First used medically in 1985, robots now make an impact in laparoscopy, neurosurgery, orthopedic surgery, emergency response, and various other medical disciplines. This paper provides a review of medical robot history and surveys the capabilities of current medical robot systems, primarily focusing on commercially available systems while covering a few prominent research projects. By examining robotic systems across time and disciplines, trends are discernible that imply future capabilities of medical robots, for example, increased usage of intraoperative images, improved robot arm design, and haptic feedback to guide the surgeon.

https://downloads.hindawi.com/journals/jr/2012/401613.pdf

Medical Robots: Current Systems and Research Directions

Within only a few decades from its initial introduction, the field of surgical robotics has evolved into a dynamic and rapidly growing research area with increasing clinical uptake worldwide. Initially introduced for stereotaxic neurosurgery, surgical robots are now involved in an increasing number of procedures, demonstrating their practical clinical potential while propelling further advances in surgical innovations. Emerging platforms are also able to perform complex interventions through only a single-entry incision, and navigate through natural anatomical pathways in a tethered or wireless fashion. New devices facilitate superhuman dexterity and enable the performance of surgical steps that are otherwise impossible. They also allow seamless integration of microimaging techniques at the cellular level, significantly expanding the capabilities of surgeons. This paper provides an overview of the significant achievements in surgical robotics and identifies the current trends and future research directions of the field in making surgical robots safer, smaller, and smarter.

/pdf/from-passive-tool-holders-to-microsurgeons-safer-smaller-2ss5wj05z6.pdf

From Passive Tool Holders to Microsurgeons: Safer, Smaller, Smarter Surgical Robots

Commercial surgical robots have been in clinical use since the mid-1990s, supporting surgeons in various tasks. In the past decades, many systems emerged as research platforms, and a few entered the global market. This paper summarizes the currently available surgical systems and research directions in the broader field of surgical robotics. The widely deployed teleoperated manipulators aim to enhance human cognitive and physical skills and provide smart tools for surgeons, while image-guided robotics focus on surpassing human limitations by introducing automated targeting and treatment delivery methods. Both concepts are discussed based on prototypes and commercial systems. Through concrete examples the possible future development paths of surgical robots are illustrated. While research efforts are taking different approaches to improve the capacity of such systems, the aim of this survey is to assess their maturity from the commercialization point of view.

Current Capabilities and Development Potential in Surgical Robotics

A system for measuring the position of a hand-held tool (100) relative to a body in six degrees of freedom employs the camera (115) attached via mechanical linkage to the tool so that the camera moves together with the prosimal portion of the tool and has a field of view including the distal end (122) of the tool.

System and method for optical position measurement and guidance of a rigid or semi-flexible tool to a target

In this paper, we present a novel robotic assistant dedicated to medical interventions under computed tomography scan guidance. This compact and lightweight patient-mounted robot is designed so as to fulfill the requirements of most interventional radiology procedures. It is built from an original 5 DOF parallel structure with a semispherical workspace, particularly well suited to CT-scan interventional procedures. The specifications, the design, and the choice of compatible technological solutions are detailed. A preclinical evaluation is presented, with the registration of the robot in the CT-scan.

/pdf/a-patient-mounted-robotic-platform-for-ct-scan-guided-4f6lgljb04.pdf

A Patient-Mounted Robotic Platform for CT-Scan Guided Procedures

We have developed a new technique to measure the overall application accuracy of image-guided stereotactic systems. It has been used to measure the accuracy of the Pathfinder neurosurgical robot, which uses a robot-mounted camera to triangulate fiducial skin markers, virtually eliminating line-of-sight problems experienced by other optical localisation methods. A phantom consisting of plastic spheres on stalks was used. The targets are the centre of the spheres. Points on a sphere's surface were automatically selected on CT images, from which the centre of the sphere was calculated in image space to greater precision than the CT voxel dimensions. A depth gauge was attached to Pathfinder in place of a biopsy needle and driven to the target as defined on CT. Pathfinder then moved to several points over the sphere, moving perpendicular to the trajectory in a grid pattern. By considering the depth gauge reading, 3D points on the sphere's surface were measured in robot space and the centre of the sphere was found. The difference between the actual and planned targets yields the overall accuracy. Preliminary experiments show that the application accuracy of Pathfinder is 2.7 mm. Further calibrations of the robot are expected to improve this value significantly.

Paul Byrne

Papers

The application accuracy of the Pathfinder neurosurgical robot