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Robotics in child neurosurgery.

We felt there was a need for a new device with "minimal invasive" tracking hardware, to be used in image-guided neurosurgery, and the system we designed to fill this need is now presented. It combines precision of movement, stability and self-positioning capabilities together with optically tracked registration and procedural control within the structure of a surgical microscope. The results are reduced setup time and minimal "distraction" from the procedure itself, factors of special relevance in child neurosurgery. The system is composed of a six-axis industrial robot suitable for use in the operating room, carrying a surgical microscope. Three progressive scan-synchronized infrared cameras mounted around the lenses of the scope are used to register the patient's position and track surgical instruments with reference to the registered space. Orientation of the microscope during surgery is obtained with a six-axis joystick used as a microscope handle. The system has been clinically used in 14 cases, and it has proven itself to be reliable, providing the expected performance advantages. The implementation of a tracked ultrasound or endoscope intraoperative imaging source is also described.

Brain Diseases↗

Modeling of a bipedal robot using mutually coupled Rayleigh oscillators.

The objective of the work presented here was the modeling of a bipedal robot using a central pattern generator (CPG) formed by a set of mutually coupled Rayleigh oscillators. We analyzed a 2D model, with the three most important determinants of gait, that performs only motions parallel to the sagittal plane. Using oscillators with integer relation of frequency, we determined the transient motion and the stable limit cycles of the network formed by the three oscillators, showing the behavior of the knee angles and the hip angle. A comparison of the plotted graphs revealed that the system provided excellent results when compared to experimental analysis. Based on the results of the study, we come to the conclusion that the use of mutually coupled Rayleigh oscillators can represent an excellent method of signal generation, allowing their application for feedback control of a walking machine.

Animals↗

The turn-back-and-look behaviour: bee versus robot.

Honeybees and social wasps departing from a novel food source perform stereotype flight manoeuvres, termed the turn-back-and-look behaviour (TBL). Based on results of behavioural studies, it is proposed that the image motion generated by the TBL provides the insect with information about the three-dimensional structure of the goal's surroundings, thus enabling it to select reliable landmarks that will guide it to the goal upon return. The colour, shape, and size of landmarks, on the other hand, are learned mainly during arrival at the food source. However, when bees are prevented from learning these cues on arrival, they learn them during the TBL, despite the fact that this performance does not require the use of image motion. A recently developed model shows that landmark learning can indeed be accomplished during the TBL by exploiting cues others than image motion. A mobile robot equipped with the appropriate software selects, during the TBL, reliable marks and returns to the site of departure from different locations by accomplishing image matching along a two-dimensional vector field.

Animals↗

Disruptive visions: a robot is not a machine...systems integration for surgeons.

The discipline of surgery has become even more complex with the rapid introduction of revolutionary technologies. Laparoscopic surgery is just the simplest and first of these new directions. Robotic surgery and image-guided therapy are the next generation. As biosurgery and other modalities are introduced, the complexity will increase exponentially. In order to understand and utilize the new technologies, surgeons need to be grounded in the science of systems integration. The pervasive influence of this new requirement, as well as the skills, education, training, and assessment needs, are defined.

Attitude of Health Personnel↗

Robotic-assisted thoracoscopic resection of esophageal leiomyoma.

Esophageal leiomyoma represents 70-80% of all benign esophageal tumors but only approximately 0.5% of all esophageal neoplasms; optimal surgical treatment consists of local resection. We present the first reported robotic-assisted thoracoscopic resection of two patients with esophageal leiomyoma using the daVinci Surgical System. Operative technique and technical considerations are presented.

Aged↗

Prolonged intraperitoneal versus extraperitoneal insufflation of carbon dioxide in patients undergoing totally endoscopic robot-assisted radical prostatectomy.

BACKGROUND: Extraperitoneal laparoscopic prostatectomy is an alternative to the intraperitoneal method. However, the effects of extraperitoneal carbon dioxide (CO2) insufflation on hemodynamics and respiratory data have not been adequately studied. This study compared the effects of prolonged intra- and extraperitoneal CO2 insufflation on hemodynamics and gas exchange. METHODS: For this study, 20 patients were assigned to receive totally endoscopic robot-assisted radical prostatectomy (TERP) via the intra- or extraperitoneal approach. Hemodynamic parameters and respiratory data were obtained during 8 h of insufflation and analyzed for statistical differences. RESULTS: With both insufflation methods, arterial CO2 pressure increased rapidly, reaching higher levels with extraperitoneal insufflation. Therefore, patients managed with extraperitoneal insufflation required a significantly higher minute ventilation. Heart rate and central venous pressure increased in both groups, whereas mean arterial blood pressure and pH decreased. CONCLUSIONS: Prolonged intra- and extraperitoneal CO2 insufflation for TERP resulted in significant, but mostly clinically unimportant, hemodynamic alterations. Carbon dioxide absorption was more pronounced with extraperitoneal insufflation.

Aged↗

Endoscopic robot-assisted extended thymectomy by subxiphoid approach with sternal lifting: feasibility in the pig.

BACKGROUND: In the search for novel approaches to thoracoscopic thymectomy we assessed the feasibility of a subxiphoid approach using computer-enhanced instruments and sternal lifting. METHODS: In 12 pigs, after lifting of the sternum, ports were placed subxiphoid (stereoscope) and in the left and right fourth intercostal space (instruments). Using computer-enhanced instruments, dissection of the thymus and anterior mediastinal fat pads was started at the diaphragm and continued cephalad. RESULTS: After setup of the robot system (23 +/- 6 min, mean +/- SD), the thymus, including both superior horns, and fat pads in the anterior mediastinum and cardiophrenic angles were dissected (109 +/- 23 min), with excellent view of the phrenic nerves. Visual inspection after sternotomy after the procedure showed all thymic and fatty tissue was removed. CONCLUSIONS: In the pig, endoscopic extended thymectomy can be safely performed by subxiphoid access using computer-enhanced instruments, sternal lifting, and three ports total.

Animals↗

Wireless capsule endoscopy: from diagnostic devices to multipurpose robotic systems.

In the recent past, the introduction of miniaturised image sensors with low power consumption, based on complementary metal oxide semiconductor (CMOS) technology, has allowed the realisation of an ingestible wireless capsule for the visualisation of the small intestine mucosa. The device has received approval from Food and Drug Administration and has gained momentum since it has been more successful than traditional techniques in the diagnosis of small intestine disorders. In 2004 an esophagus specific capsule was launched, while a solution for colon is still under development. However, present solutions suffer from several limitations: they move passively by exploiting peristalsis, are not able to stop intentionally for a prolonged diagnosis, they receive power from an internal battery with short length, and their usage is restricted to one organ, either small bowel or esophagus. However the steady progresses in many branches of engineering, including microelectromechanical systems (MEMS), are envisaged to affect the performances of capsular endoscopy. The near future foreshadows capsules able to pass actively through the whole gastrointestinal tract, to retrieve views from all organs and to perform drug delivery and tissue sampling. In the long term, the advent of robotics could lead to autonomous medical platforms, equipped with the most advanced solutions in terms of MEMS for therapy and diagnosis of the digestive tract. In this review, we discuss the state of the art of wireless capsule endoscopy (WCE): after a description on the current status, we present the most promising solutions.

Capsule Endoscopes↗

Methods and results for semi-automated cloning using integrated robotics.

The Joint Center for Structural Genomics (JCSG) has emphasized automation and parallel processing approaches. Here, we describe automated methods used across the cloning process with results from JCSG projects. The protocols for PCR, restriction digests and ligations, as well as for gel electrophoresis and microtiter plate assays have all been automated. The system has the capacity to routinely process 384 clones a week. This throughput can adequately supply our expression and purification pipeline with expression-ready clones, including novel targets and truncations. The utility of our system is demonstrated by our results from three diverse projects. In summary, 94% of the PCR amplicons generated to date have been successfully cloned and verified by sequencing (83% of the total attempted targets). Our results demonstrate the capabilities of this robotic platform to provide an avenue to high-throughput cloning which requires little manpower and is rapid and cost-effective while providing insights for method optimization.

Cloning, Molecular↗

In vivo robotic capsules: determination of the number of turns of its power receiving coil.

This paper introduces a strategy how to determine the number of turns of the receiving coil for in vivo robotic capsules to maximize the regulated load power. For the expected functionality additional to the endoscopic function, it is necessary to employ wireless power transmission and increase the receiving power to a maximum. The functional relation between the number of turns and the power is derived and verified by implementing a ferrite-loaded receiver coil.

Capsule Endoscopes↗

Robotic pyeloplasty.

In addition to the classic open surgery, a variety of minimally invasive therapeutic options have been developed for the treatment of ureteropelvic junction obstruction, including an endoscopic antegrade or retrograde ureteropelvic junction obstruction visually controlled incision or radioscopically controlled Acucise (Applied Medical, Laguna Hills, CA), which does not share the high success rate that results from open-surgical dismembered pyeloplasty. Laparoscopic pyeloplasty, which duplicates the open technique and differs only by the mode of access, has proven to have positive results when performed by experts, but remains a demanding technique that requires a long learning curve. Providing a three-dimensional vision, an unprecedented control of the endocorporeal instruments, and an ergonomic surgeon's position, robots may allow urologists with limited laparoscopic experience to rapidly master the endocorporeal management of ureteropelvic junction obstruction. They likely will propel minimally invasive urology forward in the next several years.

Humans↗

Automated sequential trace enrichment of dialysates and robotics. A technique for the preparation of biological samples prior to high-performance liquid chromatography.

The development of the sample preparation process, the automated sequential trace enrichment of dialysates, in association with a cartesian robotic sampler is described. The system has been applied to the total automation of the preparation of biological samples and high-performance liquid chromatographic analysis. Concepts of the technique are reported together with an examination of its application to free and total analyte estimation. Examples of chromatographic separations obtained from the preparation of a variety of different analytes and sample materials are given.

Amino Acids↗

The Space Station Freedom Flight Telerobotic Servicer: the design and evolution of a dexterous space robot.

The Flight Telerobotic Servicer (FTS) Project at the Goddard Space Flight Center is developing an advanced telerobotic system to assist in and reduce crew extravehicular activity (EVA) for Space Station) Freedom (SSF). The FTS will provide a telerobotic capability to the Freedom Station in the early assembly phases of the program and will be employed for assembly, maintenance, and inspection applications throughout the lifetime of the space station. Appropriately configured elements of the FTS will also be employed for robotic manipulation in remote satellite servicing applications and possibly the Lunar/Mars Program. In mid-1989, the FTS entered the flight system design and implementation phase (Phase C/D) of development with the signing of the FTS prime contract with Martin Marietta Astronautics Group in Denver, Colorado. The basic FTS design is now established and can be reported on in some detail. This paper will describe the FTS flight system design and the rationale for the specific design approaches and component selections. The current state of space technology and the nature of the FTS task dictate that the FTS be designed with sophisticated teleoperation capabilities for its initial primary operating mode. However, there are technologies, such as advanced computer vision and autonomous planning techniques currently in research and advanced development phases which would greatly enhance the FTS capabilities to perform autonomously in less structured work environments. Therefore, a specific requirement on the initial FTS design is that it has the capability to evolve as new technology becomes available. This paper will describe the FTS design approach for evolution to more autonomous capabilities. Some specific task applications of the FTS and partial automation approaches of these tasks will also be discussed in this paper.

Biomechanical Phenomena↗

Development of a robot arm and workstation for the disabled.

A robotic workstation for the severely physically disabled is being developed. The prototype system consists of a commercially available arm mounted in a workstation set up for various manipulative tasks. This system has been tested with eight disabled users in a hospital situation and is to undergo evaluation in the homes of disabled users. Based on experience with this system, a new arm has been designed and will be built into a redesigned workstation.

Computer Systems↗

High-performance liquid chromatographic method for the determination of nefazodone and its metabolites in human plasma using laboratory robotics.

A quantitative analytical method, using high-performance liquid chromatography and ultraviolet detection, has been established for the determination of nefazodone (NEF) and its metabolites, m-chlorophenylpiperazine (mCPP),p-hydroxynefazodone (PHN), and hydroxynefazodone (HO-NEF), in human plasma. The fully automated, robotic procedure consisted of addition of internal standard (aprindine), extraction with butyl chloride, followed by phase separation, organic phase evaporation, reconstitution of the residue, and injection onto the chromatographic system. The limits of detection for NEF, mCPP, PHN, and HO-NEF were 5, 1, 10, and 5 ng/ml, respectively, at a signal-to-noise ratio of 4. The method had a linear range of 10-1000 ng/ml for NEF and HO-NEF, 20-2000 ng/ml for PHN, and 2.5-250 ng/ml for mCPP. Correlation coefficients of 0.996 or greater were obtained during validation and study sample analysis.

Adolescent↗

Chromatography in DNA radiolabeling: hands-off automation using a robotic workstation.

The experiments described in the present paper were performed in order to determine whether the Biomek-1000 (Beckman Instruments, Fullerton, CA, USA) automated laboratory workstation can be used in a fully automated DNA labeling method followed by automated gravity-driven size exclusion purification of molecular probes. To this aim, we performed random oligodeoxyribonucleotide priming of a HIV-1 LTR probe that was used for molecular hybridization to Southern blotted polymerase chain reaction products. The results obtained demonstrate that the automatically labeled probe can be efficiently purified by automated and gravity-driven Sephadex G-50 chromatography, without any major changes in hybridization property. This robotic methodology can be used in several procedures employing radioisotope labeling.

Base Sequence↗

Manual and automated (robotic) high-performance liquid chromatography methods for the determination of mycophenolic acid and its glucuronide conjugate in human plasma.

A manual and an automated (Zymark PyTechnology robot) HPLC method for simultaneous determination of plasma mycophenolic acid (MPA) and its glucuronide conjugate (MPAG) are described here. Both methods are reproducible and accurate, and both are equivalent in all respects, including quantification limits (MPA, 0.100 microgram/ml; MPAG, 4.00 micrograms/ml), range (using 0.05-0.5 ml of plasma: MPA, 0.0500-20.0 micrograms/aliquot; MPAG, 2.00-200 micrograms/aliquot), precision, and accuracy. MPA and MPAG were stable under the conditions used with both methods. Results from aliquots of paired control samples, analyzed by the manual method over three years at six analytical laboratories, showed excellent agreement in precision and accuracy.

Chromatography, High Pressure Liquid↗

Determination of alosetron in human plasma or serum by high-performance liquid chromatography with robotic sample preparation.

A method of analysis for the determination of alosetron in human plasma or serum has been developed. The method was fully automated using a laboratory robot in order to improve analytical precision, efficiency and safety. The assay involved solid-phase extraction with reversed-phase HPLC separation and fluorescence detection. A validation exercise over the concentration range of 0.1 to 20 ng/ml demonstrated the selectivity, linearity, sensitivity, accuracy, precision, extraction efficiency, ruggedness and stability of the method. The method has been applied in support of numerous human pharmacokinetic/biopharmaceutic studies over the last five years.

Carbolines↗