11,284 research outputs found
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
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A Novel Lumbar Motion Segment Classification to Predict Changes in Segmental Sagittal Alignment After Lateral Interbody Fixation.
Study designRetrospective cohort study.ObjectivesLateral interbody fixation is being increasingly used for the correction of segmental sagittal parameters. One factor that affects postoperative correction is the resistance afforded by posterior hypertrophic facet joints in the degenerative lumbar spine. In this article, we describe a novel preoperative motion segment classification system to predict postoperative correction of segmental sagittal alignment after lateral lumbar interbody fusion.MethodsPreoperative computed tomography scans were analyzed for segmental facet osseous anatomy for all patients undergoing lateral lumbar interbody fusion at 3 institutions. Each facet was assigned a facet grade (min = 0, max = 2), and the sum of the bilateral facet grades was the final motion segment grade (MSG; min = 0, max = 4). Preoperative and postoperative segmental lordosis was measured on standing lateral radiographs. Postoperative segmental lordosis was also conveyed as a percentage of the implanted graft lordosis (%GL). Simple linear regression was conducted to predict the postoperative segmental %GL according to MSG.ResultsA total of 36 patients with 59 operated levels were identified. There were 19 levels with MSG 0, 14 levels with MSG 1, 13 levels with MSG 2, 8 levels with MSG 3, and 5 levels with MSG 4. Mean %GL was 115%, 90%, 77%, 43%, and 5% for MSG 0 to 4, respectively. MSG significantly predicted postoperative %GL (P < .01). Each increase in MSG was associated with a 28% decrease in %GL.ConclusionsWe propose a novel facet-based motion segment classification system that significantly predicted postoperative segmental lordosis after lateral lumbar interbody fusion
Planning and Real Time Control of a Minimally Invasive Robotic Surgery System
This paper introduces the planning and control software of a teleoperating robotic system for minimally invasive surgery. It addresses the problem of how to organize a complex system with 41 degrees of freedom including robot setup planning, force feedback control and nullspace handling with three robotic arms. The planning software is separated into sequentially executed planning and registration procedures. An optimal setup is first planned in virtual reality and then adapted to variations in the operating room. The real time control system is composed of hierarchical layers. The design is flexible and expandable without losing performance. Structure, functionality and implementation of planning and control are described. The robotic system provides the surgeon with an intuitive hand-eye-coordination and force feedback in teleoperation for both hands
Computer- and robot-assisted Medical Intervention
Medical robotics includes assistive devices used by the physician in order to
make his/her diagnostic or therapeutic practices easier and more efficient.
This chapter focuses on such systems. It introduces the general field of
Computer-Assisted Medical Interventions, its aims, its different components and
describes the place of robots in that context. The evolutions in terms of
general design and control paradigms in the development of medical robots are
presented and issues specific to that application domain are discussed. A view
of existing systems, on-going developments and future trends is given. A
case-study is detailed. Other types of robotic help in the medical environment
(such as for assisting a handicapped person, for rehabilitation of a patient or
for replacement of some damaged/suppressed limbs or organs) are out of the
scope of this chapter.Comment: Handbook of Automation, Shimon Nof (Ed.) (2009) 000-00
Automated pick-up of suturing needles for robotic surgical assistance
Robot-assisted laparoscopic prostatectomy (RALP) is a treatment for prostate
cancer that involves complete or nerve sparing removal prostate tissue that
contains cancer. After removal the bladder neck is successively sutured
directly with the urethra. The procedure is called urethrovesical anastomosis
and is one of the most dexterity demanding tasks during RALP. Two suturing
instruments and a pair of needles are used in combination to perform a running
stitch during urethrovesical anastomosis. While robotic instruments provide
enhanced dexterity to perform the anastomosis, it is still highly challenging
and difficult to learn. In this paper, we presents a vision-guided needle
grasping method for automatically grasping the needle that has been inserted
into the patient prior to anastomosis. We aim to automatically grasp the
suturing needle in a position that avoids hand-offs and immediately enables the
start of suturing. The full grasping process can be broken down into: a needle
detection algorithm; an approach phase where the surgical tool moves closer to
the needle based on visual feedback; and a grasping phase through path planning
based on observed surgical practice. Our experimental results show examples of
successful autonomous grasping that has the potential to simplify and decrease
the operational time in RALP by assisting a small component of urethrovesical
anastomosis
Minimally Invasive Mitral Valve Surgery I: Patient Selection, Evaluation, and Planning.
Widespread adoption of minimally invasive mitral valve repair and replacement may be fostered by practice consensus and standardization. This expert opinion, first of a 3-part series, outlines current best practices in patient evaluation and selection for minimally invasive mitral valve procedures, and discusses preoperative planning for cannulation and myocardial protection
Optical techniques for 3D surface reconstruction in computer-assisted laparoscopic surgery
One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-opera- tive morphology and motion of soft-tissues. This information is prerequisite to the registration of multi-modal patient-specific data for enhancing the surgeon’s navigation capabilites by observ- ing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted in- struments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This paper reviews the state-of-the-art methods for optical intra-operative 3D reconstruction in laparoscopic surgery and discusses the technical challenges and future perspectives towards clinical translation. With the recent paradigm shift of surgical practice towards MIS and new developments in 3D opti- cal imaging, this is a timely discussion about technologies that could facilitate complex CAS procedures in dynamic and deformable anatomical regions
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