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PubMedDate not supplied

An intelligent end-effector for a rehabilitation robot.

A UMI RTX robot, modified with limited end-effector sensors and a restricted but effective vision system, is currently used in a developmental education setting for severely physically disabled children. The low physical and cognitive abilities of the children involved in the project require a semi-autonomous robot with environmental sensing capability to operate in a task oriented mode. A variety of low-cost sensors including proximity, distance, force and slip sensors, have been investigated for integration in end-effectors for the RTX robot. The sensors employed on a modified end-effector are detailed and experimental results are presented. A design for an end-effector with integrated sensors is discussed. The integration of the sensor information into a high-level, task-oriented programming language is detailed and examples of high-level control sequences using sensor inputs are presented. Finally, the development of intelligent gripping strategies based on sensor information is discussed.

Artificial Intelligence↗

PubMed2003

Geometric accuracy in robot-assisted total hip replacement surgery.

OBJECTIVE: Robot-Assisted Surgery in Total Hip Replacement (RAS-THR) has become a fairly widespread procedure for hip replacement surgery in Europe. However, data on the geometric accuracy of the overall process have so far been unavailable. The equipment manufacturers have only published data on the accuracy of certain elements of the procedure (e.g., the accuracy of the robot system). This study aimed to investigate the overall geometric accuracy of the complete process of RAS-THR, as well as the influence of some of the individual component steps. MATERIALS AND METHODS: An anthropomorphic phantom has been developed representing the hip and upper leg region of a human body. The entire RAS-THR procedure can be carried out using this phantom. Studies were conducted to investigate the overall accuracy of the process, as well as the influence of some individual steps in the procedure, using both the ROBODOC and CASPAR systems. RESULTS: Overall geometric accuracy of the RAS-THR process was found to be within a standard deviation of 0.5 mm and 0.3 degrees in the critical directions. Most individual steps in the process make similar contributions to the overall variation. The two robot systems examined offer comparable accuracy. CONCLUSION: Initial results seem to indicate that the RAS-THR process is acceptably accurate. However, acceptance criteria for the necessary geometric accuracy have not yet been defined.

Arthroplasty, Replacement, Hip↗

PubMed2005

A practical approach towards accurate dense 3D depth recovery for robotic laparoscopic surgery.

OBJECTIVE: Recovering tissue deformation during robotic-assisted minimally invasive surgery (MIS) is an important step towards motion compensation and stabilization. This article presents a practical strategy for dense 3D depth recovery and temporal motion tracking for deformable surfaces. METHODS: The method combines image rectification with constrained disparity registration for reliable depth estimation. The accuracy and practical value of the technique are validated using a tissue phantom with known 3D geometry and motion characteristics and in vivo data. RESULTS: Results from the phantom model correctly follow the motion trend indicated from the ground truth provided by CT scanning, and regression analysis shows the intrinsic accuracy that can be achieved with the proposed technique. Results applied to in vivo robotic-assisted MIS data are also provided, indicating the practical value of the proposed method. CONCLUSION: The proposed method presents a practical strategy for dense depth recovery of surface structure in robotic-assisted MIS that incorporates stereo vision. Results on phantom and in vivo data indicate the quality of the method and also highlight the importance of further considering the effects of specular highlights.

Algorithms↗

PubMed2006

Computer aided robotic radiosurgery.

Radiosurgery involves the precise delivery of sharply collimated high-energy beams of radiation to a distinct target volume along selected trajectories. Historically, accurate targeting required the application of a stereotactic frame, thus limiting the use of this procedure to single treatments of selected intracranial lesions. However, the scope of radiosurgery has undergone a remarkable broadening since the introduction of image-guided robotic radiosurgery. Recent developments in real-time image guidance provide an effective frameless alternative to conventional radiosurgery and allow both the treatment of lesions outside the skull and the possibility of performing hypofractionation. As a consequence, targets in the spine, chest and abdomen can now also be radiosurgically ablated with submillimetric precision. Meanwhile, the combination of image guidance, robotic beam delivery, and non-isocentric inverse planning can greatly enhance the conformality and homogeneity of radiosurgery. The aim of this article is to describe the technological basis of image-guided radiosurgery and provide a perspective on future developments. The current clinical usage of robotic radiosurgery will be reviewed with an emphasis on those applications that may represent a major shift in the therapeutic paradigm.

Brain Neoplasms↗

PubMed2006

Contactless measurement of cow behavior in a milking robot.

We have worked on automatically measuring the behavior of dairy cows during automatic milking. A milking robot offers a unique possibility for a dynamic measurement of physical data. Four strain gauge scales were installed into a milking robot in order to measure the weight of each leg separately, and a laser distance sensor was placed next to the robot in order to measure the radial movement of the cow's body surface. The data were collected into a PC. Three video cameras were installed to observe the system, and the data were recorded digitally. From the data, the dynamic weight or load of each leg and the respiration rate of a cow could be measured. Different stages of milking were observed, and the changes in behavior during milking were analyzed. The acquired information could be used to judge a cow's restlessness and welfare--for example, leg health and stress.

Animal Welfare↗

PubMed1987

Occupational therapists' views about the use of robotic aids for people with disabilities.

The use of robotic aids for persons with disabilities has potential benefits both in terms of cost cutting and improved health care. This article reviews robotic aids currently in use and reports the results of a survey of 51 occupational therapists at four hospitals offering rehabilitation services for patients with spinal cord injuries: Therapists were generally positive about the use of robotic aids and expressed interest in learning more about this technology.

Attitude of Health Personnel↗

PubMed1993

Robotic automation of medication-use management.

In the October 1993 issue of Physician Assistant, we published "Robots for Health Care," the first of two articles on the medical applications of robotics. That article discussed ways in which robots could help patients with manipulative disabilities to perform activities of daily living and hold paid employment; transfer patients from bed to chair and back again; add precision to the most exacting surgical procedures; and someday carry out diagnostic and therapeutic techniques from within the human body. This month, we are pleased to offer an article by Sharon Enright, an authority on pharmacy operations, who considers how an automated medication-management system that makes use of bar-code technology is capable of streamlining drug dispensing, controlling safety, increasing cost-effectiveness, and ensuring accurate and complete record-keeping.

Clinical Pharmacy Information Systems↗

PubMed1998

Motion feedback as a navigation aid in robot assisted neurosurgery.

This paper describes a test prototype for precision robot-assisted surgery using a hexapod operating robot and a movable operating cockpit. The objective of the work described is twofold: 1) To evaluate the use of hexapod robots for precisely manipulating endoscopes and surgical instruments in sub-millimeter surgery. 2) To test a new user interface concept based on motion feedback. This paper gives an overview of the system components and the user interface concept, and reports results from initial tests. Finally, the paper investigates potential applications and areas for further development.

Evaluation Studies as Topic↗

PubMed1998

A system for robot assisted maxillofacial surgery.

In maxillofacial surgery the quality of the surgical outcome mainly depends on the experience of the operating surgeon. Thus we intend to support the surgeon before and during surgery in order to enhance the surgical results. On the one hand this implies the use of image processing, three dimensional modelling techniques and visualization techniques of medical image data, on the other hand planning systems, intraoperative navigation devices and surgical robots are needed. In this paper a complex expert system is presented, which uses a planner for generating treatment plans, an infrared navigation for monitoring both patient, robot, and surgical tool, and a surgical robotic system in order to work on bone. Special stress is laid on the architecture of the planning system, the structure of the treatment plans, and the intraoperative communication protocols.

Algorithms↗

PubMed1999

Overview of clinical trials with MIT-MANUS: a robot-aided neuro-rehabilitation facility.

We are applying robotics and information technology to assist, enhance, and quantify neuro-rehabilitation. Our goal is a new class of interactive, user-affectionate clinical devices designed not only for evaluating patients, but also-for delivering meaningful therapy via engaging "video games". Notably, the novel robot MIT-MANUS has been designed and programmed for clinical neurological applications, and has undergone extensive clinical trials for more than four years at Burke Rehabilitation Hospital - White Plains, NY. This paper will review results of the first clinical trial of 20 patients, which showed that: - Stroke patients treated daily with additional robot-aided therapy during acute rehabilitation had improved outcome in motor activity at hospital discharge, when compared to a control group that received only standard acute rehabilitation treatment. - This improved outcome was sustained after three years. - The neuro-recovery process continued far beyond the commonly accepted 3 months post-stroke interval.

Double-Blind Method↗

PubMed2000

[Remote laparoscopic radical prostatectomy carried out with a robot. Report of a case].

Robotics has been commonly employed in numerous industrial fields for several decades. However, the application of this technology to surgery is a recent innovation. It provides new possibilities for facilitating specific surgical tasks, especially in the field of laparoscopy. We report a case of laparoscopic radical prostatectomy completed with the help of a remotely controlled da Vinci robot. This system offered a user friendly surgical platform and enhanced surgical dexterity. Operating time was 420 minutes and the hospital stay was 4 days. The bladder catheter was removed after 3 days. One week later, the patient was fully continent. Pathologic examination showed a pT3a tumor, with negative margins. Robotically assisted laparoscopic radical prostatectomy is feasible. Further developments in this field of technology may have new applications in laparoscopic telesurgery.

Equipment Design↗

PubMed2000

Synthesis of CAD/CAM, robotics and biomaterial implant fabrication: single-step reconstruction in computer-aided frontotemporal bone resection.

The preoperative manufacturing of individual skull implants, developed by an interdisciplinary research group at Ruhr-University Bochum, is based on the use of titanium as the most common material for implants at present. Using the existing technology for materials that can be milled or moulded, customized implants may be manufactured as well. The goal of the study was to examine biodegradable materials and to evaluate the practicability of intraoperative instrument navigation and robotics. Data acquisition of an adult sheep's head was performed with helical computer tomography (CT). The data were transferred onto a computer aided design/computer aided manufacturing system (CAD/CAM system), and two complex defects in the frontotemporal skull were designed. Standard individual titanium implants were milled for both of the defects. Additionally, for one of the defects a resection template, as well as a mould for the biodegradable poly(D,L-lactide) (PDLLA) implant, were fabricated by the CAD/CAM system. A surgeon carried out the first bone resection (#1) for the prefabricated titanium implant using the resection template and an oscillating saw. The robot system Stäubli RX90CR, modified for clinical use, carried out the other resection (#2). Both titanium implants and the PDLLA implant were inserted in their respective defects to compare the precision of their fit. A critical comparison of both implant materials and both resection types shows that fabrication of a PDLLA implant and robot resection are already possible. At present, the titanium implant and resection using a template are more convincing due to the higher precision and practicability.

Absorbable Implants↗

PubMed2000

Robotic-enhanced Dresden technique for minimally invasive bilateral internal mammary artery grafting.

BACKGROUND: The introduction of robotic-enhanced endoscopic instrumentation systems allows the surgeon to perform arterial revascularization for multivessel coronary artery disease without sternotomy. METHODS: From April 1999, 27 patients (6 female, 21 male, median age 63 +/- 8.2 years) suffering from multivessel coronary artery disease were treated surgically using arterial revascularization by means of bilateral internal mammary artery (BIMA) grafting. Both arteries were harvested totally endoscopically using the da Vinci robotic surgical system (Intuitive Surgical, Mountain View, CA). These vessels were anastomosed using the "Dresden Technique" via a left minithoracotomy in the second intercostal space. RESULTS: All patients survived the operation. The mean duration of surgery was 240 +/- 79.4 minutes. Bilateral internal mammary artery harvesting time was 88.5 +/- 15.9 minutes, and cross-clamp time was 38 +/- 10.9 minutes. An average of 2.07 anastomoses were performed per operation. Postoperatively, the patients remained in ICU for 20 +/- 2.4 hours. One patient needed reexploration due to bleeding. CONCLUSIONS: Bilateral internal mammary artery harvesting can be achieved safely with the use of wrist-enhanced instrumentation. The robotic surgical system introduces into surgical practice a new type of treatment of coronary artery disease, helping to perform arterial revascularization with a distinctly reduced surgical trauma.

Aged↗

PubMed2001

[Current status and future of surgical robotic systems].

In this review, we are commenting the current status and the future of surgical robotic systems. AESOP is a voice-controlled laparoscope manipulator that enables the "Solo-surgery". ZEUS is a master-slave manipulator that is characterized by its simplicity and lightness. da Vinci is another master-slave manipulator that has more range of freedom, therefore a surgeon can perform the operation with fewer difficulties. The technological development of high-quality and real-time 3D simulation, minimization of scopes and power saving techniques made these surgical robots realized. Although many pending matters such as lack of safety guideline or lack of accuracy of sensor/monitor have been raised in current surgical robotics, the development of the technologies may promise to resolve such matters in the future.

Forecasting↗

PubMed2001

[Clinical experience in thoracoscopic left internal mammary artery harvesting with voice activated robotic assistance].

Between September 1998 to February 2000, 45 consecutive patients underwent robotic-assisted, video-enhanced coronary artery bypass grafting. All IMA's were harvested using the voice-activated robotic assistant (AESOP 3000, Computer Motion Inc, Santa Barbara, CA) and the Harmonic scalpel (Ethicon Endo-Surgery, Cincinnati, OH). Left IMA's were successfully harvested in all patients. Harvested IMA's were anastomosed to LAD's under direct vision through limited left anterior thoracotomy. The IMA harvest time was 57.8 +/- 23.2 min, intraoperative graft flow was 34.3 +/- 20.5 ml/min, postoperative hospital stay was 3.9 +/- 1.5 days. The early postoperative angiogram showed that all grafts were patent. There was no mortality, no significant morbidity. The robotic assisted, video enhanced CABG provides safe and complete LIMA dissection with minimal manipulation and assures sufficient LITA length for tension free anastomosis.

Adult↗

PubMed2001

The use of robotic technology in the LAST operation.

BACKGROUND: The LAST operation represents a good option for single left anterior descending artery (LAD) revascularization. We report our preliminary experience with the LAST operation performed with the aid of the "da Vinci" Intuitive robotic system. METHODS: From January 2000 to May 2001, 12 patients (11 males and 1 female, mean age 62 +/- 8 years) underwent the LAST operation. All patients had a proximal LAD lesion either not suitable for coronary angioplasty or unsuccessfully treated at coronary angioplasty previously. The mean preoperative ejection fraction was 55 +/- 5%. In all patients, left internal mammary artery (LIMA) harvesting was carried out endoscopically using robotic technology. After heparin administration the LIMA was distally divided to check the adequacy of the blood flow. An incision of about 6 cm was then made in the appropriate intercostal space and the LAD was exposed using a special costal retractor. Following the insertion of a temporary intracoronary shunt, the LIMA was anastomosed to the LAD. RESULTS: No hospital or delayed death occurred. Uneventful conversion to midline sternotomy was necessary in one patient who developed ischemic changes and hemodynamic instability. One patient had a revision for postoperative bleeding. All patients were discharged within the first postoperative week and in 4 of them optimal patency of the LIMA graft was angiographically documented. CONCLUSIONS: The use of robotic technology seems to overcome all the drawbacks associated with the LAST operation and enhances the role of minimally invasive surgery in coronary artery revascularization.

Aged↗

PubMedDate not supplied

[Robotic and systems technology for advanced endoscopic procedures].

The advent of endoscopic techniques changed surgery in many regards. This paper intends to describe an overview about technologies to facilitate endoscopic surgery. The systems described have been developed for the use in general surgery, but an easy application also in other fields of endoscopic surgery seems realistic. The introduction of system technology and robotic technology enables today to design a highly ergonomic solo-surgery platform. This consists of a system of devices for endoscopic surgery (HF, light source, etc...) with which the surgeon interacts directly, positioning systems for optic and instruments that the surgeon drives as the likes without assistance, and a chair to increase the comfort of the surgeon during surgery. The system of endoscopic devices named OREST (Dornier, München) designed already in 1992 opened the way to a number of systems available today that allow to the surgeon a direct control of the instrumentation. A considerable step ahead in endoscopic technology is the introduction of robotic technology to design assisting systems for solo-surgery and microsurgical instrument manipulators. Results of a number of experimental trials on combinations of different positioning devices are presented and commented. A further step in the employment of robotic technology is the design of "master-slave manipulators" to provide the surgeon with additional degrees of freedom of instrumentation. In 1996 a first prototype of an endoscopic manipulator system, named ARTEMIS, designed in cooperation with the Research Center in Karlsruhe, could be used in experimental applications. Clinical use of the system, however, will require further development of the arm mechanics and the control system. The combination with the implementation of telecommunication technology will open new frontiers, such as teleconsulting, teleassistance and telemanipulation.

Endoscopes↗

PubMed1996

Adapting mobile robotic technology to intralaboratory specimen transport.

OBJECTIVE: To evaluate and implement two identical inexpensive robotic vehicles for transport of patient specimens within our clinical laboratory. DESIGN: We accepted delivery of the first two robotic vehicles produced by a local vendor and studied the vehicles for 13 months. The first 4 months of familiarization and customization were followed by 9 months of routine use. SETTING: Within the specimen-processing, hematology, and chemistry sections of a large academic medical center's clinical laboratory, one floor below ground. INTERVENTION: The vehicles replaced 1.5 individuals who transported specimens. OUTCOME MEASURES: The number of kilometers the vehicles traveled and the number of routes begun, completed, not completed, and with unknown status. In addition, we assessed the types of problems that occurred, employee satisfaction, and financial payback. RESULTS: When used on all shifts for 13 months, the vehicles traveled an average of over 2000 routes and 212 km per month. At any one time, at least one vehicle was operational. Of the 17 problems that occurred, the most frequent were navigational problems caused by obstacles, such as personnel, in the vehicle's right-of-way. For 6 of the last 9 months, navigational, mechanical, and electronic problems together occurred no more than two or three times per week. Financial payback for the vehicles occurred in less than one year. CONCLUSIONS: By the end of the study, the robotic vehicles completed 99.4% of their routes. Specimen-processing and transport personnel reported the vehicles made their jobs easier and improved timeliness of specimen delivery. We anticipate our potential savings over 5 years to be approximately $200,000 (US).

Academic Medical Centers↗