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

Intraoperative Planning and Execution of Arbitrary Orthopedic Interventions Using Handheld Robotics and Augmented Reality

The focus of this work is a generic, intraoperative and image-free planning and execution application for arbitrary orthopedic interventions using a novel handheld robotic device and optical see-through glasses (AR). This medical CAD application enables the surgeon to intraoperatively plan the intervention directly on the patient’s bone. The glasses and all the other instruments are accurately calibrated using new techniques. Several interventions show the effectiveness of this approach

On the Application of Mechanical Vibration in Robotics-Assisted Soft Tissue Intervention

Mechanical vibration as a way of transmitting energy has been an interesting subject to study. While cyclic oscillation is usually associated with fatigue effect, and hence a detrimental factor in failure of structures and machineries, by controlled transmission of vibration, energy can be transferred from the source to the target. In this thesis, the application of such mechanical vibration in a few surgical procedures is demonstrated. Three challenges associated with lung cancer diagnosis and treatment are chosen for this purpose, namely, Motion Compensation, tumor targeting in lung Needle Insertion and Soft Tissue Dissection: A robotic solution is proposed for compensating for the undesirable oscillatory motion of soft tissue (caused by heart beat and respiration) during needle insertion in the lung. An impedance control strategy based on a mechanical vibratory system is implemented to minimize the tissue deformation during needle insertion. A prototype was built to evaluate the proposed approach using: 1) two Mitsubishi PA10-7C robots, one for manipulating the macro part and the other for mimicking the tissue motion, 2) one motorized linear stage to handle the micro part, and 3) a Phantom Omni haptic device for remote manipulation. Experimental results are given to demonstrate the performance of the motion compensation system. A vibration-assisted needle insertion technique has been proposed in order to reduce needle–tissue friction. The LuGre friction model is employed as a basis for the study and the model is extended and analyzed to include the impact of high-frequency vibration on translational friction. Experiments are conducted to evaluate the role of insertion speed as well as vibration frequency on frictional effects. In the experiments conducted, an 18 GA brachytherapy needle was vibrated and inserted into an ex-vivo soft tissue sample using a pair of amplified piezoelectric actuators. Analysis demonstrates that the translational friction can be reduced by introducing a vibratory low-amplitude motion onto a regular insertion profile, which is usually performed at a constant rate. A robotics-assisted articulating ultrasonic surgical scalpel for minimally invasive soft tissue cutting and coagulation is designed and developed. For this purpose, the optimal design of a Langevin transducer with stepped horn profile is presented for internal-body applications. The modeling, optimization and design of the ultrasonic scalpel are performed through equivalent circuit theory and verified by finite element analysis. Moreover, a novel surgical wrist, compatible with the da Vinci® surgical system, with decoupled two degrees-of-freedom (DOFs) is developed that eliminates the strain of pulling cables and electrical wires. The developed instrument is then driven using the dVRK (da Vinci® research kit) and the Classic da Vinci® surgical system

Advanced Applications of Rapid Prototyping Technology in Modern Engineering

Rapid prototyping (RP) technology has been widely known and appreciated due to its flexible and customized manufacturing capabilities. The widely studied RP techniques include stereolithography apparatus (SLA), selective laser sintering (SLS), three-dimensional printing (3DP), fused deposition modeling (FDM), 3D plotting, solid ground curing (SGC), multiphase jet solidification (MJS), laminated object manufacturing (LOM). Different techniques are associated with different materials and/or processing principles and thus are devoted to specific applications. RP technology has no longer been only for prototype building rather has been extended for real industrial manufacturing solutions. Today, the RP technology has contributed to almost all engineering areas that include mechanical, materials, industrial, aerospace, electrical and most recently biomedical engineering. This book aims to present the advanced development of RP technologies in various engineering areas as the solutions to the real world engineering problems

From teleoperation to autonomous robot-assisted microsurgery: A survey

Robot-assisted microsurgery (RAMS) has many benefits compared to traditional microsurgery. Microsurgical platforms with advanced control strategies, high-quality micro-imaging modalities and micro-sensing systems are worth developing to further enhance the clinical outcomes of RAMS. Within only a few decades, microsurgical robotics has evolved into a rapidly developing research field with increasing attention all over the world. Despite the appreciated benefits, significant challenges remain to be solved. In this review paper, the emerging concepts and achievements of RAMS will be presented. We introduce the development tendency of RAMS from teleoperation to autonomous systems. We highlight the upcoming new research opportunities that require joint efforts from both clinicians and engineers to pursue further outcomes for RAMS in years to come

Control techniques for mechatronic assisted surgery

The treatment response for traumatic head injured patients can be improved by using an autonomous robotic system to perform basic, time-critical emergency neurosurgery, reducing costs and saving lives. In this thesis, a concept for a neurosurgical robotic system is proposed to perform three specific emergency neurosurgical procedures; they are the placement of an intracranial pressure monitor, external ventricular drainage, and the evacuation of chronic subdural haematoma. The control methods for this system are investigated following a curiosity led approach. Individual problems are interpreted in the widest sense and solutions posed that are general in nature. Three main contributions result from this approach: 1) a clinical evidence based review of surgical robotics and a methodology to assist in their evaluation, 2) a new controller for soft-grasping of objects, and 3) new propositions and theorems for chatter suppression sliding mode controllers. These contributions directly assist in the design of the control system of the neurosurgical robot and, more broadly, impact other areas outside the narrow con nes of the target application. A methodology for applied research in surgical robotics is proposed. The methodology sets out a hierarchy of criteria consisting of three tiers, with the most important being the bottom tier and the least being the top tier. It is argued that a robotic system must adhere to these criteria in order to achieve acceptability. Recent commercial systems are reviewed against these criteria, and are found to conform up to at least the bottom and intermediate tiers. However, the lack of conformity to the criteria in the top tier, combined with the inability to conclusively prove increased clinical benefit, particularly symptomatic benefit, is shown to be hampering the potential of surgical robotics in gaining wide establishment. A control scheme for soft-grasping objects is presented. Grasping a soft or fragile object requires the use of minimum contact force to prevent damage or deformation. Without precise knowledge of object parameters, real-time feedback control must be used to regulate the contact force and prevent slip. Moreover, the controller must be designed to have good performance characteristics to rapidly modulate the fingertip contact force in response to a slip event. A fuzzy sliding mode controller combined with a disturbance observer is proposed for contact force control and slip prevention. The robustness of the controller is evaluated through both simulation and experiment. The control scheme was found to be effective and robust to parameter uncertainty. When tested on a real system, however, chattering phenomena, well known to sliding mode research, was induced by the unmodelled suboptimal components of the system (filtering, backlash, and time delays). This reduced the controller performance. The problem of chattering and potential solutions are explored. Real systems using sliding mode controllers, such as the control scheme for soft-grasping, have a tendency to chatter at high frequencies. This is caused by the sliding mode controller interacting with un-modelled parasitic dynamics at the actuator-input and sensor-output of the plant. As a result, new chatter-suppression sliding mode controllers have been developed, which introduce new parameters into the system. However, the effect any particular choice of parameters has on system performance is unclear, and this can make tuning the parameters to meet a set of performance criteria di cult. In this thesis, common chatter-suppression sliding mode control strategies are surveyed and simple design and estimation methods are proposed. The estimation methods predict convergence, chattering amplitude, settling time, and maximum output bounds (overshoot) using harmonic linearizations and invariant ellipsoid sets