Purpose of Review Robotic assistance systems for diagnosis and therapy have become technically mature and widely available. Thus, they play an increasingly important role in patient care. This paper provides an overview of the general concepts of robotically assisted surgical systems, briefly revisiting historical and current developments in the surgical robotics market and discussing current focus areas of research. Comprehensiveness cannot be achieved in this format, but besides the general overview, references to further readings and more comprehensive reviews with regard to particular aspects are given. Therefore, the work at hand is considered as an introductory paper into the topic and especially addresses investigators, researchers, medical device manufacturers, and clinicians, who are new to this field. Recent Findings The current research in Robotically Assisted Surgical Systems (RASS) increasingly uses established robotic platforms. To minimize the patient trauma while optimizing the dexterity of the surgeon, miniaturized instruments and semi-autonomous assistance functions are developed. To provide the surgeon with all necessary information in an adequate manner, novel imaging sensors as well as techniques for multimodal sensory feedback and augmented reality are investigated. The Surgical Data Science applies data management and processing approaches including machine learning on medical data to provide optimal, individualized and contextual support to the surgeon. Summary Robotic systems will significantly influence future patient care. Since they must fulfill manifold medical, technical, regulatory and economic requirements, their development calls for a close, active and interdisciplinary cooperation between stakeholders from hospitals, industry and science.
Urolithiasis is a common disease with increasing prevalence across all ages. A common treatment option for smaller kidney stones is flexible ureterorenoscopy (fURS), where a flexible ureteroscope (FU) is used for stone removal and to inspect the renal collecting system. The handling of the flexible ureteroscope and end effectors (EEs), however, is challenging and requires two surgeons. In this paper, we introduce a modular robotic system for endoscope manipulation, which enables solo surgery (SSU) and is adaptable to various hand-held FUs. Both the developed hardware components and the proposed workflow and its representation in software are described. We then present and discuss the results of an initial user study. Finally, we describe subsequent developmental steps towards more extensive testing by clinical staff.
To enhance the capability of the DLR MIRO for physical human robot interaction (pHRI), six buttons were integrated as additional input interface along the robot structure. A ring of eight RGB-LEDs at the instrument interface informs the user as additional output interface about the robot’s state. The mechatronic design, which is transferable to other robots, adapts to the existing communication infrastructure of the robot and therefore offers real-time capability. Besides the interaction with the robot itself, it also allows the control of third party devices connected to its communication network. Both interfaces can be flexibly programmed e.g. in C++ or Simulink.
Using a pressurized waterjet for cutting or abrasing tissue is a well established method in surgery. This paper presents a robotic tool for minimally invasive waterjet surgery with two degrees of freedom, integrated suction and an optional splash protection. The function of the tool and the effect of the splash protection on the suction of the applicated water was successfully evaluated in tests with ballistic gelatine. Based on this evaluated design, a concept for further increasing the oscillation frequency of the instrument tip is introduced and the results of preliminary tests of a simplified mockup are shown.
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