This paper provides a broad overview of medical robot systems used in surgery. After introducing basic concepts of computer-integrated surgery, surgical CAD/CAM, and surgical assistants, it discusses some of the major design issues particular to medical robots. It then illustrates these issues and the broader themes introduced earlier with examples of current surgical CAD/CAM and surgical assistant systems. Finally, it provides a brief synopsis of current research challenges and closes with a few thoughts on the research/industry/clinician teamwork that is essential for progress in the field.

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Medical robotics in computer-integrated surgery

The present invention provides a system and single or multi-functional element device that can be inserted and temporarily placed or implanted into a structure having a lumen or hollow space, such as a subject's abdominal cavity to provide therewith access to the site of interest in connection with minimally invasive surgical procedures. The insertable device may be configured such that the functional elements have various degrees of freedom of movement with respect to orienting the functional elements or elements to provide access to the site from multiple and different orientations/perspectives as the procedure dictates, e.g., to provide multiple selectable views of the site, and may provide a stereoscopic view of the site of interest.

Insertable device and system for minimal access procedure

Surgical methods and devices allow closed-chest surgery to be performed on a heart of a patient while the heart is beating. A region of the heart is stabilized by engaging a surface of the heart with a stabilizer without having to stop the heart. Motion of the target tissues is inhibited sufficiently to treat the target tissues with robotic surgical tools which move in response to inputs of a robotic system operator. A stabilizing surface of the stabilizer is coupled to a drive system to position the surface from outside the patient, preferably by actuators of the robotic servomechanism. Exemplary stabilizers includes a suture or other flexible tension member spanning between a pair of jointed bodies, allowing the member to occlude a coronary blood vessel and/or help stabilize the target region between the stabilizing surfaces.

Stabilizer for robotic beating-heart surgery

In one embodiment of the invention, a method for a robotic system is disclosed to track one or more robotic instruments. The method includes generating kinematics information for the robotic instrument within a field of view of a camera; capturing image information in the field of view of the camera; and adaptively fusing the kinematics information and the image information together to determine pose information of the robotic instrument. Additionally disclosed is a robotic medical system with a tool tracking sub-system. The tool tracking sub-system receives raw kinematics information and video image information of the robotic instrument to generate corrected kinematics information for the robotic instrument by adaptively fusing the raw kinematics information and the video image information together.

Methods and systems for robotic instrument tool tracking with adaptive fusion of kinematics information and image information

Haptic perception plays a very important role in surgery. It enables the surgeon to feel organic tissue hardness, measure tissue properties, evaluate anatomical structures, and allows him/her to commit appropriate force control actions for safe tissue manipulation. However, in minimally invasive surgery, the surgeon's ability of perceiving valuable haptic information through surgical instruments is severely impaired. Performing the surgery without such sensory information could lead to increase of tissue trauma and vital organic tissue damage. In order to restore the surgeon's perceptual capability, methods of force and tactile sensing have been applied with attempts to develop instruments that can be used to detect tissue contact forces and generate haptic feedback to the surgeon. This paper reviews the state-of-the-art in force and tactile sensing technologies applied in minimally invasive surgery. Several sensing strategies including displacement-based, current-based, pressure-based, resistive-based, capacitive-based, piezoelectric-based, vibration-based, and optical-based sensing are discussed.

State-of-the-Art in Force and Tactile Sensing for Minimally Invasive Surgery

The paper briefly describes daVinci/sup TM/, a surgical telerobot designed to provide enhanced dexterity to doctors performing minimally invasive surgical procedures. The rationale for a full 7-degree-of-freedom master-slave system is presented along with a discussion of the resulting computational architecture and recent clinical applications.

http://robotics.stanford.edu/~jks/pubs/2000-Guthart-Salisbury-Intuitive%20Telesurgery%20System-ICRA.pdf

G.S. Guthart

Papers

The Intuitive/sup TM/ telesurgery system: overview and application