Surgical Robotic Arm Research Articles

Development of a surgical robotic arm not requiring positioning on an insertion port with semi-active joints

Development of a surgical robotic arm not requiring positioning on an insertion port with semi-active joints

Improving backdrivability in preoperative manual manipulability of minimally invasive surgery robot

PurposeThe purpose of this paper is to propose a control algorithm to improve the backdrivability performance of minimally invasive surgical robotic arms, so that precise manual manipulations of robotic arms can be performed in the preoperative operation.Design/methodology/approachFirst, the flexible-joint dynamic model of the 3-degree of freedom remote center motion (RCM) mechanisms of minimally invasive surgery (MIS) robot is derived and its dynamic parameters and friction parameters are identified. Next, the angular velocities and angular accelerations of joints are estimated in real time by the designed Kalman filter. Finally, a control algorithm based on Kalman filter is proposed to enhance the backdrivability of RCM mechanisms by compensating for the internally generated gravitational, frictional and inertial resistances experienced during the positioning and orientating.FindingsThe parameter identification for RCM mechanisms can be experimentally evaluated from comparison between the measured torques and the reconstructed torques. The accuracy and convergence of the real-time estimation of angular velocity and acceleration of the joint by the designed Kalman filter can be verified from corresponding simulation experiments. Manual adjustment experiments and animal experiments validate the effectiveness of the proposed backdrivability control algorithm.Research limitations/implicationsThe backdrivability control algorithm presented in this paper is a universal method to enhance the manual operation performance of robots, which can be used not only in the medical robot preoperative manual manipulation but also in robot haptic interaction, industrial robot direct teaching and active rehabilitation training of rehabilitation robot and so on.Originality/valueCompared with other backdrivability design methods, the proposed algorithm achieves good backdrivability for RCM mechanisms without using force sensors and accelerometers. In addition, this paper presents a new static friction compensation approach for a joint moving with very low velocity.

Disposable Fluidic Actuators for Miniature In-Vivo Surgical Robotics.

Fusion of robotics and minimally invasive surgery (MIS) has created new opportunities to develop diagnostic and therapeutic tools. Surgical robotics is advancing from externally actuated systems to miniature in-vivo robotics. However, with miniaturization of electric-motor-driven surgical robots, there comes a trade-off between the size of the robot and its capability. Slow actuation, low load capacity, sterilization difficulties, leaking electricity and transferring produced heat to tissues, and high cost are among the key limitations of the use of electric motors in in-vivo applications. Fluid power in the form of hydraulics or pneumatics has a long history in driving many industrial devices and could be exploited to circumvent these limitations. High power density and good compatibility with the in-vivo environment are the key advantages of fluid power over electric motors when it comes to in-vivo applications. However, fabrication of hydraulic/pneumatic actuators within the desired size and pressure range required for in-vivo surgical robotic applications poses new challenges. Sealing these types of miniature actuators at operating pressures requires obtaining very fine surface finishes which is difficult and costly. The research described here presents design, fabrication, and testing of a hydraulic/pneumatic double-acting cylinder, a limited-motion vane motor, and a balloon-actuated laparoscopic grasper. These actuators are small, seal-less, easy to fabricate, disposable, and inexpensive, thus ideal for single-use in-vivo applications. To demonstrate the ability of these actuators to drive robotic joints, they were modified and integrated in a robotic arm. The design and testing of this surgical robotic arm are presented to validate the concept of fluid-power actuators for in-vivo applications.

Clinical applicability of robot-guided contact-free laser osteotomy in cranio-maxillo-facial surgery: in-vitro simulation and in-vivo surgery in minipig mandibles

Laser was being used in medicine soon after its invention. However, it has been possible to excise hard tissue with lasers only recently, and the Er:YAG laser is now established in the treatment of damaged teeth. Recently experimental studies have investigated its use in bone surgery, where its major advantages are freedom of cutting geometry and precision. However, these advantages become apparent only when the system is used with robotic guidance. The main challenge is ergonomic integration of the laser and the robot, otherwise the surgeon's space in the operating theatre is obstructed during the procedure. Here we present our first experiences with an integrated, miniaturised laser system guided by a surgical robot. An Er:YAG laser source and the corresponding optical system were integrated into a composite casing that was mounted on a surgical robotic arm. The robot-guided laser system was connected to a computer-assisted preoperative planning and intraoperative navigation system, and the laser osteotome was used in an operating theatre to create defects of different shapes in the mandibles of 6 minipigs. Similar defects were created on the opposite side with a piezoelectric (PZE) osteotome and a conventional drill guided by a surgeon. The performance was analysed from the points of view of the workflow, ergonomics, ease of use, and safety features. The integrated robot-guided laser osteotome can be ergonomically used in the operating theatre. The computer-assisted and robot-guided laser osteotome is likely to be suitable for clinical use for ostectomies that require considerable accuracy and individual shape.

A new kinematics method based on a dynamic visual window for a surgical robot

SUMMARYThis paper proposes a new effective kinematics method based on the dynamic visual window (DVW) for a surgical robot that is equipped with two instrument arms and one laparoscope arm, to enable doctors to achieve operations with their visual habits under the laparoscopic visual environment. The problem of the consistency principle between the doctor's operations under the visual window's feedback and the master–slave operations of the surgical robot is solved. The kinematics models of the surgical robotic arms are established, and the new kinematics methods based on the DVW of the laparoscope and instrument arms are proposed according to their inverse kinematics with respect to the visual coordinate system. Finally, the proposed kinematics method is verified by simulation experiments based on the theoretical algorithm and the mechanism model; the multiple sets of the simulation data are presented to illustrate the correctness and feasibility of the new method in this research.

An active hybrid parallel robot for minimally invasive surgery

During the last years, there has been an increase in research in the field of medical robots. This trend motivated the development of a new robotics field called ''robotic-assisted minimally invasive surgery''. The paper presents the kinematic and dynamic behavior of a parallel hybrid surgical robot PARASURG-9M. The robot consists of two subsystems: a surgical robotic arm, PARASURG 5M with five motors, and an active robotized surgical instrument PARASIM with four motors. The methodology for the robot kinematics is presented and the algorithm for robot workspace generation is described. PARASURG-9M inverse dynamic simulation is performed using MSC Adams and finally some numerical and simulation results of the developed experimental model with its system control are also described.

Development of a Cable Actuated Joint for a Surgical Robotic Flexible Arm

Advances in robotics surgery are focused on facili- tating complex surgical procedures and overcoming existing natural limitations associated with Minimal Invasive Surgery (MIS). Distal dexterity in the robotic manipulator is of pri- mary importance for tool manipulation and the performance of complex surgical tasks as suturing. The present work deals with the development of a cable actuated 2 degrees of freedom (DoF) joint mechanism to be integrated as a wrist in a surgical robotic continuum-like robot.

Force Signal Tuning for a Surgical Robotic Arm Using PID Controller

In this paper, the modeling, control and simulation of a robotic arm is presented. The goal of the controller is to improve and adjust the output force of the arm using Proportional Integral Differential (PID) controllers. Lately the application of robotics in the field of surgery has opened fields of research that has helped ensure the accuracy, durability, dexterity and the ability for repetition. The combination of the human surgeon's judgmental capabilities with these aforementioned characteristics proves to be an interestingly challenging duo/encounter. The studied system is simulated to consist of the equations of the dynamic motion of the robotic arm with the controller participation. Using the concept of force balance between the surgical robotic arm and the organ, PID controllers are added to smoothen and to slow down the output impact force of the robot in all dimensions. The system is investigated without any control system, with PI controller and PID controller. Different gain values for PID controllers are studied. Output obtained from the simulation show satisfactory response.

Transoral Robotic Surgery of the Skull Base: A Cadaver and Feasibility Study

Objective: The goal of this study was to determine the potential role as well as the current limitations of the da Vinci Surgical System robot in transoral surgery of the skull base. Methods: The da Vinci robot was used to perform dissections of the skull base on 7 cadaver heads with their neck and clavicles intact. Neurosurgeons and otolaryngologists familiar with all facets of the open microscopic, minimally invasive, endoscopic and transoral robotic surgical procedure proceeded with the approach to and dissection of the human skull base. Results: The da Vinci robot provided superb illumination and 3-dimensional depth perception. The 30- degree endoscope improved cephalad visualization, and the ‘intuitive’ nature of the da Vinci surgical robot arms provided an advantage by their ability to suture the dura at the level of the clivus. An entirely transoral route provides access to the middle and lower clivus as well as the infratemporal fossa, but access to the sellar region and anterior cranial fossa is limited via a purely transoral route. Tremor-free dural closure was successfully performed. Conclusion: Our findings suggest that transoral robotic surgery utilizing the da Vinci robot system holds great potential for skull base surgical resection of extradural and intradural tumors of the middle and lower clivus and infratemporal fossa. A collaborative approach with neurosurgeon and otolaryngologist alternating at the master console and bedside is a successful strategy. Further instrument development is necessary, and continued investigation is warranted.

Transoral robotic surgery of craniocervical junction and atlantoaxial spine: a cadaveric study

The goal of this study was to determine the potential role and current limitations of the da Vinci surgical robot in transoral decompression of craniocervical junction (CCJ). The da Vinci Surgical System was used in 2 cadaver heads with neck and clavicles intact. Both neurosurgeons and otolaryngologists familiar with the open microscopic procedure, as well as the transoral robotic surgical procedure, undertook dissection and decompression of the CCJ. The robotic system provided superb illumination and 3D depth perception even several centimeters deep to the posterior oropharyngeal mucosa. The 30 degrees endoscope improved cephalad visualization, eliminating the need to split the soft palate for exposure of the lower clivus. The "intuitive" nature of the da Vinci surgical robot arms provided an advantage in allowing the ability to suture the dura mater in a deep, dark corridor. Because visualization was excellent, tremor-free closure was possible. The authors' findings suggest that transoral robotic surgery, with the da Vinci robot system, holds great potential for decompression of the CCJ as well as resection of both extra- and intradural tumors of this region. Further instrument development is necessary and continued investigation is warranted.

Electromagnetic navigation improves minimally invasive robot-assisted lung brachytherapy

Objective: Recent advances in minimally invasive thoracic surgery have renewed an interest in the role of interstitial brachytherapy for lung cancer. Our previous work has demonstrated that a minimally invasive robot-assisted (MIRA) lung brachytherapy system produced results that were equal to or better than those obtained with standard video-assisted thoracic surgery (VATS) and comparable to results with open surgery. The purpose of this project was to evaluate the performance of an integrated system for MIRA lung brachytherapy that incorporated modified electromagnetic navigation and ultrasound image guidance with robotic assistance.Methods: The experimental test-bed consisted of a VATS box, ZEUS® and AESOP® surgical robotic arms, a seed injector, an ultrasound machine, video monitors, a computer, and an endoscope. Our previous custom-designed electromagnetic navigational software and the robotic controller were modified and incorporated into the MIRA III system to become the next-generation MIRA IV. Inactive brachytherapy seeds were injected as close as possible to a small metal ball target embedded in an opaque agar cube. The completion time, the number of attempts, and the accuracy of seed deployment were compared for manual placement, standard VATS, MIRA III, and the new MIRA IV system.Results: The MIRA IV system significantly reduced the median procedure time by 61% (104 s to 41 s), tissue trauma by 75% (4 attempts to 1 attempt), and mean seed placement error by 64% (2.5 mm to 0.9 mm) when compared to a standard VATS. MIRA IV also reduced the mean procedure time by 48% (85 s to 44 s) and the seed placement error by 68% (2.8 mm to 0.9 mm) compared to the MIRA III system.Conclusions: A modified integrated system for performing minimally invasive robot-assisted lung brachytherapy was developed that incorporated electromagnetic navigation and an improved robotic controller. The MIRA IV system performed significantly better than standard VATS and better than MIRA III.

Electromagnetic navigation improves minimally invasive robot-assisted lung brachytherapy

Objective: Recent advances in minimally invasive thoracic surgery have renewed an interest in the role of interstitial brachytherapy for lung cancer. Our previous work has demonstrated that a minimally invasive robot-assisted (MIRA) lung brachytherapy system produced results that were equal to or better than those obtained with standard video-assisted thoracic surgery (VATS) and comparable to results with open surgery. The purpose of this project was to evaluate the performance of an integrated system for MIRA lung brachytherapy that incorporated modified electromagnetic navigation and ultrasound image guidance with robotic assistance.Methods: The experimental test-bed consisted of a VATS box, ZEUS® and AESOP® surgical robotic arms, a seed injector, an ultrasound machine, video monitors, a computer, and an endoscope. Our previous custom-designed electromagnetic navigational software and the robotic controller were modified and incorporated into the MIRA III system to become the next-generation MIRA IV. Inactive brachytherapy seeds were injected as close as possible to a small metal ball target embedded in an opaque agar cube. The completion time, the number of attempts, and the accuracy of seed deployment were compared for manual placement, standard VATS, MIRA III, and the new MIRA IV system.Results: The MIRA IV system significantly reduced the median procedure time by 61% (104 s to 41 s), tissue trauma by 75% (4 attempts to 1 attempt), and mean seed placement error by 64% (2.5 mm to 0.9 mm) when compared to a standard VATS. MIRA IV also reduced the mean procedure time by 48% (85 s to 44 s) and the seed placement error by 68% (2.8 mm to 0.9 mm) compared to the MIRA III system.Conclusions: A modified integrated system for performing minimally invasive robot-assisted lung brachytherapy was developed that incorporated electromagnetic navigation and an improved robotic controller. The MIRA IV system performed significantly better than standard VATS and better than MIRA III.

Magnetic resonance imaging‐compatible, three‐degrees‐of‐freedom joystick for surgical robot

This paper presents a magnetic resonance (MR) compatible joystick for controlling a surgical robot arm. The surgical robot can be used to assist the surgeon in high precision neurosurgery tasks. Conventional joysticks cannot be used in magnetic resonance imaging (MRI) environments, because they generally contain ferromagnetic materials such as iron, which create distortions in MR images. Moreover, dangerous situations may arise, when an object containing ferromagnetic materials passes through the strong magnetic field of an imaging device. Currents generated by device electronics produce magnetic fields that distort MR images. Operation of the joystick described here is based on measuring light intensity. Optical fibres are used for target illumination and for transmitting the reflected light. Their use enables the joystick electronics to be kept at a safe distance from the imaging machine. Experimental results prove that the joystick can be constructed on the presented operating principle using the designed mechanical structure. When the joystick was placed 15 cm away from the phantom object, it didn't cause any distortion to the MR image. The developed joystick can be used in an MRI environment. However, further development need to be done in order to avoid losses caused by bending optical fibres.

Image-Guided Robotic Surgery

Medical image processing leads to an improvement in patient care by guiding the surgical gesture. Three-dimensional models of patients that are generated from computed tomographic scans or magnetic resonance imaging allow improved surgical planning and surgical simulation that offers the opportunity for a surgeon to train the surgical gesture before performing it for real. These two preoperative steps can be used intra-operatively because of the development of augmented reality, which consists of superimposing the preoperative three-dimensional model of the patient onto the real intraoperative view. Augmented reality provides the surgeon with a view of the patient in transparency and can also guide the surgeon, thanks to the real-time tracking of surgical tools during the procedure. When adapted to robotic surgery, this tool tracking enables visual serving with the ability to automatically position and control surgical robotic arms in three dimensions. It is also now possible to filter physiologic movements such as breathing or the heart beat. In the future, by combining augmented reality and robotics, these image-guided robotic systems will enable automation of the surgical procedure, which will be the next revolution in surgery.

An overview of the intuitive system: The surgeon's perspective

An overview of the intuitive system: The surgeon's perspective