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RESEARCH ARTICLE OPEN ACCESS

Robotics in Medicine Applications

Shripad Shashikant Chopade¹, Sagar Pradip Kauthalkar², Chaitanya
Bhalchandra Bhandari³
Shripad Shashikant Chopade, M Tech (Machine Design & Robotics), Research Scholar, India
Sagar Pradip Kauthalkar, M Tech (Machine Design & Robotics), Research Scholar, India
Chaitanya Bhalchandra Bhandari, Research Scholar, India

Abstract
Robotics for medical applications started fifteen years ago while for biological applications it is rather new
(about five years old). Robotic surgery can accomplish what doctors cannot because of precision and
repeatability of robotic systems. Besides, robots are able to operate in a contained space inside the human body.
All these make robots especially suitable for non-invasive or minimally invasive surgery and for better
outcomes of surgery. Today, robots have been demonstrated or routinely used for heart, brain, and spinal cord,
throat, and knee surgeries at many hospitals in the United States (International Journal of Emerging Medical
Technologies, 2005).
Robots in medicine deserve enhanced attention, being a field where their instrumental ids enable
exacting options. The availability of oriented effectors, capable to get into the human body with no or negligible
impact, is challenge, evolving while micro-mechanics aims at nanotechnology. The survey addresses sets of
known achievements, singling out noteworthy autonomous in body devices, either co-robotic surgical aids, in
view of recognizing shared benefits or hindrances, to explore how to conceive effective tools, tailored to answer
given demands, while remaining within established technologies.
Nanorobotics is the still largely hypothetical technology of creating machines or robots at or close to
the scale of a nanometer (10-9meters). Also known as nanobots or nanites, they would be constructed from
nanoscale or molecular components. So far, researchers have only been able to produce some parts of such a
machine, such as bearings, sensors, and synthetic molecular motors, but they hope to be able to create entire
robots as small as viruses or bacteria, which could perform tasks on a tiny scale. Possible applications include
micro surgery (on the level of individual cells), utility fog, manufacturing, weaponry and cleaning. This
presentation provides a survey of current developments, in the spirit of focusing the trends toward the said turn.

Keywords :Bearings, Robot Machinery, Sensors, Synthetic molecular motors, Telesurgery techniques.

I. Introduction of a human being that performs the mechanical

functions of a human being but lacks sensitivity.” One
Robotics is a field that has many exciting of the first robots developed was by Leonardo da
potential applications. It is also a field in which Vinci in 1495; a mechanical armored knight that was
expectations of the public often do not match current used to amuse royalty. This was then followed by
realities. Truly incredible capabilities are being sought creation of the first operational robot by Joseph Marie
and demonstrated in research laboratories around the Jacquard in 1801, in which an automated loom,
world. However, it is very difficult to build a controlled by punch cards, created a reproducible
mechanical device (e.g. a robotic arm) that has pattern woven into cloth. Issac Asimov further
dexterity comparable to a human‟s limbs. It is even elucidated the role of robotics in 1940 through short
more difficult to build a computer system that can stories; however, it was his three laws of robotics that
perceive its environment, reason about the received popular acclaim. The three laws states are,
environment and the task at hand, and control a robotic 1) A robot may not injure a human being, or through
arm with anything remotely approaching the inaction allow a human being to come to harm
capabilities of a human being. 2) A robot must obey the orders given it by human
beings except where such orders would conflict with
II. History of robotics First Law.
3) A robot must protect its own existence as long as
such protection does not conflict with the First or
The word robot (from the Czech word robota
Second Law.
meaning compulsory labor) was defined by the
Robotic Institute of America as “a machine in the form

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III. Applications in Medicine various means. The main method is that of computer
Robots are filling an increasingly important tomography (CT). CT is the process whereby a stack
role of enhancing patient safety in the hurried pace of Of cross-sectional views of the patient are taken using
clinics and hospitals where attention to details and magnetic-resonance-imaging or x-ray methods. This
where reliability are essential. In recent years, robots kind of imaging is necessary for all types of operative
are moving closer to patient care, compared with their procedure and, as such, does not differ from traditional
previous role as providing services in the surgical techniques.
infrastructure of medicine. Examples of past use are in
repetitive activities of cleaning floors and washing
equipment and carrying hot meals to patients‟ bedside.
What is new is finding them in clinical laboratories
identifying and measuring blood and other specimen
for testing, and in pharmacies counting pills and
delivering them to nurses on „med-surg-units‟ or
ICU‟s. Or bringing banked blood from the laboratory
to the ED, surgery or ICU for transfusions. Robots are
being used as very accurate „go-fors‟!

An early active robot, „Robodoc‟ was designed to mill

perfectly round lumens in the shafts of fractured
bones, to improve the bonding of metal replacements
such as for femur heads and knee joints. The future of Fig 1: A patient having a brain scan
this system remains uncertain because of questions
about the ultimate beneficial outcomes. This two-dimensional (2D) data must then be
converted into a 3D model of the patient (or, more
The reasons behind the interest in the usually, of the area of interest). The reasons for this
adoption of medical robots are multitudinous. Robots transformation are twofold. Firstly, the 2D data, by its
provide industry with something that is, to them, more very nature, is lacking in information. The patient is,
valuable than even the most dedicated and hard- obviously, a 3D object and as such, occupies a spatial
working employee - namely speed, accuracy, volume. Secondly, it is more accurate and intuitive for
repeatability, reliability and cost-efficiency. A robotic a surgeon, when planning a procedure, to view the
aid, for example, one that holds a viewing instrument data in the form that it actually exists. It should be
for a surgeon, will not become fatigued, for however noted, however, that the speed of said hardware is
long it is used. It will position the instrument increasing all the time and the price will decrease too,
accurately with no tremor and it will be able to as the technology involved becomes more
perform just as well on the 100th occasion as it did commonplace. This means that the process will be
on the first. more cost-efficient and increasingly routine in the
future.
IV. Robotic surgery
The third phase of the planning is the actual
Robotic surgery is the process whereby a robot development of the plan itself. This involves
actually carries out a surgical procedure under the determining the movements and forces of the robot in
control of nothing other than its computer program. a process called „path planning‟ - literally planning the
Although a surgeon almost certainly will be involved paths that the robot will follow.
in the planning of the procedure to be performed and
will also observe the implementation of that plan, the
execution of the plan will not be accomplished by
them - but by the robot.
In order to look at the different issues involved in the
robotic fulfillment of an operation, the separate
sections of a typical robotic surgery (although robotic
surgery is far from typical) are explained below.
Surgical planning

Surgical planning consists of three main

parts. These are imaging the patient, creating a
satisfactory three-dimensional (3D) model of the
imaging data, and planning/rehearsing the operation. Fig 2: A surgery simulation to aid planning
The imaging of the patient may be accomplished via

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It is here that the 3D patient model comes The alternative to fiducially-based registration is that
into play, as it is where all the measurements and paths of „surface- based‟ registration. This technique uses
are taken from. This emphasizes the importance of the surfaces that are intrinsic to the data itself. The benefit
accuracy of the model, as any errors will be interpreted of this method is that it does not require the use of
as absolute fact by the surgeons (and hence the robot) expensive and traumatically invasive markers. The
in their determination of the plan. illustration of the implementation of this concept is
. shown below. On the Left (a) is a brain with extracted
V. Registration of robot to patient curves shown in red. On the right (b) is the final 3D
model gained from these curves:
The registration of the robot and the patient is the
correlation of the robot‟s data about the patient with
the actual patient, in terms of positioning. There are
two important stages in the registration procedure -
fixation of the patient and the robot, and intra-surgical
registration itself. Fixation is an essential ingredient
of a successful robotic operation. Robots act upon pre-
programmed paths , these programs are much more
complex if they must take into account the fact that
the patient‟s position may be different to the inputted
data and, in fact, continually changing. For this reason
(a) Extracted curves (red) (b) Model produced from curves
it is imperative that the robot can act in, at least, a
semi-ordered environment.
Fig 4: Curves
Fixation of the patient that is fixing the
The success of surface-registration is highly
patient in position (i.e. on the operating table), is
dependent upon the realism and accuracy of the 3D
achieved through strapping and clamping of the areas
models gained pre-operatively and upon the sensing
pertinent to the surgery. This is common in traditional
accuracy of intra-surgical data acquisition. Geometric
surgery, too. For example, the head is fixed in position
surface model validation is complicated since errors
during neurosurgery through the application of a head-
can be introduced at several stages of model creation:
fixation device known as a „stereo tactic unit‟. during imaging, „segmentation‟ and surface creation.
Fixation of the robot is achieved through analogous Prior to the emergence of surface-based techniques for
methods. surgery, 3D modeling medical data has been primarily
used as a teaching aid in the study of anatomy (e.g.
VOXEL-MAN). These models have very different
accuracy requirements to those used for surface-based
registration.

VI. Execution of robotic procedure

Once all of the preparation is complete, it is

time to pass control to the robot for the actual
implementation of the surgery. The robots used for
automated surgery tend, at the present time, to be
Fig 3: Patient held in fixed position for neurosurgery adapted industrial robots; for example, the PUMA
robot arm having brought up the fact that the surgeon
The intra-surgical registration itself is the is reliant upon the engineering behind the tools that
process of establishing a common reference frame they are using, it is clear that companies would not
between the pre-surgical data (3D model and wish to risk possible legal proceedings should one of
associated surgical plan) and the corresponding patient their products fail. Once the robotic procedure is
anatomy. There are two primary techniques of initiated, sensors collect real-time data from the
achieving this common frame of reference. operating site and pass this to a display, via which the
surgeon observes the operation.
The first, and most usual, method is to attach
fiducial to the underlying patient structures pre-
operatively. These fiducial are then sensed, and
compared to the pre-operative data, to precisely align
the two data sets. Furthermore, these fiducial are
invasive and cause added trauma to the patient in sites
physically far from the primary field of surgical focus.

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is usually imaged before the operation starts and the

information sent to the surgeon. In telesurgery the
surgeon cannot rely on anything but the sensor data,
which is transmitted from the remote location. The
sensor data, therefore, must be absolutely correct. For
this purpose, a host of different schemes are used.

Telesurgery is mainly used as a form of

minimally invasive surgery. In traditional surgery, the
physical hand size has always been a limiting factor
when it comes to delicate surgery in hard-to-reach
places. Since the robot can theoretically be as small as
is desired, it can enter through a small opening,
navigate through the body and finally reach and
operate in places that would otherwise be inaccessible
without a large incision made specifically to facilitate
entry. Recent experiments even involve the robot
being inserted through a small puncture in the thigh
and guided all the way to the brain through blood
Fig 5: The operating theatre in a robotic surgery vessels as narrow as 1.5mm in diameter.

VII. Robots in Telesurgery

While, in robotic surgery, the robot is given

some initial data information and allowed to proceed
on its own, there are some other applications of
robotics in surgery where the robot is actually guided
by a human throughout the process. The actions of the
robot are not predetermined, but rather controlled in
real-time by the surgeon. The remote location can be
as far away as the other side of the world, or as near as
the next room. Since there is distance separating the
surgeon and the patient, it is evident that the surgeon Fig 7: Endoscopy using telesurgery techniques
cannot operate using his own hands. A robot, local to Over the next ten years, breakthroughs in
the patient, becomes the surgeon‟s hands, while an nanotechnology may help us build better and
intricate interface conveys the robot‟s senses to the smaller machines.
surgeon (making use of while an intricate interface
conveys the robot‟s senses to the surgeon (making use A nanometer is just one-millionth of a
of visual, aural, force and tactile feedback). millimetre in length and nanotechnology involves
studying and working with materials on an ultra-small
scale. Using nanotechnology, scientists have created
tiny walking nanobot, using only the building blocks
of life: DNA.

Fig 6: Surgeon in Telesurgery console Fig 8: DNA

In the sense that the robot is the one The microscopic walker, which is only 10
performing the surgery, telesurgery is a part of robotic nanometers long, uses its legs to move along a
surgery. Furthermore, as in robotic surgery, the patient footpath. Nanotechnology could also lead to a range
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Vol. 3, Issue 5, Sep-Oct 2013, pp.247-251

of materials with new qualities such as stay-clean glass Conference on Intelligent Robots and
and magnetic liquids. There may also be Systems. Advanced Robotic Systems and the
breakthroughs from scientists trying to implant Real World (Cat.No.94CH3447-0),
computer programs into living creatures - known as Sept.1994, Vol.2, pp.739-52
wetware. This technology could help people with
false arms or legs to move them just by thinking about
it.

VIII. Conclusions

Medical robotics, and particularly

autonomous surgical robotics, is still in an embryonic
stage. To conclude, there are several steps that must be
taken in order to further the use and development of
robots in surgery (and in medicine in general). These
are:
The development and international adoption,
of safety standards the aim of task-specific, as opposed
to general-purpose, robots the education of the medical
community in the acceptance and integration of
Robots.
The economic and social advantages to be
gained from the mass-use of robotics in medicine (and
particularly surgery), as already expounded, are
enormous. If all of the above steps are taken, then the
full potential of robotics can be exploited in the
medical sector, as it has been in industrial applications,
for the improved welfare of society everywhere.

References

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