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At least 1,279 records · Page 71Linked to original sources

PubMed2006

Evaluation of an intuitive writing interface in robot-aided laser laparoscopic surgery.

OBJECTIVE: The feasibility of the conceptual Intuitive Writing Interface (IWI) in robot-aided laser laparoscopic surgery has been demonstrated previously. This paper investigates the potential improvement of IWI by comparing conventional manipulation (CM) and IWI manipulation (IM) and conducting an animal experiment. MATERIALS AND METHODS: Three tasks were designed that were considered to be representative of laser laparoscopic surgical procedures. All test participants used both CM and IM in all tasks. Completion time and error level of each task were taken as comparative indices and were integrated into a self-defined Index of Time and Error (ITE). Six sequential in vitro trials were carried out to investigate learning curves. In addition, nephrectomy was performed on a rabbit by employing IWI in robot-aided laser laparoscopic surgery. RESULTS: The results showed significant advantages for IM, with shorter completion time, more successful shots, and smaller error length in the three tasks, as compared to CM. The learning curve showed a promising trend for IM. More than half of the participants performed better with IM. The animal model experiment demonstrated the clinical feasibility of IM, but at the same time revealed some limitations. CONCLUSIONS: The new IWI interface definitely improved laser laparoscopic procedures by taking advantage of familiar writing skills. With its flexibility of implementation and ease of use, IWI has clear potential for use in laser laparoscopic procedures.

Animals↗

PubMed2006

Image-guided system with miniature robot for precise positioning and targeting in keyhole neurosurgery.

This paper describes a novel image-guided system for precise automatic targeting in minimally invasive keyhole neurosurgery. The system consists of the MARS miniature robot fitted with a mechanical guide for needle, probe or catheter insertion. Intraoperatively, the robot is directly affixed to a head clamp or to the patient's skull. It automatically positions itself with respect to predefined targets in a preoperative CT/MRI image following an anatomical registration with an intraoperative 3D surface scan of the patient's facial features and registration jig. We present the system architecture, surgical protocol, custom hardware (targeting and registration jig), and software modules (preoperative planning, intraoperative execution, 3D surface scan processing, and three-way registration). We also describe a prototype implementation of the system and in vitro registration experiments. Our results indicate a system-wide target registration error of 1.7 mm (standard deviation = 0.7 mm), which is close to the required 1.0-1.5 mm clinical accuracy in many keyhole neurosurgical procedures.

Magnetic Resonance Imaging↗

PubMed2006

Febotics - a marriage of fetal surgery and robotics.

For a fetus diagnosed with a severe congenital anomaly, surgery may offer an alternative to abortion, intra-uterine death, or a life with disability. Expertise is limited however, to a few treatment centers worldwide, and there are many technical hurdles to overcome, including requirements for miniaturized instrumentation, real-time high-resolution imaging, and harmless fetal access. This article highlights recent practices in prenatal intervention and various initiatives to integrate robotics into the fetal operating room. While the number of potential patients is low, research for implementation of robotics in the field of fetal surgery is justified by the morbidity rates of current procedures, proven favorable outcomes with intervention, and the educational value with potential for extension to other medical disciplines.

Animals↗

PubMed2006

Towards robotized beating heart TECABG: assessment of the heart dynamics using high-speed vision.

Active robotic filtering is probably the solution for beating heart Totally Endoscopic Coronary Artery Bypass Grafting (TECABG). In this work, we assess the heart motion dynamics by simultaneous use of high-speed imaging of optical markers attached to the heart, ECG signals and ventilator airflow acquisitions. Our goal is to assess the heart motions (shape, velocity, acceleration) in order to be able to make more accurate specifications for a novel, dedicated robot that could follow these motions in real time. Furthermore, using two additional inputs (ECG and airflow), we propose a novel robust prediction algorithm that could be used with a predictive control algorithm to improve the tracking accuracy.

Algorithms↗

PubMed2006

Gaze-contingent control for minimally invasive robotic surgery.

OBJECTIVE: Recovering tissue depth and deformation during robotically assisted minimally invasive procedures is an important step towards motion compensation, stabilization and co-registration with preoperative data. This work demonstrates that eye gaze derived from binocular eye tracking can be effectively used to recover 3D motion and deformation of the soft tissue. METHODS: A binocular eye-tracking device was integrated into the stereoscopic surgical console. After calibration, the 3D fixation point of the participating subjects could be accurately resolved in real time. A CT-scanned phantom heart model was used to demonstrate the accuracy of gaze-contingent depth extraction and motion stabilization of the soft tissue. The dynamic response of the oculomotor system was assessed with the proposed framework by using autoregressive modeling techniques. In vivo data were also used to perform gaze-contingent decoupling of cardiac and respiratory motion. RESULTS: Depth reconstruction, deformation tracking, and motion stabilization of the soft tissue were possible with binocular eye tracking. The dynamic response of the oculomotor system was able to cope with frequencies likely to occur under most routine minimally invasive surgical operations. CONCLUSION: The proposed framework presents a novel approach towards the tight integration of a human and a surgical robot where interaction in response to sensing is required to be under the control of the operating surgeon.

Algorithms↗

PubMed2002

Investing in a robotic milking system: a Monte Carlo simulation analysis.

This paper uses Monte Carlo simulation methods to estimate the breakeven value for a robotic milking system (RMS) on a dairy farm in the United States. The breakeven value indicates the maximum amount that could be paid for the robots given the costs of alternative milking equipment and other important factors (e.g., milk yields, prices, length of useful life of technologies). The analysis simulates several scenarios under three herd sizes, 60, 120, and 180 cows. The base-case results indicate that the mean breakeven values are $192,056, $374,538, and $553,671 for each of the three progressively larger herd sizes. These must be compared to the per-unit RMS cost (about $125,000 to $150,000) and the cost of any construction or installation of other equipment that accompanies the RMS. Sensitivity analysis shows that each additional dollar spent on milking labor in the parlor increases the breakeven value by $4.10 to $4.30. Each dollar increase in parlor costs increases the breakeven value by $0.45 to $0.56. Also, each additional kilogram of initial milk production (under a 2x system in the parlor) decreases the breakeven by $9.91 to $10.64. Finally, each additional year of useful life for the RMS increases the per-unit breakeven by about $16,000 while increasing the life of the parlor by 1 yr decreases the breakeven value by between $5,000 and $6,000.

Animals↗

PubMed2006

On the design of robotic hands for brain-machine interface.

Brain-machine interface (BMI) is the latest solution to a lack of control for paralyzed or prosthetic limbs. In this paper the authors focus on the design of anatomical robotic hands that use BMI as a critical intervention in restorative neurosurgery and they justify the requirement for lower-level neuromusculoskeletal details (relating to biomechanics, muscles, peripheral nerves, and some aspects of the spinal cord) in both mechanical and control systems. A person uses his or her hands for intimate contact and dexterous interactions with objects that require the user to control not only the finger endpoint locations but also the forces and the stiffness of the fingers. To recreate all of these human properties in a robotic hand, the most direct and perhaps the optimal approach is to duplicate the anatomical musculoskeletal structure. When a prosthetic hand is anatomically correct, the input to the device can come from the same neural signals that used to arrive at the muscles in the original hand. The more similar the mechanical structure of a prosthetic hand is to a human hand, the less learning time is required for the user to recreate dexterous behavior. In addition, removing some of the nonlinearity from the relationship between the cortical signals and the finger movements into the peripheral controls and hardware vastly simplifies the needed BMI algorithms. (Nonlinearity refers to a system of equations in which effects are not proportional to their causes. Such a system could be difficult or impossible to model.) Finally, if a prosthetic hand can be built so that it is anatomically correct, subcomponents could be integrated back into remaining portions of the user's hand at any transitional locations. In the near future, anatomically correct prosthetic hands could be used in restorative neurosurgery to satisfy the user's needs for both aesthetics and ease of control while also providing the highest possible degree of dexterity.

Brain↗

PubMed2005

Robotic-assisted laparoscopic resection of ectopic pancreas in the posterior wall of gastric high body: case report and review of the literature.

Minimally invasive surgery has revolutionized the treatment of gastrointestinal tumors. Submucosal tumors of the stomach can be resected using laparoscopic techniques. We report here a case of ectopic pancreas tissue in the gastric wall that was removed using robotic-assisted laparoscopic resection. The patient was a 15-year-old female who presented with abdominal discomfort and tarry stools. Laboratory analysis showed iron deficiency anemia. Preoperative endoscopy revealed a submucosal lesion in the posterior wall of the gastric high body. Intraoperative upper endoscopy clearly located the lesion. A robotic-assisted laparoscopic wedge resection of the putative gastric submucosal tumor was performed. The pathology results showed an ectopic pancreas. The patient had an uneventful recovery and we believe that this is a valid treatment option for this benign condition.

Adolescent↗

PubMedDate not supplied

Courier robot keeps hospital staff 'on the job'.

A courier robot at Abington Memorial Hospital has allowed the hospital to maintain high standards of patient care in the face of budget constraints. The robot handles after-hours deliveries of meals and supplies efficiently and cost-effectively, thus freeing support staff to focus on other tasks.

Communication↗

PubMed1997

The use of a robotic device for gait training and rehabilitation.

This study was aimed at investigating normal subjects walking with support using a robotic device (REHABOT) intended for gait training and rehabilitation of physically disabled individuals. Ground reaction forces, knee joint kinematics, temporal factors of gait, and oxygen cost were measured on fourteen healthy subjects. The apparatus was to support 0%, 20%, 40% and 60% of each subject's body weight through an upper torso harness connected to the robotic device. Each subject was then asked to walk on a 10 meter circular pathway. Temporal factors of gait, ground reaction forces and knee kinematic measurements showed little change from 0% to 40%, but a significant alteration in these gait parameters was noticed when 60% of the subject's body weight was supported. Oxygen cost decreased significantly (P < 0.05) from 0% to 40%, but increased at 60%. These results suggest that body weight support up to 40% reduces energy demands without significantly altering gait patterns. Consequently the REHABOT can be considered as a gait training device for patients with weight-bearing difficulties. This apparatus may also be used as an exercise machine for certain patients who cannot walk un-assisted.

Adult↗

PubMedDate not supplied

Impact on human resources: Core Laboratory versus laboratory information system versus modular robotics.

Technological advances in laboratory systems have had a great impact on human resources. Surviving the changes requires an in-depth understanding of the technology to implement the appropriate operational model. St. Mary's is a 414-bed, acute care hospital. For 18 months, the laboratories went through the process of moving from a noncomputerized traditional model laboratory (i.e., by discipline) to a fully computerized Core Lab. The Core Lab concept fully integrates biochemistry, hematology, blood bank, and microbiology into two sections (not physically separated): tests processed by automation and tests processed manually. This approach led to a 15% reduction in staff while the volume doubled. The transitions occurred sequentially: from traditional laboratory to Core Lab (noncomputerized), from manual Core Lab to fully computerized Core Lab, and ultimately from a simulation of manual preanalytical phase to automated preanalytical phase (modular robotics). The findings show that Core Lab and computerization have almost the same impact on human resources, 35% and 30% respectively, and modular robotics the least impact with 17%.

Clinical Laboratory Information Systems↗

PubMedDate not supplied

Robotics, automation, and the new role of process control.

The natural progression of automation in the clinical laboratory next will lead to robotic devices to perform many of the manual tasks still remaining. To date, most efforts of laboratory automation have been directed at the analytic phase. New targets for automation will be at the preanalytic and postanalytic phases where many of the bottlenecks in specimen flow now occur in highly repetitive manual tasks. Laboratory professionals will have a unique opportunity to incorporate new concepts of robotics in their facilities to improve error rates and to use massive laboratory databases to improve medical and public health services.

Autoanalysis↗

PubMed1999

[Informatics, robotics and medicine].

Information technology is becoming common use in Medicine. Among the numerous applications are data processing, image analysis, 3D reconstruction, telemedicine, to mention only few of them. The interest of computers in surgical research and development is lesser known. Two examples are given: computer aided conception and simulation of physiologic systems. Robotics has been introduced more recently. There are three types of robotics corresponding to three types of use: targetting used by neural surgeons to localize tumors or anatomical structures, visualization used by general surgeons to hold and mobilize laparoscopes, instrumentation introduced more recently by cardiac surgeons to perform totally endoscopic cardiac operations. All these techniques open new ways for tomorrow "Instrumental Medicine".

Image Processing, Computer-Assisted↗

PubMed2000

[Image guided and robotic treatment--the advance of cybernetics in clinical medicine].

The introduction of advanced technology in hospitals has changed the treatment practice towards more image guided and minimal invasive procedures. Modern computer and communication technology opens up for robot aided and pre-programmed intervention. Several robotic systems are in clinical use today both in microsurgery and in major cardiac and orthopedic operations. As this trend develops, professions which are new in this context such as physicists, mathematicians and cybernetic engineers will be increasingly important in the treatment of patients.

Cybernetics↗

PubMedDate not supplied

Modular robotic assembly of small devices.

The use of robots for the automatic assembly of devices of up to 100 x 100 x 100 mm is relatively uncommon today. Insufficient return on investment and the long lead times that are required have been limiting factors. Innovations in vision technology have led to the development of robotic assembly systems that employ flexible part-feeding. The benefits of these systems are described, which suggest that better ratios of price to productivity and deployment times are now achievable.

Equipment Design↗

PubMed2000

[Thoracoscopic major lung resection using a newly developed instrument retraction system and a voice-controlled robot].

We report a case of thoracoscopic major lung resection using a newly-developed instrument retraction system and a voice-controlled robot for lung cancer in a 72-year-old woman. The patient was referred to our department for further examination of an abnormal shadow on chest x-ray. A chest computed tomographic scan indicated a suspicion of malignancy. Bronchoscopic brush cytology revealed a lung cancer. Thoracoscopic middle lobectomy of the right lung with dissection of the mediastinal lymphnodes was successfully performed without a human assistance with no complications. The postoperative course was uneventful. Thoracoscopic major lung resection using an instrument retraction system and a voice-controlled robot may be feasible in selected cases.

Adenocarcinoma↗

PubMed2000

3-D image guidance for minimally invasive robotic coronary artery bypass.

BACKGROUND: The introduction of a robot-assisted microsurgical system has made endoscopic coronary artery bypass grafting (ECABG) possible. Despite the success of this approach, surgeons still require better visualization tools for pre-surgical planning and intra-operative image guidance. Such visualization tools could, for example, assist in the placement of thoracic ports to acquire optimum access to the target vessels. In this paper we discuss the essential steps toward image-guided completely endoscopic coronary bypass surgery with robot assistance, and we present our preliminary efforts toward the development of a three-dimensional (3-D) virtual cardiac surgical planning platform (VCSP) for ECABG. METHODS: Preoperative 3-D images of the thorax acquired with computed tomography and electrocardiogram-gated magnetic resonance imaging are imported into VCSP. Using VCSP, a user may interactively visualize and manipulate the simulated thoracic ports in 3-D within the reconstructed thoracic region. We have also implemented a virtual endoscope to simulate the endoscopic view observed by the surgeon during the operation. Once the port placements for optimal access to the target vessels are determined, the positions of the simulated tools can be recorded and marked on the patient to specify the positions for port incisions. RESULTS: A static thorax phantom was used to verify the port placements obtained from VCSP simulations. The angles and the distances between the ports, the endoscope and the markers that were placed on the surface of the phantom were measured, and the results were compared with those obtained from simulation. The physical measured distances and angles agreed with the simulated results with average errors of 4 mm and 2 degrees, respectively. CONCLUSIONS: The VCSP image-guided surgical system allows a surgeon to visualize a patient's thorax in a 3-D interactive environment for planning surgical procedures, and to determine the optimum port placement based on preoperative 3-D images. However, during an operation, the positions and orientation of the heart and the coronary arteries are changed from their corresponding locations in the preoperative images due to carbon-dioxide insufflation, lung deflation, and dynamic motions of the beating heart. One of our future goals of this project is the use of mathematical models that correct for these changes so that our system could be applied to intra-operative image guidance.

Adult↗

PubMed1999

Simulation of the primate motor cortex and free arm movements in three-dimensional space: a robot arm system controlled by an artificial neural network.

It has been recently discovered that neuronal activity in the primate motor cortex varies in an orderly fashion with the direction of movement of behaving monkeys in three-dimensional (3-D) space. Furthermore, cell activity is highest in a certain direction, the cell's preferred direction, and decreases progressively in other directions. For a particular movement direction, each cell makes a contribution in the direction of its preferred direction to yield a neuronal population vector that points in the direction of movement well before the movement begins. Simulation of motor cortical activity is useful with a randomly selected Poisson distribution. Poisson spike trains are used as input to an artificial neural network (ANN) that produces motor actions in the form of a Cartesian coordinate to a PUMA robotic arm system. The ANN consists of a three-layered feed-forward system that uses a specific cosine algorithm as synaptic weights between the interconnected units described in the angle between the preferred direction vector of the neuron and the movement vector. The robot responds to commands, generating actual trajectories in close agreement with desired trajectories. It is shown that the time-varying motor output is controlled by the impulse activity with a good estimate of the direction of movement with 100-150 cells.

Animals↗