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At least 703 records · Page 39Linked to original sources

PubMed2005

Implementation of an intuitive writing interface and a laparoscopic robot for gynaecological laser assisted surgery.

The research reported in this paper aims at applying the human handwriting skill to improve and facilitate the control of laser-assisted laparoscopic surgery operations performed by gynaecological surgeons. For the purpose, a laparoscopic robot was interfaced with a digitizing tablet. This interface, further called the intuitive writing interface (IWI), directly converts the hand trajectory, handwritten on the tablet, into an input signal to the robot. It replaces the traditional complex manipulations performed by the surgeon during manual laparoscopic surgery by natural handwriting. It provides the surgeon with an intuitive 'what-you-draw-is-what-you-cut' control facility by employing his/her familiar handwriting skills to control the laser ablation process accurately. The system was successfully built and tested in vitro. Performance tests on the robot resulted in tracking errors in the order of 1 mm in the target plane at an ablation speed of 20 mm/s. The high accuracy of the system was successfully demonstrated by cutting characters 4 mm high on an apple. These results indicate that laser ablation performance is upgraded by the IWI to the accuracy levels of human handwriting, which is much higher than can be obtained with manual laser laparoscopy. Safety features include the use of pen contact with the tablet as a safety switch, and back drivability in the robot joints for easy manual positioning and evacuation in case of emergency.

Computer Peripherals↗

PubMed1997

A new oscillating saw for robotic aided surgery.

In this paper a brief description of a computer and robotic aided surgery system is given with a detailed overview of the necessity to develop special tools for robotic surgery. The application range of this robotic system has been specially focused on the orthopaedics field and, more particularly, on the execution of osteotomies. It was therefore necessary to develop a new saw device which would meet medical and--from the robot system point of view--mechanical as well as functional requirements. After describing the device which was developed on the basis of these requirements, a detailed comparative study of off-the-shelf oscillating saws and the new device is given at the end of the paper.

Equipment Design↗

PubMed1991

The development of a surgeon robot for prostatectomies.

The removal of prostatic tissue through transurethral resection of the prostate (TURP) is an operation that can require considerable skill from a surgeon as well as being a lengthy procedure. The potential for using robotic techniques was investigated in a preliminary feasibility study using a standard six axis 'Puma' robot. This led to the construction of a manually operated 'safety frame' which has been shown to be effective through clinical trials on 30 patients. A special-purpose robot, based on the design of the manual frame, has now been constructed. Some of the safety issues are discussed which make this procedure an ideal candidate for a robotic device.

Equipment Design↗

PubMed1995

Robotic-assisted internal fixation of femoral fractures.

Closed surgical techniques for the internal fixation of femoral fractures require orthopaedic surgeons to work in close proximity to X-rays. In addition to the occupational health risk this imposes, inexperienced surgeons often encounter great difficulty in achieving optimal positioning of fracture repair fixtures. A vision-guided robotic system has been proposed as a possible solution to these problems and an initial investigation involving two exemplar orthopaedic procedures has been undertaken. Robotic surgery assistance imposes rigorous safety-related design constraints, since the orthopaedic robot must operate in close proximity to the patient and operating staff. The design and implementation of a purpose-built robotic system for orthopaedic surgery assistance is described in this paper.

Femoral Fractures↗

PubMed2002

[CRANIO--development of a system for computer- and robot-assisted craniotomy].

In the framework of the DFG project CRANIO, we are dealing with the problems of computer-assisted planning and robot-assisted realization of craniotomy, with optional skull reconstruction. A CT dataset was obtained from a phantom skull model and basic operation planning as well as different registration methods were performed. As one option it is possible to mill a contour on the skull or even to remove the entire area with a robot-guided microsurgical milling tool. In this context, work space tests were performed with a hexapod parallel robot. The milling of any contour geometry could be realized with different tool angles using the existing CRIGOS robot system without additional axes.

Computer Simulation↗

PubMed2006

Implications of assist-as-needed robotic step training after a complete spinal cord injury on intrinsic strategies of motor learning.

Robotic training paradigms that enforce a fixed kinematic control might be suboptimal for rehabilitative training because they abolish variability, an intrinsic property of neuromuscular control (Jezernik et al., 2003). In the present study we introduce "assist-as-needed" (AAN) robotic training paradigms for rehabilitation of spinal cord injury subjects. To test the efficacy of these robotic control strategies to teach spinal mice to step, we divided 27 adult female Swiss-Webster mice randomly into three groups. Each group was trained robotically by using one of three control strategies: a fixed training trajectory (Fixed group), an AAN training paradigm without interlimb coordination (Band group), and an AAN training paradigm with bilateral hindlimb coordination (Window group). Beginning at 14 d after a complete midthoracic spinal cord transection, the mice were trained daily (10 min/d, 5 d/week) to step on a treadmill 10 min after the administration of quipazine (0.5 mg/kg), a serotonin agonist, for a period of 6 weeks. During weekly performance evaluations, the mice trained with the AAN window paradigm generally showed the highest level of recovery as measured by the number, consistency, and periodicity of steps during the testing sessions. In all three measurements there were no significant differences between the Band and the Fixed training groups. These results indicate that the window training approach, which includes loose alternating interlimb coordination, is more effective than a fixed trajectory paradigm with rigid alternating interlimb coordination or an AAN paradigm without any interlimb constraints in promoting robust postinjury stepping behavior.

Animals↗

PubMed2004

Robotic aortic valve replacement: case report.

We have developed a technique that enables robotic aortic valve replacement with port access via a small right anterior thoracotomy and minimally invasive aortic cross clamping. The procedure is performed under video guidance with all the annular sutures placed with the robot. In the case we report, the patient's postoperative course was extremely simple and pain was minimal. We believe that this is the first reported aortic valve replacement using robotic technology and that it opens a new field of application for robotic assisted surgery.

Aortic Valve Insufficiency↗

PubMedDate not supplied

Robotic upper-limb neurorehabilitation in chronic stroke patients.

This pilot study tested the effectiveness of an intense, short-term upper-limb robotic therapy for improvement in motor outcomes among chronic stroke patients. We enrolled 30 subjects with upper-limb deficits due to stroke of at least 6 mo duration and with a Motor Power Assessment grade of 3 or less. Over 3 wk, 18 sessions of robot-assisted task-specific therapy were delivered with the use of a robotic exercise device that simulates a conventional therapy known as skateboard therapy. Primary outcome measures included reliable, validated impairment and disability measures of upper-limb motor function. Statistically significant improvements were observed for severely impaired participants when we compared baseline and posttreatment outcomes (p < 0.05). These results are important because they indicate that improvement is not limited to those with moderate impairments but is possible among severely impaired chronic stroke patients as well. Moderately and severely impaired patients in our study were able to tolerate a massed-practice therapy paradigm with intensive, frequent, and repetitive treatment. This information is useful in determining the optimal target population, intensity, and duration of robotic therapy and sample size for a planned larger trial.

Adult↗

PubMedDate not supplied

Motions or muscles? Some behavioral factors underlying robotic assistance of motor recovery.

Robotics and related technologies have begun to realize their promise to improve the delivery of rehabilitation therapy. However, the mechanism by which they enhance recovery remains unclear. Ultimately, recovery depends on biology, yet the details of the recovery process remain largely unknown; a deeper understanding is important to accelerate refinements of robotic therapy or suggest new approaches. Fortunately, robots provide an excellent instrument platform from which to study recovery at the behavioral level. This article reviews some initial insights about the process of upper-limb behavioral recovery that have emerged from our work. Evidence to date suggests that the form of therapy may be more important than its intensity: muscle strengthening offers no advantage over movement training. Passive movement is insufficient; active participation is required. Progressive training based on measures of movement coordination yields substantially improved outcomes. Together these results indicate that movement coordination rather than muscle activation may be the most appropriate focus for robotic therapy.

Behavior↗

PubMed1998

Meat quality variation in the robotic sorting of pork loins.

A robot was used to make fiber-optic reflectance measurements from 400 to 700 nm in 10-nm increments at six sites, 10 cm apart, along the length of 48 pork loins. Meat quality was assessed in the longissimus dorsi near the thoracolumbar junction using 1) a bag-drip method for fluid loss, 2) a subjective evaluation of wetness, 3) a colorimeter measurement of paleness (CIE L), and 4) a subjective evaluation for Japanese pork color scores (JPCS). Sorting of the loins in the commercial plant from which they originated was correlated (P < .01) with fluid loss (r=.57), with wetness scores (r=-.57), with CIE L* (r=.71), and with JPCS (r=-.64). Laboratory measurements of pH at the site of meat quality assessment were correlated (P < .01) with fluid loss (r=-.61), with wetness scores (r=.65), with CIE L* (r=-.74), and with JPCS (r=.77). Average spectra obtained robotically were correlated (P < .01) with fluid loss (r=.56 at 670 nm, and R=.76 adding 560 and 540 nm), with wetness score (r=-.65 at 480 nm, and R=.75 adding 530 and 570 nm), with CIE L* (r=.76 at 480 nm, and R=.82 adding 690 and 520 nm), and with JPCS (r=-.70). In sorting loins that were all categorized as normal at the plant, mean reflectance data collected robotically were correlated with fluid loss, r=.42 (P > .05) at 700 nm and R=.58 (P > .05) adding 430 nm; with wetness score, r=.25 (P > .05); with CIE L*, r=.58 (P < .025) at 700 nm; and with JPCS, r=-.71 (P < .01) at 700 nm. Thus, as well as detecting obvious PSE loins, the robotic probe also had a limited capability to sort loins all categorized as normal at the plant.

Animals↗

PubMedDate not supplied

A feasibility study of a robot manipulator for the disabled.

A robotic manipulator system appears to offer much potential for a severely handicapped person who has little or no hand function. Existing environmental control systems fulfil an important role, but are limited to preselected tasks. The robotic system described here aims to overcome such limitations by providing a user-controlled manipulative device, which is not restricted to preselected tasks. The paper describes the development of a system based on a relatively cheap desk-top mounted robotic device controlled by a microcomputer, in order to investigate the feasibility of such a system. The problems which have been encountered are the provision of user input commands from a person with limited control function, and also the progression from general control of the robot to the performing of useful domestic tasks. The paper also describes and discusses the results of a user survey and user trials.

Adult↗

PubMed2003

Experimental robotic milling in skull-base surgery.

OBJECTIVE: In the field of otorhinolaryngology, a variety of skull implants have been developed to assist hearing-impaired or even deaf patients. The first step in the implantation procedure, and also in lateral skull-base surgery, is to drill the calvarian or mastoid bone. We intended to investigate the hitherto unknown parameters for performing this procedure and to establish the first set-up for robotic milling of the lateral skull base. MATERIALS AND METHODS: Experimental milling of the skull base was conducted on two human specimens using a hexapod robot. RESULTS: Optimized parameters were determined with a drill speed of 30,000 revolutions/min and a form feed rate of 5 mm/s for the calvarium and 1 mm/s for mastoid bone, respectively, in a spiral-path fashion. While using a cutting burr, mean force levels were 4.81 N for calvarian bone and 6.12 N for mastoid bone, respectively--well below our empirical limit of 10 N. However, maximum levels easily surpassed these limits, reaching 27.7 N. CONCLUSION: The prerequisites for robotic skull-base surgery were fulfilled. With further work to implement feedback of sensory input, robots may increase precision for various tasks in skull-base surgery.

Humans↗

PubMed2004

Virtual remote center of motion control for needle placement robots.

OBJECTIVE: We present an algorithm that enables percutaneous needle-placement procedures to be performed with unencoded, unregistered, minimally calibrated robots while removing the constraint of placing the needle tip on a mechanically enforced Remote Center of Motion (RCM). MATERIALS AND METHODS: The algorithm requires only online tracking of the surgical tool and a five-degree-of-freedom (5-DOF) robot comprising three prismatic DOF and two rotational DOF. An incremental adaptive motion control cycle guides the needle to the insertion point and also orients it to align with the target-entry-point line. The robot executes RCM motion without having a physically constrained fulcrum point. RESULTS: The proof-of-concept prototype system achieved 0.78 mm translation accuracy and 1.4 degrees rotational accuracy (this is within the tracker accuracy) within 17 iterative steps (0.5-1 s). CONCLUSION: This research enables robotic assistant systems for image-guided percutaneous procedures to be prototyped/constructed more quickly and less expensively than has been previously possible. Since the clinical utility of such systems is clear and has been demonstrated in the literature, our work may help promote widespread clinical adoption of this technology by lowering system cost and complexity.

Algorithms↗

PubMed2005

Preliminary evaluation of a mobile robotic device for navigation and intervention on the beating heart.

This article describes the development and preliminary testing of a mobile robotic device to facilitate minimally invasive beating-heart intrapericardial intervention. The HeartLander robot will be introduced beneath the pericardium via subxiphoid incision, adhere to the epicardium, navigate to any location, and administer therapy under the control of the physician. As compared to current robotic cardiac surgical techniques, this novel paradigm obviates immobilization of the heart and eliminates access limitations. Furthermore, it does not require lung deflation and differential ventilation and thus could enable outpatient cardiac surgery. The current HeartLander prototypes use suction to maintain prehension of the epicardium and wire actuation to perform locomotion. A fiber optic videoscope displays visual feedback to the physician, who controls the device through a joystick interface. The initial prototype demonstrated successful prehension, turning, and locomotion on open-chest, beating-heart porcine models where the pericardium was removed (N = 3). A smaller second-generation prototype with an injection system demonstrated locomotion and myocardial injection of dye, both performed with the pericardium intact (N = 3). These trials illustrate the feasibility of using a miniature mobile robot to navigate upon the beating heart and perform intrapericardial therapy.

Animals↗

PubMed2002

Robotic milking and its effect on fertility and cell counts.

The aim of this study was to analyze the effect of robotic milking (RM) on fertility and somatic cell counts (SCC) among dairy herds participating in the national Dutch milk recording system. It was hypothesized that RM, and a higher milking frequency in general, would have negative effects on fertility, due to expected and supposed deeper negative energy balance (NEB). Herds increasing milking frequency from two to three times daily consistently had increased production. Milk production during RM was intermediate between the amounts obtained by milking twice versus three times a day. Milking three times a day and the associated higher production had no significant effect on reproductive measures such as nonreturn rate at 56 d post insemination (NR56) or days to first service. Although RM did not affect NR56, use of the robot was associated with an increase in days to first service. An increase in milking frequency from two to three times daily did not affect SCC, but SCC were significantly increased after milking with the robot. Robotic milking has a significant positive effect on production and no negative effect on fertility as measured by NR56. The effect of RM in increasing days to first service appears due to reasons other than increased production and a more NEB. Increased SCC during RM is potentially of concern. From the data available, the relationship of RM to clinical mastitis could not be determined but this aspect needs further attention.

Animals↗

PubMed2005

Microsurgical robotic system for the deep surgical field: development of a prototype and feasibility studies in animal and cadaveric models.

OBJECT: To enhance the surgeon's dexterity and maneuverability in the deep surgical field, the authors developed a master-slave microsurgical robotic system. This concept and the results of preliminary experiments are reported in this paper. METHODS: The system has a master control unit, which conveys motion commands in six degrees of freedom (X, Y, and Z directions; rotation; tip flexion; and grasping) to two arms. The slave manipulator has a hanging base with an additional six degrees of freedom; it holds a motorized operating unit with two manipulators (5 mm in diameter, 18 cm in length). The accuracy of the prototype in both shallow and deep surgical fields was compared with routine freehand microsurgery. Closure of a partial arteriotomy and complete end-to-end anastomosis of the carotid artery (CA) in the deep operative field were performed in 20 Wistar rats. Three routine surgical procedures were also performed in cadavers. The accuracy of pointing with the nondominant hand in the deep surgical field was significantly improved through the use of robotics. The authors successfully closed the partial arteriotomy and completely anastomosed the rat CAs in the deep surgical field. The time needed for stitching was significantly shortened over the course of the first 10 rat experiments. The robotic instruments also moved satisfactorily in cadavers, but the manipulators still need to be smaller to fit into the narrow intracranial space. CONCLUSIONS: Computer-controlled surgical manipulation will be an important tool for neurosurgery, and preliminary experiments involving this robotic system demonstrate its promising maneuverability.

Anastomosis, Surgical↗

PubMed2006

Clinical characteristics of remote Zeus robot-assisted laparoscopic cholecystectomy: a report of 40 cases.

AIM: To summarize the performing essentials and analyze the characteristics of remote Zeus robot-assisted laparoscopic cholecystectomy. METHODS: Robot-assisted laparoscopic cholecystectomy was performed in 40 patients between May 2004 and July 2005. The operating procedures and a variety of clinical parameters were recorded and analyzed. RESULTS: Forty laparoscopic cholecystectomy procedures were successfully completed with Zeus robotic system. And there were no post-operative complications. Total operating time, system setup time and performing time were 100.3 +/- 18.5 min, 27.7 +/- 8.8 min and 65.6 +/- 18.3 min, respectively. The blood loss and post-operative hospital stay were 30.6 +/- 10.2 mL and 2.8 +/- 0.8 d, respectively. Camera clearing times and time used for operative field adjustment were 1.1+/- 1.0 min and 2.0 +/- 0.8 min, respectively. The operative error was 7.5%. CONCLUSION: Robot-assisted laparoscopic cholecystectomy following the principles of laparoscopic operation has specific performing essentials. It preserves the benefits of minimally invasive surgery and offers enhanced ability of controlling operation field, precise and stable operative manipulations.

Adolescent↗

PubMed1994

Outfitting your hospital for the new wave of robots.

Automated materials handling systems have provided dramatic labor savings and efficiency benefits to healthcare facilities. A growing trend is the use of a new breed of service robots that provide automated materials handling without major modifications to the existing building. The robots navigate through hallways, go through doors and ride elevators using a computerized controller that contains a layout of each floor of the hospital; the robots do not rely on any type of physical track to guide them on their way. The robots are programmed to pick up or deliver supplies to nursing stations or other departments, and determine the best route. Purchase and rental options exist at a substantial savings over human labor.

Cost Savings↗