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

Bergeles, Christos; Yang, Guang‐Zhong

doi:10.1109/tbme.2013.2293815

Cited by 182 publications

(99 citation statements)

References 138 publications

(154 reference statements)

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“…Minimally-invasive surgery has been revolutionized in the past few decades by the widespread adoption of long, flexible, continuum manipulators for performing many interventional procedures [1]. These devices, including endoscopes and catheters, are favored as they can pass through a single, small incision and perform treatments in distal locations within the body.…”

Section: Introductionmentioning

confidence: 99%

Autonomous Control of Continuum Robot Manipulators for Complex Cardiac Ablation Tasks

Yip

Sganga

Camarillo

2017

J. Med. Robot. Res.

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Continuum manipulators enable minimally-invasive surgery on the beating heart, but the challenges involved in manually controlling the manipulator's tip position and contact force with the tissue result in failed procedures and complications. The objective of this work is to achieve autonomous robotic control of a continuum manipulator's position and force in a beating heart model. We present a model-less hybrid control approach that regulates the tip position/force of manipulators with unknown kinematics/ mechanics, under unknown constraints along the manipulator's body. The algorithms estimate the Jacobian in the presence of heartbeat disturbances and sensor noise in real time, enabling closed-loop control. Using this model-less control approach, a robotic catheter autonomously traced clinically relevant paths on a simulated beating heart environment while regulating contact force. A gating procedure is used to tighten the treatment margins and improve precision. Experimental results demonstrate the capabilities of the robot (1:4 AE 1:1 mm-1:9 AE 1:4 mm tracking error) while user demonstrations show the difficulty of manually performing the same task (2:6 AE 2:0 mm-4:3 AE 3:9 mm tracking error). This new, robotically-enabled contiguous ablation method could reduce ablation path discontinuities, improve consistency of treatment, and therefore improve clinical outcomes.

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Section: Introductionmentioning

confidence: 99%

Autonomous Control of Continuum Robot Manipulators for Complex Cardiac Ablation Tasks

Yip

Sganga

Camarillo

2017

J. Med. Robot. Res.

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“…Time needed for hardware design, new micro-motors or superior tendon biomaterials to be developed and integrated into sub-5-mm-sized instruments. On the horizon are ultimate goals of micro-or even nanobots that may wirelessly enter and exit the body in a silent but pervasive manner to accomplish surgical tasks [34]. This would represent entirely new paradigms of surgery such as the ''swallowable surgeon'' [34].…”

Section: Awaitmentioning

confidence: 99%

“…On the horizon are ultimate goals of micro-or even nanobots that may wirelessly enter and exit the body in a silent but pervasive manner to accomplish surgical tasks [34]. This would represent entirely new paradigms of surgery such as the ''swallowable surgeon'' [34]. To reject and abandon first-generation rigid multi-arm robotic systems Pediatr Surg Int would cause serious detriment to the motivation of academic institutions and R&D groups pursuing more advanced and better-suited robotic technologies for future clinical use.…”

Section: Awaitmentioning

confidence: 99%

Robotic surgery in children: adopt now, await, or dismiss?

et al. 2015

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The role of robot-assisted surgery in children remains controversial. This article aims to distil this debate into an evidence informed decision-making taxonomy; to adopt this technology (1) now, (2) later, or (3) not at all. Robot-assistance is safe, feasible and effective in selected cases as an adjunctive tool to enhance capabilities of minimally invasive surgery, as it is known today. At present, expectations of rigid multi-arm robotic systems to deliver higher quality care are over-estimated and poorly substantiated by evidence. Such systems are associated with high costs. Further comparative effectiveness evidence is needed to define the case-mix for which robot-assistance might be indicated. It seems unlikely that we should expect compelling patient benefits when it is only the mode of minimally invasive surgery that differs. Only large higher-volume institutions that share the robot amongst multiple specialty groups are likely to be able to sustain higher associated costs with today's technology. Nevertheless, there is great potential for next-generation surgical robotics to enable better ways to treat childhood surgical diseases through less invasive techniques that are not possible today. This will demand customized technology for selected patient populations or procedures. Several prototype robots exclusively designed for pediatric use are already under development. Financial affordability must be a high priority to ensure clinical accessibility.

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“…2 P. Wisanuvej is also with Kasetsart University, Bangkok, Thailand. be provided in close proximity to the surgical workspace, requiring many degrees-of-freedom (DoFs) and high dexterity at the instrument tip [2]. To meet these requirements, novel kinematic models including constant curvature sections or links consisting of multiple dependent joints are developed, requiring new models to describe the forward and differential kinematics [3], [4].…”

Section: Introductionmentioning

confidence: 99%

Effective Manipulation in Confined Spaces of Highly Articulated Robotic Instruments for Single Access Surgery

Leibrandt

Wisanuvej

Gras

et al. 2017

IEEE Robot. Autom. Lett.

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Abstract-The field of robotic surgery increasingly advances towards highly articulated and continuum robots, requiring new kinematic strategies to enable users to perform dexterous manipulation in confined workspaces. This development is driven by surgical interventions accessing the surgical workspace through natural orifices such as the mouth or the anus. Due to the long and narrow nature of these access pathways, external triangulation at the fulcrum point is very limited or absent, which makes introducing multiple degrees of freedom at the distal end of the instrument necessary. Additionally, high force and miniaturization requirements make the control of such instruments particularly challenging. This paper presents the kinematic considerations needed to effectively manipulate these novel instruments and allow their dexterous control in confined spaces. A non-linear calibration model is further used to map joint to actuator space and improve significantly the precision of the instrument's motion. The effectiveness of the presented approach is quantified with bench tests, and the usability of the system is assessed by three user studies simulating the requirements of a realistic surgical task.

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

Cited by 182 publications

References 138 publications

Autonomous Control of Continuum Robot Manipulators for Complex Cardiac Ablation Tasks

Autonomous Control of Continuum Robot Manipulators for Complex Cardiac Ablation Tasks

Robotic surgery in children: adopt now, await, or dismiss?

Effective Manipulation in Confined Spaces of Highly Articulated Robotic Instruments for Single Access Surgery

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