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At least 253 records · Page 14Linked to original sources

PubMed1994

Robot for CT-guided stereotactic neurosurgery.

At the 1989 meeting of the World Society for Stereotactic and Functional Neurosurgery in Maebashi, the authors presented the concept and design of a stereotactic neurosurgical robot. The first prototype has now been completed and has entered clinical testing. The characteristics are as follows. The robot is positioned behind the CT scan and operates inside the CT gantry. It is linked to the CT table and moves freely along its longitudinal axis, allowing for intraoperative scanning at any cranial level. The patient's body rests on the CT table, but the stereotactic headframe is fixed to the robot, allowing precise measurements of the head position under stereotactic conditions. During scanning, each CT slice appears immediately on the robotic workstation for selection of target and trajectory. In addition to the tool for automatic penetration of the skin, skull, and meninges, the robot is able to handle two other stereotactic instruments and to perform a complete stereotactic procedure without physical intervention by the physician. So far, depth electrodes and biopsy instruments have been developed for use by the robot. Since all parts of the robot were designed solely for stereotactic neurosurgery, integration of safety aspects was optimized. The first operations using an aspiration biopsy probe were successfully performed on 2 patients with malignant intracerebral cystic lesions on September 4, 1993.

Humans↗

PubMed2005

Active vision and receptive field development in evolutionary robots.

In this paper, we describe the artificial evolution of adaptive neural controllers for an outdoor mobile robot equipped with a mobile camera. The robot can dynamically select the gazing direction by moving the body and/or the camera. The neural control system, which maps visual information to motor commands, is evolved online by means of a genetic algorithm, but the synaptic connections (receptive fields) from visual photoreceptors to internal neurons can also be modified by Hebbian plasticity while the robot moves in the environment. We show that robots evolved in physics-based simulations with Hebbian visual plasticity display more robust adaptive behavior when transferred to real outdoor environments as compared to robots evolved without visual plasticity. We also show that the formation of visual receptive fields is significantly and consistently affected by active vision as compared to the formation of receptive fields with grid sample images in the environment of the robot. Finally, we show that the interplay between active vision and receptive field formation amounts to the selection and exploitation of a small and constant subset of visual features available to the robot.

Artificial Intelligence↗

PubMed1995

Evolving mobile robots in simulated and real environments.

The problem of the validity of simulation is particularly relevant for methodologies that use machine learning techniques to develop control systems for autonomous robots, as, for instance, the artificial life approach known as evolutionary robotics. In fact, although it has been demonstrated that training or evolving robots in real environments is possible, the number of trials needed to test the system discourages the use of physical robots during the training period. By evolving neural controllers for a Khepera robot in computer simulations and then transferring the agents obtained to the real environment we show that (a) an accurate model of a particular robot-environment dynamics can be built by sampling the real world through the sensors and the actuators of the robot; (b) the performance gap between the obtained behaviors in simulated and real environments may be significantly reduced by introducing a "conservative" form of noise; (c) if a decrease in performance is observed when the system is transferred to a real environment, successful and robust results can be obtained by continuing the evolutionary process in the real environment for a few generations.

Algorithms↗

PubMed2005

Efficacy of novel robotic camera vs a standard laparoscopic camera.

To improve visualization during minimal access surgery, a novel robotic camera has been developed. The prototype camera is totally insertable, has 5 degrees of freedom, and is remotely controlled. This study compared the performance of laparoscopic surgeons using both a laparoscope and the robotic camera. The MISTELS (McGill Inanimate System for the Training and Evaluation of Laparoscopic Skill) tasks were used to test six laparoscopic fellows and attending surgeons. Half the surgeons used the laparoscope first and half used the robotic camera first. Total scores from the MISTELS sessions in which the laparoscope was used were compared with the sessions in which the robotic camera was used and then analyzed with a paired t test (P < .05 was considered significant). All six surgeons tested showed no significant difference in their MISTELS task performance on the robotic camera compared with the standard laparoscopic camera. The mean MISTELS score of 963 for all subjects who used a laparoscope and camera was not significantly different than the mean score of 904 for the robotic camera (P = .17). This new robotic camera prototype allows for equivalent performance on a validated laparoscopic assessment tool when compared with performance using a standard laparoscope.

Equipment Design↗

PubMed2005

A semi-active milling procedure in view of preparing implantation beds in robot-assisted orthopaedic surgery.

Bone cutting in total joint reconstructions requires a high accuracy to obtain a well-functioning and long-lasting prosthesis. Hence robot assistance can be useful to increase the precision of the surgical actions. A drawback of current robot systems is that they autonomously machine the bone, in that way ignoring the surgeon's experience and introducing a safety risk. This paper presents a semi-active milling procedure to overcome that drawback. In this procedure the surgeon controls robot motion by exerting forces on a force-controlled lever that is attached to the robot end effector. Meanwhile the robot constrains tool motion to the planned motion and generates a tool feed determined by the feed force that the surgeon executes. As a case study the presented milling procedure has been implemented on a laboratory set-up for robot-assisted preparation of the acetabulum in total hip arthroplasty. Two machining methods have been considered. In the first method the surgeon determines both milling trajectory and feed by the forces that he/she executes on the force-controlled lever. In the second method the cavity is machined contour by contour, and the surgeon only provides the feed. Machining experiments have shown that the first method results in large surface irregularities and is not useful. The second method, however, results in accurate cavity preparation and has therefore potential to be implemented in future robot systems.

Acetabulum↗

PubMed2005

Spinal cord-transected mice learn to step in response to quipazine treatment and robotic training.

In the present study, concurrent treatment with robotic step training and a serotonin agonist, quipazine, generated significant recovery of locomotor function in complete spinal cord-transected mice (T7-T9) that otherwise could not step. The extent of recovery achieved when these treatments were combined exceeded that obtained when either treatment was applied independently. We quantitatively analyzed the stepping characteristics of spinal mice after alternatively administering no training, manual training, robotic training, quipazine treatment, or a combination of robotic training with quipazine treatment, to examine the mechanisms by which training and quipazine treatment promote functional recovery. Using fast Fourier transform and principal components analysis, significant improvements in the step rhythm, step shape consistency, and number of weight-bearing steps were observed in robotically trained compared with manually trained or nontrained mice. In contrast, manual training had no effect on stepping performance, yielding no improvement compared with nontrained mice. Daily bolus quipazine treatment acutely improved the step shape consistency and number of steps executed by both robotically trained and nontrained mice, but these improvements did not persist after quipazine was withdrawn. At the dosage used (0.5 mg/kg body weight), quipazine appeared to facilitate, rather than directly generate, stepping, by enabling the spinal cord neural circuitry to process specific patterns of sensory information associated with weight-bearing stepping. Via this mechanism, quipazine treatment enhanced kinematically appropriate robotic training. When administered intermittently during an extended period of robotic training, quipazine revealed training-induced stepping improvements that were masked in the absence of the pharmacological treatment.

Animals↗

PubMed2005

Ongoing procedure development in robotically assisted totally endoscopic coronary artery bypass grafting (TECAB).

BACKGROUND: Totally endoscopic coronary artery bypass grafting (TECAB) using robotics requires stepwise introduction into a heart surgery program. It is the aim of this study to evaluate the state of procedure development after continued application of telemanipulation techniques in the clinical setting. We also sought to assess perioperative and intermediate term clinical results after robotically assisted CABG. PATIENTS AND METHODS: From June 2001 to March 2005, robotically assisted CABG using the daVinci system was carried out in 107 patients with single and multi-vessel coronary artery disease. The following procedures were performed: robotically assisted endoscopic left internal mammary artery (LIMA) harvesting and completion of the procedure as conventional CABG, MIDCAB, or OPCAB (n = 22), robotically assisted suturing of LIMA-to-LAD anastomoses during conventional CABG (n = 28), TECAB on the arrested heart using remote access perfusion (n = 48), TECAB on the beating heart using an endostabilizer (n = 8), takedown of adhesions (TECAB intended) (n = 1). RESULTS: Hospital mortality was 0% and cumulative risk adjusted mortality reached 1.6 lives saved versus EuroSCORE predictions. Undesirable surgical events (USE) such as conversion, on table revision, or postoperative revision procedures occurred in 34 out of 107 (32%) patients. Median ventilation time and ICU stay, however, were 11(0-278) hours and 21(11-389) hours, respectively. Cumulative 3 years survival was 100% and freedom from angina at 3 years was 97%. CONCLUSIONS: We conclude that despite being surgically challenging robotically assisted coronary artery surgery can be implemented with acceptable safety. TECAB procedures have reached a reproducible state. Perioperative mortality after robotically assisted CABG may be lower than predicted. Intermediate term clinical results are very satisfactory.

Adult↗

PubMed2006

Robotic prostatectomy: a pooled analysis of published literature.

OBJECTIVE: Robotic prostatectomy has been recently added to the treatment armamentarium of localized prostate cancer. We reviewed published data on this modality with critical appraisal of outcomes and complications. METHODS: A Medline search was performed that encompassed all published articles on robotic prostatectomy. Select data on open radical retropubic (RRP) and laparoscopic (LP) prostatectomy from centers of excellence in the USA and Europe were included for objective comparison. Perioperative parameters, pathological results, including surgical margin rate, complications and postoperative continence and potency rates were reported. Advantages and shortcomings of robotic prostatectomy, and the learning curve and cost issues were also addressed. RESULTS: Robotic prostatectomy offers advantages of minimally invasive access surgery, including enhanced visualization, decreased bleeding and transfusion rate, shorter hospital stay and faster recovery. Pathological outcomes are comparable to RRP and LP with acceptable positive margin rate. At short-term follow-up, continence and potency results appear to be equivalent to RRP and LP. The learning curve of robotic prostatectomy is faster than that of LP. Cost remains a matter of debate at the present time. Long-term cancer control results of robotic prostatectomy are still maturing. CONCLUSIONS: Robotic prostatectomy is a promising minimally invasive surgical approach for men with localized prostate cancer. Short-term clinical and pathological results compare favorably to RRP and LP.

Humans↗

PubMed1999

Voice-controlled robotic arm in laparoscopic surgery.

AIM: To report on our experience with a voice-directed robotic arm for scope management in different procedures for "solo-surgery" and in complex laparoscopic operations. METHODS: A chip card with orders for the robotic arm is individually manufactured for every user. A surgeon gives order through a microphone and the optic field is thus under direct command of the surgeon. RESULTS: We analyzed 200 cases of laparoscopic procedures (gallbladder, stomach, colon, and hernia repair) done with the robotic arm. In each procedure the robotic arm worked precisely; voice understanding was exact and functioned flawlessly. A hundred "solo-surgery" operations were performed by a single surgeon. Another 96 complex videoscopic procedures were performed by a surgeon and one assistant. In comparison to other surgical procedures, operative time was not prolonged, and the number of used ports remained unchanged. CONCLUSION: Using the robotic arm in some procedures abolishes the need for assist ance. Further benefit accrued by the use of robotic assistance includes greater stability of view, less inadvertent smearing of the lens, and the absence of fatigue. The robotic arm can be used successfully in every operating theater by all surgeons using laparoscopy.

Acoustics↗

PubMed2000

Robotic remote laparoscopic nephrectomy and adrenalectomy: the initial experience.

PURPOSE: We evaluated the feasibility of performing laparoscopic nephrectomy and adrenalectomy exclusively by using robotic telepresent technology from a remote workstation and compared outcomes with those of conventional laparoscopy in an acute porcine model. MATERIALS AND METHODS: Five pigs underwent bilateral laparoscopic nephrectomy (robotic in 5 and conventional in 4) and adrenalectomy (robotic in 4 and conventional in 3). In the 9 robotic laparoscopic procedures all intraoperative manipulations were completely performed telerobotically from a remote workstation without any conventional laparoscopic assistance on site. Animals were sacrificed acutely. RESULTS: Robotic laparoscopic nephrectomy required significantly longer total operative (85.2 versus 38.5 minutes, p = 0.0009) and actual surgical (73.4 versus 27.5 minutes, p = 0.0002) time than conventional laparoscopy. However, blood loss and adequacy of surgical dissection were comparable in the 2 groups. Robotic laparoscopic adrenalectomy required longer total operative (51 versus 32.3 minutes, p = 0.13) and actual surgical (38.5 versus 18.7 minutes, p = 0.14) time than conventional laparoscopy. The solitary complication in this study was an inferior vena caval tear during robotic right adrenalectomy, which was adequately repaired by sutures telerobotically in a remote manner. CONCLUSIONS: To our knowledge we present the initial experience with remote telerobotic laparoscopic nephrectomy and adrenalectomy. Telepresent laparoscopic surgery is feasible.

Adrenalectomy↗

PubMed2001

Robotic assisted, laparoscopic pelvic lymph node dissection in humans.

PURPOSE: We evaluate the feasibility and efficacy of robotic assisted, laparoscopic pelvic lymph node dissection for locally advanced prostate cancer staging. MATERIALS AND METHODS: Robotic assisted, laparoscopic pelvic lymph node dissection was performed in 10 consecutive patients with mainly T3 M0 prostatic carcinoma (robotic group). Operative, postoperative and pathological parameters were compared with the results of the last 10 patients undergoing conventional, laparoscopic pelvic lymph node dissection performed with similar indications by the same operator (laparoscopy group). RESULTS: All operations were performed according to the established protocol with no specific intraoperative or postoperative complications. No conversion was required, and no technical incidents were observed in the robotic group. Mean operating time plus or minus standard deviation for the robotic group was 125 +/- 57 minutes (range 75 to 215), significantly longer than that for the laparoscopy group, which was 60 +/- 15 minutes (p = 0.0013). In the robotic group 2 patients presented with postoperative lymphoceles revealed in 1 by deep venous thrombosis and in the second by obturator pain. In the laparoscopy group 1 patient presented with acute urinary retention. The histological results concerning the number of lymph nodes removed were similar in both groups (p = 0.5). CONCLUSIONS: We show the technical feasibility of robotic assisted, laparoscopic pelvic lymph node dissection in humans. Although the benefit of this technique has not yet been established, predictable technological improvements would suggest the development of telesurgery and an improved precision of surgical procedure.

Aged↗

PubMed1999

Endoscopic coronary artery bypass graft (ECABG) procedure with robotic assistance.

BACKGROUND: Technical details of the Robotically assisted endoscopic coronary artery bypass graft (ECABG) procedure on the cadaver model are reported. Moreover, this study will provide essential techniques, steps, and procedural development concepts necessary to introduce the ZEUS Robotic Surgical System (Computer Motion, Inc., Goleta, CA) into the human operating room. METHODS: Between August 1998 and March 1999, an ECABG procedure was performed on 10 cadaver torsos. The cadaver torso was placed in the left anterior oblique (LAO) position. The left and right internal mammary arteries (IMA) were taken down endoscopically. The ends of the IMA's were intracorporeally prepared. An upper partial sternotomy was demonstrated for perfusion cannulation and proximal anastomoses for multiple vessel revascularization. An arteriotomy was created with an endoscopic scalpel. The IMA was anastomosed to a chosen coronary using robotic assistance. The patency was verified by probing and injecting of methylene blue. RESULTS: Templates were developed to determine the placement of the robotic arms. Port templates were developed to both harvest the IMA's and perform the desired anastomoses. The following vessels were accessed through the developed port templates and retraction of the heart: left anterior descending (LAD), right coronary artery (RCA), diagonal (D(1)), obtuse marginal (OM(1) and OM(2)), and posterior descending artery (PDA). CONCLUSIONS: The use of robotic assistance during an ECABG procedure on a cadaver model is feasible. This study is a necessary and useful progression from the use of robotics in the animal lab to the use of robotics in the human operating room.

Coronary Artery Bypass↗

PubMed2001

[Development of a system for robot aided teeth alignment of complete denture].

OBJECTIVE: To develop a robot aid aligning artificial teeth for complete denture. METHODS: The CRS-450, a 6-direction-free robot was utilized to make the grasped object realize any position and pose, and to develop an adjustable tooth arrangement machine. The geometry parameters of the shape of agomphious jaw were obtained through 3-D laser scanning and measuring system. The math's model, which was set up according to senior prosthodontic experts' experiences on tooth arrangement, was used to control program of experts in arranging teeth, 3-D denture simulation, and robots in arranging teeth. The program used VC++ and RAPL robot languages. When the teeth arrangement plan was formed, the data were transmitted to a robot, who would fix the position and finish the fabrication of complete denture. RESULTS: A complete system of robot-aided complete denture teeth arranging was set up and tried using this system to make an artificial dentition for a patient. There were still some errors in the articulation of the dentition, which needed adjustment and perfection. CONCLUSIONS: We succeed in using robot to fabricate artificial dentition for the first time. Although the dentition is not perfect in articulation, the system's scientific significance is profound. The results have proved that the designing idea and technical routine are workable.

Denture Design↗

PubMed2002

[Initial use of the newly developed voice-controlled robot system for a solitary pulmonary arterio-venous malformation].

We herein report an initial experience of thoracoscopic surgery for a solitary arterior-venous malformation (PAVM) with the AESOP 3000 HR voice-controlled robot to hold a thoracoscope. A 52-year-old woman was hospitalized due to a transient loss of consciousness. A brain magnetic resonance image and electroencephalogram (EEG) were normal. A chest computed tomogram indicated a suspicion of PAVM. The definite diagnosis of the PAVM was made by the 3-dimensional computed tomogram and pulmonary angiography. Thoracoscopic operation with the voice-controlled robot (AESOP 3000 HR) was conducted. The operating staffs were able to assemble the AESOP 3000 HR robotic system safely and quickly without difficulty. The robot functioned without problems throughout the procedure. No complications or events related or unrelated to the maneuvers of the robot during the operation were noted. The procedure of the pulmonary resection with the voice-controlled robot was successfully preformed by a single surgeon. The operating time was 110 minutes, and the volume of the intraoperative bleeding was 10 g. The postoperative course was uneventful. The use of the AESOP 3000 HR robot may be more convenient and friendly in thoracoscopic procedure.

Arteriovenous Malformations↗

PubMedDate not supplied

Robot-assisted surgery: the future is here.

According to L. Wiley Nifong, director of robotic surgery at East Carolina University's Brody School of Medicine, "Nationally, only one-fourth of the 15 million surgeries performed each year are done with small incisions or what doctors call 'minimally invasive surgery'." Robots could raise that number substantially (Stark 2002). Currently, healthcare organizations use robot technology for thoracic, abdominal, pelvic, and neurological surgical procedures. Minimally invasive surgery reduces the amount of inpatient hospital days, and the computer in the system filters any hand tremors a physician may have during the surgery. The use of robot-assisted surgery improves quality of care because the patient experiences less pain after the surgery. Robot-assisted surgery demonstrates definite advantages for the patient, physician, and hospital; however, healthcare organizations in the United States have yet to acquire the technology because of implementation costs and the lack of FDA (Food and Drug Administration) approval for using the technology for certain types of heart procedures. This article focuses on robot-assisted surgery advantages to patients, physicians, and hospitals as well as on the disadvantages to physicians. In addition, the article addresses implementation costs, which creates financial hurdles for most healthcare organizations; offers recommendations for administrators to embrace this technology for strategic positioning; and enumerates possible roles for robots in medicine.

Device Approval↗

PubMed2004

Robotic surgery in otorhinolaryngology.

Otoneurosurgery may greatly benefit from enhanced precision through robotics or from new procedures only made possible with robotic aid. Different implant cavities were milled by a serial robot (Stäubli RX 130) in formaldehyde fixed human skull bones. A variety of sensor data (force, momentum, temperature,...) were measured and evaluated. Ultrasound probes of different frequencies were used to measure skull bone thickness. With a serial robot Stäubli RX 130 it was possible to mill an exact implant cavity for various CI main modules in a human skull specimen. While milling with speed controlled by force feedback, the heat production was tremendously reduced as compared to the non controlled mode. Using coded excitation and a matched-filter technique, a 3D ultrasound scan of the skull bone could be performed in order to plan the drilling task for the robot by means of local navigation. This is the first functional robotic milling procedure for otoneurosurgery with force-based speed control in an experimental setting. Force feedback smoothes the robot's movements and reduces heat damage to surrounding tissues. Ultrasound navigation may replace the need for CT scanning in the future.

Equipment Design↗

PubMed2004

Application of robotics in general surgery: initial experience.

Robotic surgery was recently approved for clinical use in general abdominal surgery. The aim of this study was to review our experience with the da Vinci surgical system during laparoscopic general surgical procedures. Eighteen patients underwent robotically assisted laparoscopic abdominal surgery between June 2002 and March 2003. Main outcome measures were operative time, room setup time, robotic arm-positioning and surgical time, blood loss, conversion to laparoscopy, length of stay, and morbidity. The types of robotically assisted laparoscopic procedures were excision of gastric leiomyoma (n = 1), Heller myotomy (n = 1), cholecystectomy (n = 2), gastric banding (n = 2), Nissen fundoplication (n = 4), and gastric bypass (n = 8). The mean room setup time was 63 +/- 14 minutes, and the mean robotic arm-positioning time was 16 +/- 7 minutes. Conversion to laparoscopy occurred in two (11%) of 18 cases because of equipment difficulty (n = 1) and technical difficulty (n = 1). Estimated blood loss was 91 +/- 71 mL. The mean operative time was 156 +/- 42 minutes, and the robotic operative time was 27% of the total operative time. The mean length of hospital stay was 2.2 +/- 1.5 days. There was one postoperative wound infection and one anastomotic stricture. Robotically assisted laparoscopic abdominal surgery is feasible and safe; however, the theoretical advantages of the da Vinci surgical system were not clinically apparent.

Adult↗

PubMed2005

Spherical mechanism analysis of a surgical robot for minimally invasive surgery -- analytical and experimental approaches.

Recent advances in technology have led to the fusion of MIS techniques and robot devices. However, current systems are large and cumbersome. Optimizing the surgical robot mechanism will eventually lead to its integration into the operating room (OR) of the future becoming the extended presence of the surgeon and nurses in a room occupied by the patient alone. By optimizing a spherical mechanism using data collected in-vivo during MIS procedures, this study is focused on a bottom-up approach to developing a new class of surgical robotic arms while maximizing their performance and minimizing their size. The spherical mechanism is a rotational manipulator with all axes intersecting at the center of the sphere. Locating the rotation center of the mechanism at the MIS port makes this class of mechanism a suitable candidate for the first two links of a surgical robot for MIS. The required dexterous workspace (DWS) is defined as the region in which 95% of the tool motions are contained based on in-vivo measurements. The extended dexterous workspace (EDWS) is defined as the entire abdominal cavity reachable by a MIS instruments. The DWS is defined by a right circular cone with a vertex angle of 60 degrees and the EDWS is defined by a cone with an elliptical cross section created by two orthogonal vertex angles of 60 degrees and 90 degrees. A compound function based on the mechanism's isotropy and the mechanism stiffness was considered as the performance metric cost function. Optimization across both the DWS and the EDWS lead to a serial mechanism configuration with link length angles of 74 degrees and 60 degrees for a serial configuration. This mechanism configuration maximized the kinematic performance in the DWS while keeping the EDWS as its reachable workspace. Surgeons, using a mockup of two mechanisms in a MIS setup, validated these results experimentally. From these experiments the serial configuration was deemed most applicable for MIS robotic applications compared to a parallel mechanism configuration. The mechanical design of a cable actuated surgical robot was based on optimized link length angles. The system is currently being integrated into a fully operated two-arm system. Small form-factor surgical robotic arms with optimized dexterous workspaces will facilitate the integration of multiple arms while avoiding self-collision in the OR of the future.

Robotics↗