Robot Autonomy for Surgery

Autonomous surgery involves having surgical tasks performed by a robot operating under its own will, with partial or no human involvement. There are several important advantages of automation in surgery, which include increasing precision of care due to sub-millimeter robot control, real-time utilization of biosignals for interventional care, improvements to surgical efficiency and execution, and computer-aided guidance under various medical imaging and sensing modalities. While these methods may displace some tasks of surgical teams and individual surgeons, they also present new capabilities in interventions that are too difficult or go beyond the skills of a human. In this chapter, we provide an overview of robot autonomy in commercial use and in research, and present some of the challenges faced in developing autonomous surgical robots

Towards an Implantable Vestibular Prosthesis: The Surgical Challenges

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Robots and tools for remodeling bone

The field of robotic surgery has progressed from small teams of researchers repurposing industrial robots, to a competitive and highly innovative subsection of the medical device industry. Surgical robots allow surgeons to perform tasks with greater ease, accuracy, or safety, and fall under one of four levels of autonomy; active, semi-active, passive, and remote manipulator. The increased accuracy afforded by surgical robots has allowed for cementless hip arthroplasty, improved postoperative alignment following knee arthroplasty, and reduced duration of intraoperative fluoroscopy among other benefits. Cutting of bone has historically used tools such as hand saws and drills, with other elaborate cutting tools now used routinely to remodel bone. Improvements in cutting accuracy and additional options for safety and monitoring during surgery give robotic surgeries some advantages over conventional techniques. This article aims to provide an overview of current robots and tools with a common target tissue of bone, proposes a new process for defining the level of autonomy for a surgical robot, and examines future directions in robotic surgery

A clinical review of robotic navigation in total knee arthroplasty: historical systems to modern design.

Robotic-assisted total knee arthroplasty (RA-TKA) has shown improved reproducibility and precision in mechanical alignment restoration, with improvement in early functional outcomes and 90-day episode of care cost savings compared to conventional TKA in some studies. However, its value is still to be determined.Current studies of RA-TKA systems are limited by short-term follow-up and significant heterogeneity of the available systems.In today\u27s paradigm shift towards an increased emphasis on quality of care while curtailing costs, providing value-based care is the primary goal for healthcare systems and clinicians. As robotic technology continues to develop, longer-term studies evaluating implant survivorship and complications will determine whether the initial capital is offset by improved outcomes.Future studies will have to determine the value of RA-TKA based on longer-term survivorships, patient-reported outcome measures, functional outcomes, and patient satisfaction measures

Influence of the localization strategy on the accuracy of a neurosurgical robot system

Precise navigation of surgical instruments is one of the most important features of autonomous surgical robots. In this paper, we introduce a concept of robot localization strategy and analyse its influence on the overall application error of a robot system for frameless stereotactic neurosurgery named RONNA. Localization strategies utilize specific angles at which the robot can approach a target point, orientations, and types of movement during the procedure of physical space fiducial marker localization and positioning to the target points. The localization strategies developed in this study are a neutral orientation strategy (NOS), an orientation correction strategy (OCS) and a joint displacement minimization strategy (JDMS). To evaluate the robot positioning performance with the localization strategies applied, we performed laboratory phantom measurements using a different number of fiducial markers in the registration procedure. When three, four, and five fiducial markers were used, the application error for the NOS was 1.571±0.256 mm, 1.397±0.283 mm, and 1.327±0.274 mm, and for the OCS, it was 0.429±0.133 mm, 0.284±0.068mm, and 0.260±0.076 mm, respectively. The application error for the JDMS was 0.493±0.176 mm with four and 0.369±0.160 mm with five fiducial markers used

Robot Assisted Laser Osteotomy

In the scope of this thesis world\u27s first robot system was developed, which facilitates osteotomy using laser in arbitrary geometries with an overall accuracy below 0.5mm. Methods of computer and robot assisted surgery were reconsidered and composed to a workflow. Adequate calibration and registration methods are proposed. Further a methodology for transferring geometrically defined cutting trajectories into pulse sequences and optimized execution plans is developed