspective.

Ophthalmology is one of the most enriched fields, allowing the domain of artificial intelligence to be part of its point of interest in scientific research. The requirement of specialized microscopes and visualization systems presents a challenge to adapting robotics in ocular surgery. Cyber-surgery has been used in other surgical specialties aided by Da Vinci robotic system. This study focuses on the current perspective of using robotics and cyber-surgery in ophthalmology and highlights factors limiting their progression. A review of literature was performed with the aid of Google Scholar, Pubmed, CINAHL, MEDLINE (N.H.S. Evidence), Cochrane, AMed, EMBASE, PsychINFO, SCOPUS, and Web of Science. Keywords: Cybersurgery, Telesurgery, ophthalmology robotics, Da Vinci robotic system, artificial intelligence in ophthalmology, training on robotic surgery, ethics of the use of robots in medicine, legal aspects, and economics of cybersurgery and robotics. 150 abstracts were reviewed for inclusion, and 68 articles focusing on ophthalmology were included for full-text review. Da Vinci Surgical System has been used to perform a pterygium repair in humans and was successful in ex vivo corneal, strabismus, amniotic membrane, and cataract surgery. Gamma Knife enabled effective treatment of uveal melanoma. Robotics used in ophthalmology were: Da Vinci Surgical System, Intraocular Robotic Interventional Surgical System (IRISS), Johns Hopkins Steady-Hand Eye Robot and smart instruments, and Preceyes' B.V. Cybersurgery is an alternative to overcome distance and the shortage of surgeons. However, cost, availability, legislation, and ethics are factors limiting the progression of these fields. Robotic and cybersurgery in ophthalmology are still in their niche. Cost-effective studies are needed to overcome the delay. Technologies, such as 5G and Tactile Internet, are required to help reduce resource scheduling problems in cybersurgery. In addition, prototype development and the integration of artificial intelligence applications could further enhance the safety and precision of ocular surgery.

Development Strategies for Artificial Intelligence and Robotics in Medicine

Development Strategies for Artificial Intelligence and Robotics in Medicine

Medical Robotics: Opportunities in China

Medical robotics is a rapidly advancing discipline that is leading the evolution of robot-assisted surgery, personalized rehabilitation and assistance, and hospital automation. In China, both research and commercial developments in medical robotics have undergone exponential growth in recent years. In this review, we first give an overview of the clinical and social demands that motivate the rapid development in medical robotics. For each subdiscipline (surgery, rehabilitation and personal assistance, and hospital automation), we then summarize the major research projects sponsored by National Key Research and Development Programs. The remaining technical, commercial, and regulatory challenges are highlighted. This review also outlines some of the new opportunities in endoluminal and interventional robotics, micro- and nanorobotics, soft exoskeletons, intelligent human–robot interaction, and telemedicine and telesurgery, which may support the general uptake of robotics in medicine.

Feasibility of telesurgery in the modern era.

Telesurgery is not a foreign concept and dates to as early as the 1920s. The use of robots in medicine has had a very positive effect and improved outcomes with little to no adverse effects. Having global access to telemedicine and telesurgery during the COVID-19 pandemic and being able to provide top medical care to gravely ill and contagious patients without compromising the safety of the medical team would be a very big achievement. We explore the hurdles needed to make it a realistic goal and give recommendations to achieve it utilizing the major advancements that have occurred over the past few years in the fields of engineering, communication etc. The biggest issues needed to be addressed are of financial investment, legal concerns, and availability of high-speed uninterrupted data connections.

Evolving artificial intelligence and robotics in medicine, evolving European law. Comparative remarks based on the surgery litigation

This article discusses key and critical tort law issues that have arisen from artificial intelligence and robotic medical applications. It aims at addressing the most recent European regulatory trajectories – ultimately traced by the Proposal for the Artificial Intelligence Act April 21 2021 – starting from the study of the legal issues that stemmed from the instructive experience of the US litigation on robotic surgery, which was foregoing on account of its cutting-edge and accelerated enhancement of the field. The recognition and analysis of the criticalities about products’ malfunctioning as well as the focus on other producers’ duties will lead the reader to reflect on the suitability of the legal rules planned by the European Authorities on the ground of the empirical features of the new step of technological progress in the field in question.

Analyzing the features of service robotics development and distribution during the coronavirus pandemic

Subject. The work analyzes the features of service robotics development and distribution during the coronavirus pandemic, using the case of delivery drones and UVC disinfection robots. Objectives. The aim is to identify the main trends in the development of certain types of service robots during the COVID-19 period, analyze technical and economic characteristics, assess assistive technologies for the future development of robotics. Methods. The study draws on methods of correlation and regression analysis. To assess the development trends of certain types of service robots, we apply website data of manufacturers of the equipment under consideration. Results. We unveil major trends in the development and production of certain types of service robots during the fight against coronavirus, using the case of unmanned aerial vehicles and disinfection robots. The development of delivery drones is aimed at solving the problems of flight efficiency, increasing the flight time, reducing the energy use and noise, and ensuring the safety of delivered goods. Medical robotics developers focus on streamlining the management interface, increasing the speed of task execution, enhancing the reporting abilities. Conclusions. Our analysis shows that the coronavirus pandemic affected the speed of development and implementation of robots in medicine. The market is shifting towards the production of UV-disinfection robots. The most important technical and economic characteristics of the main types of disinfection robots are the surface treatment cycle to achieve the maximum disinfecting effect, maximum operating time (without recharging), charging time, wavelength of radiation, weight of device.

Exploring Medical Students’ and Faculty’s Perception on Artificial Intelligence and Robotics. A Questionnaire Survey

Over the last decade, the emerging fields of artificial intelligence (AI) and robotics have been introduced in medicine, gaining much attention. This study aims to assess the insight of medical students and faculty regarding AI and robotics in medicine. A cross-sectional study was conducted among medical students and faculty of the University of Nicosia. An online questionnaire was used to evaluate medical students’ and faculty’s prior knowledge and perceptions toward AI and robotics. Data analysis was carried out using SPSS software, and the statistical significance was assumed as p value < 0.05. Three hundred eighty-seven medical students and 23 faculty responded to the questionnaire. Students who were “familiar” with AI and robotics stated that these breakthrough technologies make them more enthusiastic about working in their speciality of interest (p value = 0.012). Also, students (59.9%) and faculty (47.8%) agreed that physician’s opinion should be followed when doctors’ and AI’s judgment differ and that the doctor in charge should be liable for possible AI’s mistakes (38.8% students: 47.7% faculty). Although the most significant drawback of AI and robotics in healthcare is the dehumanization of medicine (54.5% students; 47.8% faculty), most participants (77.6% students; 78.2% faculty) agreed that medical schools should include in their curriculum AI and robotics by offering relevant courses (39.5% students; 52.2% faculty). Medical students and faculty are not anxious about the advancements of AI and robotics in medicine. Medical schools should take the lead and introduce AI and robotics in undergraduate medical curricula because the new era needs fully aware healthcare providers with better insight regarding these concepts.

РОБОТОТЕХНИКА КАК ПЕРСПЕКТИВНАЯ ЛИНИЯ ПЕДАГОГИЧЕСКОГО ПРОЦЕССА В МЕДИЦИНСКОМ ВУЗЕ

The purpose of this article is to study the use of robotics in the educational process of a medical university. The advent of new digital technologies has introduced changes in both diagnostic and therapeutic procedures. The author of the article confirms that medical robotics is a new science that is becoming increasingly important and acceptable in the field of health care and medical education. This science is growing rapidly and offers enormous potential that can bring meaningful improvements in clinical procedures for many surgical pathologies. The article uses methods of complex theoretical and descriptive analysis. The author notes that medical universities are faced with the tasks of training future doctors, their practical training and assessing the level of qualification of medical specialists. Surgical training for a long time was based on the use of various models and animals, which completely did not allow students to practice surgical skills. The scientific novelty of the work is that modern medical robotics has been studied, used in the training of future doctors and in the process of working as practitioners in medical institutions. The author of the article highlighted several main areas in which the use of robots in medicine develops: liberation from routine, qualitative improvement of treatment, solving non-standard, complex problems. The practical significance of the work is due to the fact that the author concludes that robotics and modern information technologies allow the training of future doctors in a simulated environment so that students master surgical techniques without causing any harm to the health of patients. Robotic systems are a tool that can be easily used even by those who have never used them.

Robotics in physical medicine and neurorehabilitation

Introduction. Robots have been used for rehabilitation purposes since the 1960s. The aim of this paper is to present the application of robotics in physical medicine and rehabilitation with special reference to robotic devices used in rehabilitation. Material and Methods. The paper uses literature related to the application of robotics in medicine and rehabilitation. The literature review was conducted using the following databases: Serbian Library Consortium for Coordinated Acquisition, Medical Literature Analysis and Retrieval System, Google Scholar, Science Citation Index, and portal of Croatian scientific journals ?Hrcak?. Development of robotics in rehabilitation. Nowadays, there are a great number of different robotic systems for rehabilitation. Robotics in rehabilitation is of utter importance because it works on the principle of neuroplasticity. Robots for lower limb rehabilitation. These robotic systems are most often in the form of exoskeletons. Robots for upper limb rehabilitation. Upper limb rehabilitation robots are therapeutic devices that help or provide support for arm or hand movements. Robot for upper body rehabilitation. Robot ?Tymo?. Conclusion. By using robots in physical medicine and neurorehabilitation, a faster and more complete functional recovery of the patient can be achieved.

Građanskopravna odgovornost za štetu koju počini robot pri vršenju medicinskog zahvata

Robots in medicine, unlike industrial automation, can be viewed as an extension or enhancement of human capabilities. The legitimacy of robotics in the health care system stems from the fact that its use increases the efficiency of the treatment process and improves the health of an individual. On the other hand, involving robots in the medical procedures brings a high degree of risk and liability for damage. Legal doubts that arising in regard of the use of robots in medicine are related to civil liability for damage caused to the patient during the medical procedure. In that context, it is necessary to determine the model of indemnity liability that applies to damages due to the action of robots in a medical procedure. Which system shall be applied: the system of subjective liability based on fault (guilt), or the system of objective liability without determining the injurer's fault? This issue is gaining in importance given the degree of autonomy of robots in performing medical procedures. The paper will emphasize the need for legislative intervention in the Croatian legal system in order to adapt to the growing use of robots in medicine. The paper will summarize the results of the analysis on these issues and offer possible solutions in court practice and legal dogmatics.

Modern robotics in medicine

Today, robot-assisted surgery and the use of robots in medicine marks a qualitatively new stage in the development of minimally invasive technologies and endovideosurgery, due to the high level of accuracy, functionality and ergonomics of modern robotic systems. With the help of robotic technologies, the quality of diagnostic manipulations as well as the results of therapeutic procedures and surgical interventions are significantly improved, which ultimately leads to an improved prognosis and quality of life for patients, while also expanding the capabilities of clinicians. This review article presents the main historical milestones and prerequisites for the development of automation and robotic technologies used in various industries, from ancient times to the present. The history of the use of robotic procedures in various fields of medicine is briefly described. Special attention is paid to robot-assisted surgery as one of the main bases for applying modern technologies. At the moment, we can safely say that medical robotics plays a very important role in the development of surgery of the future.