8 research outputs found
A Method of Decreasing Time Delay for A Tele-surgery System
Abstract -The haptics-based master-slave system for Minimally Invasive Surgery is a promising way to protect surgeons from long time radiation and to train novice doctors to learn basic wire or catheter handling skills. However, the time delay of transmission of visual video and the time difference between image information and force signals restrict the application of this technology in some extent. In this paper, we proposed a new method to reduce time delay effectively. At the slave side, the tip of the active catheter is tracked in real time to provide information on the location of the catheter in the blood vessel model. And then transmitted the coordinate values to the master site. At the master site, the location of the catheter was reappeared in the navigation chart which is the same structure with the blood vessels at master side according to the coordinate values received from the slave side. Therefore the transmission time of image information is decreased. Experimental results are given to illustrate the accuracy of our method
Robot Assisted Object Manipulation for Minimally Invasive Surgery
Robotic systems have an increasingly important role in facilitating minimally invasive surgical treatments. In robot-assisted minimally invasive surgery, surgeons remotely control instruments from a console to perform operations inside the patient. However, despite the advanced technological status of surgical robots, fully autonomous systems, with decision-making capabilities, are not yet available.
In 2017, a structure to classify the research efforts toward autonomy achievable with surgical robots was proposed by Yang et al. Six different levels were identified: no autonomy, robot assistance, task autonomy,
conditional autonomy, high autonomy, and full autonomy. All the commercially available platforms in robot-assisted
surgery is still in level 0 (no autonomy). Despite increasing the level of autonomy remains an open challenge, its adoption could potentially introduce multiple benefits, such as decreasing surgeons’ workload and fatigue and pursuing a consistent
quality of procedures. Ultimately, allowing the surgeons to interpret the ample
and intelligent information from the system will enhance the surgical outcome and
positively reflect both on patients and society. Three main aspects are required to
introduce automation into surgery: the surgical robot must move with high precision,
have motion planning capabilities and understand the surgical scene. Besides
these main factors, depending on the type of surgery, there could be other aspects
that might play a fundamental role, to name some compliance, stiffness, etc. This
thesis addresses three technological challenges encountered when trying to achieve
the aforementioned goals, in the specific case of robot-object interaction. First,
how to overcome the inaccuracy of cable-driven systems when executing fine and
precise movements. Second, planning different tasks in dynamically changing environments.
Lastly, how the understanding of a surgical scene can be used to solve
more than one manipulation task.
To address the first challenge, a control scheme relying on accurate calibration is
implemented to execute the pick-up of a surgical needle. Regarding the planning of
surgical tasks, two approaches are explored: one is learning from demonstration to
pick and place a surgical object, and the second is using a gradient-based approach
to trigger a smoother object repositioning phase during intraoperative procedures.
Finally, to improve scene understanding, this thesis focuses on developing a simulation
environment where multiple tasks can be learned based on the surgical scene
and then transferred to the real robot. Experiments proved that automation of the pick and place task of different surgical objects is possible. The robot was successfully
able to autonomously pick up a suturing needle, position a surgical device for
intraoperative ultrasound scanning and manipulate soft tissue for intraoperative organ
retraction. Despite automation of surgical subtasks has been demonstrated in
this work, several challenges remain open, such as the capabilities of the generated
algorithm to generalise over different environment conditions and different patients
Medical Robotics
The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently “medical roboticists” or not
A continuum robotic platform for endoscopic non-contact laser surgery: design, control, and preclinical evaluation
The application of laser technologies in surgical interventions has been accepted in the clinical
domain due to their atraumatic properties. In addition to manual application of fibre-guided
lasers with tissue contact, non-contact transoral laser microsurgery (TLM) of laryngeal tumours
has been prevailed in ENT surgery. However, TLM requires many years of surgical training
for tumour resection in order to preserve the function of adjacent organs and thus preserve the
patient’s quality of life. The positioning of the microscopic laser applicator outside the patient
can also impede a direct line-of-sight to the target area due to anatomical variability and limit
the working space. Further clinical challenges include positioning the laser focus on the tissue
surface, imaging, planning and performing laser ablation, and motion of the target area during
surgery. This dissertation aims to address the limitations of TLM through robotic approaches and
intraoperative assistance. Although a trend towards minimally invasive surgery is apparent, no
highly integrated platform for endoscopic delivery of focused laser radiation is available to date.
Likewise, there are no known devices that incorporate scene information from endoscopic imaging
into ablation planning and execution. For focusing of the laser beam close to the target tissue, this
work first presents miniaturised focusing optics that can be integrated into endoscopic systems.
Experimental trials characterise the optical properties and the ablation performance. A robotic
platform is realised for manipulation of the focusing optics. This is based on a variable-length
continuum manipulator. The latter enables movements of the endoscopic end effector in five
degrees of freedom with a mechatronic actuation unit. The kinematic modelling and control of the
robot are integrated into a modular framework that is evaluated experimentally. The manipulation
of focused laser radiation also requires precise adjustment of the focal position on the tissue. For
this purpose, visual, haptic and visual-haptic assistance functions are presented. These support
the operator during teleoperation to set an optimal working distance. Advantages of visual-haptic
assistance are demonstrated in a user study. The system performance and usability of the overall
robotic system are assessed in an additional user study. Analogous to a clinical scenario, the
subjects follow predefined target patterns with a laser spot. The mean positioning accuracy of the
spot is 0.5 mm. Finally, methods of image-guided robot control are introduced to automate laser
ablation. Experiments confirm a positive effect of proposed automation concepts on non-contact
laser surgery.Die Anwendung von Lasertechnologien in chirurgischen Interventionen hat sich aufgrund der atraumatischen Eigenschaften in der Klinik etabliert. Neben manueller Applikation von fasergefĂĽhrten
Lasern mit Gewebekontakt hat sich die kontaktfreie transorale Lasermikrochirurgie (TLM) von
Tumoren des Larynx in der HNO-Chirurgie durchgesetzt. Die TLM erfordert zur Tumorresektion
jedoch ein langjähriges chirurgisches Training, um die Funktion der angrenzenden Organe zu
sichern und damit die Lebensqualität der Patienten zu erhalten. Die Positionierung des mikroskopis chen Laserapplikators außerhalb des Patienten kann zudem die direkte Sicht auf das Zielgebiet
durch anatomische Variabilität erschweren und den Arbeitsraum einschränken. Weitere klinische
Herausforderungen betreffen die Positionierung des Laserfokus auf der Gewebeoberfläche, die
Bildgebung, die Planung und AusfĂĽhrung der Laserablation sowie intraoperative Bewegungen
des Zielgebietes. Die vorliegende Dissertation zielt darauf ab, die Limitierungen der TLM durch
robotische Ansätze und intraoperative Assistenz zu adressieren. Obwohl ein Trend zur minimal
invasiven Chirurgie besteht, sind bislang keine hochintegrierten Plattformen fĂĽr die endoskopische
Applikation fokussierter Laserstrahlung verfĂĽgbar. Ebenfalls sind keine Systeme bekannt, die
Szeneninformationen aus der endoskopischen Bildgebung in die Ablationsplanung und -ausfĂĽhrung
einbeziehen. Für eine situsnahe Fokussierung des Laserstrahls wird in dieser Arbeit zunächst
eine miniaturisierte Fokussieroptik zur Integration in endoskopische Systeme vorgestellt. Experimentelle Versuche charakterisieren die optischen Eigenschaften und das Ablationsverhalten. Zur
Manipulation der Fokussieroptik wird eine robotische Plattform realisiert. Diese basiert auf einem
längenveränderlichen Kontinuumsmanipulator. Letzterer ermöglicht in Kombination mit einer
mechatronischen Aktuierungseinheit Bewegungen des Endoskopkopfes in fĂĽnf Freiheitsgraden.
Die kinematische Modellierung und Regelung des Systems werden in ein modulares Framework
eingebunden und evaluiert. Die Manipulation fokussierter Laserstrahlung erfordert zudem eine
präzise Anpassung der Fokuslage auf das Gewebe. Dafür werden visuelle, haptische und visuell haptische Assistenzfunktionen eingeführt. Diese unterstützen den Anwender bei Teleoperation
zur Einstellung eines optimalen Arbeitsabstandes. In einer Anwenderstudie werden Vorteile der
visuell-haptischen Assistenz nachgewiesen. Die Systemperformanz und Gebrauchstauglichkeit
des robotischen Gesamtsystems werden in einer weiteren Anwenderstudie untersucht. Analog zu
einem klinischen Einsatz verfolgen die Probanden mit einem Laserspot vorgegebene Sollpfade. Die
mittlere Positioniergenauigkeit des Spots beträgt dabei 0,5 mm. Zur Automatisierung der Ablation
werden abschließend Methoden der bildgestützten Regelung vorgestellt. Experimente bestätigen
einen positiven Effekt der Automationskonzepte fĂĽr die kontaktfreie Laserchirurgie
Robotic surgery, human fallibility, and the politics of care
Robotic Surgery, Human Fallibility, and the Politics of Care leverages the methods and theoretical paradigms of performance, visual, and new media studies to explore the contradictions, aspirations, and failures of modern technologized medicine. In particular, I consider the use of robots in the operating rooms of a large research hospital. University Hospital illuminates a contemporary articulation of human bodies and robotic technology that focuses and amplifies existing and emergent tensions and contradictions in modern medicine's investment in providing both care and cure. Intuitive Surgical, Inc.'s da Vinci Surgical System provides a platform for this exploration, both as a concrete, material, and particular assemblage of hardware, software and human wetware, and as a technology that offers a specific and perhaps more productive vantage point--a modest step stool--for understanding the contemporary politics of surgical pedagogy and practice. I locate the dVSS in a broader context of ambivalence that surgeons experience with regard to the manual practices of their craft, an ambivalence amplified by the increasing sophistication and automation of surgical tools and the changing ontologies of surgical practice. The surgical interface of the dVSS prosthetically enhances--as well as displaces and replaces--embodied surgical skill. At a time when all facets of medical care grapple with the problem of medical error, I outline an emergent sensibility of machinic virtuosity, articulated to both human and robotic surgical practice alike, geared toward addressing and overcoming the perceived pitfalls of human fallibility. Rather than simply enacting a technological dehumanization of medicine, robotic surgery suggests a more complicated terrain where the nature of the human and the machine bleed into each other. What I term the becoming machine of the surgeon and the becoming surgeon of the medical device occurs on the cutting edge of the robot-surgeon interface. The implications of this emergent medical sensibility are far from clear or unilateral. In closing, I reflect on the uncertain impact of the ideal of machinic virtuosity on the politics of care. This reflection considers software and machine ethics alongside medicine's aspiration to manage contingency according to the procedurality of medical and surgical protocols
Technology 2004, Vol. 2
Proceedings from symposia of the Technology 2004 Conference, November 8-10, 1994, Washington, DC. Volume 2 features papers on computers and software, virtual reality simulation, environmental technology, video and imaging, medical technology and life sciences, robotics and artificial intelligence, and electronics