Background
Autonomous control of surgical robotic platforms may offer enhancements such as higher precision, intelligent manoeuvres, tissue-damage avoidance, etc. Autonomous robotic systems in surgery are largely at the experimental level. However, they have also reached clinical application.

Methods
A literature review pertaining to commercial medical systems which incorporate autonomous and semi-autonomous features, as well as experimental work involving automation of various surgical procedures, is presented. Results are drawn from major databases, excluding papers not experimentally implemented on real robots.

Results
Our search yielded several experimental and clinical applications, describing progress in autonomous surgical manoeuvres, ultrasound guidance, optical coherence tomography guidance, cochlear implantation, motion compensation, orthopaedic, neurological and radiosurgery robots.

Conclusion
Autonomous and semi-autonomous systems are beginning to emerge in various interventions, automating important steps of the operation. These systems are expected to become standard modality and revolutionize the face of surgery. Copyright © 2011 John Wiley & Sons, Ltd.

Evolution of autonomous and semi-autonomous robotic surgical systems: a review of the literature

https://shura.shu.ac.uk/7180/1/Rodriggues_%2D_optical_techniques_%2D_Review_MIA_revision_v9.pdf

Optical techniques for 3D surface reconstruction in computer-assisted laparoscopic surgery.

Minimally invasive surgery (MIS) challenges the surgeon’s skills due to his separation from the operation area which can only be reached with long instruments. To overcome these drawbacks, minimally invasive robotic surgery (MIRS) plays an important role. This paper describes the development of actuated and sensorized instruments for minimally invasive robotic surgery which help to increase the surgeon’s immersion and dexterity.

/pdf/prototype-of-instrument-for-minimally-invasive-surgery-with-4i3pmfmw9j.pdf

Prototype of Instrument for Minimally Invasive Surgery with 6-Axis Force Sensing Capability

Research on surgical robotics demands systems for evaluating scientific approaches. Such systems can be divided into dedicated and versatile systems. Dedicated systems are designed for a single surgical task or technique, whereas versatile systems are designed to be expandable and useful in multiple surgical applications. Versatile systems are often based on industrial robots, though, and because of this, are hardly suitable for close contact with humans. To achieve a high degree of versatility the Miro robotic surgery platform (MRSP) consists of versatile components, dedicated front–ends towards surgery and configurable interfaces for the surgeon. This paper presents MiroSurge, a configuration of the MRSP that allows for bimanual endoscopic telesurgery with force feedback. While the components of the MiroSurge system are shown to fulfil the rigid design requirements for robotic telesurgery with force feedback, the system remains versatile, which is supposed to be a key issue for the further development and optimisation.

https://elib.dlr.de/76868/1/IJCARS_2009_JournalPaper_Hagn_CameraReady.pdf

DLR MiroSurge: a versatile system for research in endoscopic telesurgery.

Despite rapid developments in the research areas of medical imaging, medical image processing, and robotics, the use of computer assistance in surgical routine is still limited to diagnostics, surgical planning, and interventions on mostly rigid structures. In order to establish a computer-aided workflow from diagnosis to surgical treatment and follow-up, several proposals for computer-assisted soft tissue interventions have been made in recent years. By means of different pre- and intraoperative information sources, such as surgical planning, intraoperative imaging, and tracking devices, surgical navigation systems aim to support surgeons in localizing anatomical targets, observing critical structures, and sparing healthy tissue. Current research in particular addresses the problem of organ shift and tissue deformation, and obstacles in communication between navigation system and surgeon. In this paper, we review computer-assisted navigation systems for soft tissue surgery. We concentrate on approaches that can be applied in endoscopic thoracic and abdominal surgery, because endoscopic surgery has special needs for image guidance due to limitations in perception. Furthermore, this paper informs the reader about new trends and technologies in the area of computer-assisted surgery. Finally, a balancing of the key challenges and possible benefits of endoscopic navigation refines the perspectives of this increasingly important discipline of computer-aided medical procedures.

/pdf/navigation-in-endoscopic-soft-tissue-surgery-perspectives-9203nyb179.pdf

Navigation in endoscopic soft tissue surgery: perspectives and limitations.

Minimally invasive beating-heart surgery offers substantial benefits for the patient, compared to conventional open surgery. Nevertheless, the motion of the heart poses increased requirements to the surgeon. To support the surgeon, algorithms for an advanced robotic surgery system are proposed, which offer motion compensation of the beating heart. This implies the measurement of heart motion, which can be achieved by tracking natural landmarks. In most cases, the investigated affine tracking scheme can be reduced to an efficient block matching algorithm allowing for realtime tracking of multiple landmarks. Fourier analysis of the motion parameters shows two dominant peaks, which correspond to the heart and respiration rates of the patient. The robustness in case of disturbance or occlusion can be improved by specially developed prediction schemes. Local prediction is well suited for the detection of single tracking outliers. A global prediction scheme takes several landmarks into account simultaneously and is able to bridge longer disturbances. As the heart motion is strongly correlated with the patient's electrocardiogram and respiration pressure signal, this information is included in a novel robust multisensor prediction scheme. Prediction results are compared to those of an artificial neural network and of a linear prediction approach, which shows the superior performance of the proposed algorithms.

D.H. Boehm

Papers

Motion estimation in beating heart surgery

Autonomy and Haptic Feedback in Minimally Invasive Robotic Surgery