Surgical Robotics presentation 4
Surgical Robotics presentation 4
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Table of Content
Introduction
Section 1
Section 2
Section 3
Conclusion
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Introduction
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Comparison
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Limitations of Conventional Surgery
• 1. Lack of Precision
• 2. Invasive Nature
• 3. Restricted Access
• 5. Learning Curve
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History of Robotic Surgery
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Sections for Literature Review
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Section 1
Observation
CHAPTER 5- SURGICAL ROBOTICS
JACOB ROSEN
Department of Computer Engineering, Baskin School of Engineering, SOE-3 University
of California, Santa Cruz , 1156 High Street, Santa Cruz, CA 95064-1099, USA
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Abstract -
• he abstract highlights the transformative impact of surgical
robotics on the field of surgery, emphasizing the integration of
technological and clinical advancements
• Key topics covered include soft tissue biomechanics,
teleoperation, haptics, time delay, indexing, motion
compensation, scaling, image-guided surgery.
• The chapter concludes by the reduction of system size to
minimize tissue impact and enhancing human-machine
interaction for semi-autonomous operations.
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Scope and Background
Tool
Hand
Surgeon–Robot (S-R) Interface
Robot
(Master-Slave)
Surgeon
Virtual Reality
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Schematic representation of the surgeon-robot-patient domains
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Teleoperation
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Commercial Systems:-
Da Vinci (Intuitive Surgical)
System Architecture of da Vinci:
• Follows the classical master/slave teleoperation architecture
with a surgical console (master) and a patient-side subsystem (slave)
• Patient-side subsystem has four arms – three with MIS surgical tool
(5-8 mm) and one with two endoscopic cameras (12 mm) for a 3D view.
• Approximately 50 different tools can be mounted on robotic arms
through a sterile barrier
Operational Mode:
• While the system is based on a teleoperation architecture, the approved mode of operation is limited to co-located scenarios
where the patient-side and surgeon-side are in the same room.
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da Vinci® Robotic Surgical System
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Section 2
Case Studies
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1- Robotic Partial Nephrectomy with the Da Vinci
Xi George J. S. Kallingal, Sanjaya Swain, Fadi Darwiche, Sanoj Punnen,
MurugesanManoharan,Mark L. Gonzalgo, and Dipen J. Parekh
Department of Urology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
Partial nephrectomy
During a partial nephrectomy, only the cancerous tumor or diseased tissue
is removed (center), leaving in place as much healthy kidney tissue as
possible.
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Operative Technique
• Patients with clinical stage 1 renal masses
were offered RPN with the Da Vinci Xi
system.
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Port placement for left robotic partial
nephrectomy
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• https://youtu.be/31uGJLwUbDo?si=6fatmOgp0BBN15ko
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Results • Fifteen patients underwent RPN with the Da Vinci Xi system, with no intraoperative
complications or conversions to radical nephrectomy.
• The mean console time was 101.3 minutes, mean ischemia time was 17.5 minutes, and
estimated blood loss was 120 mL.
• Pathological analysis revealed various subtypes of renal masses, with all patients having
negative surgical margins.
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Atrial fibrillation (AFib) is an irregular and often very rapid
heart rhythm. An irregular heart rhythm is called an arrhythmia. AFib can lead
to blood clots in the heart. The condition also increases the risk of stroke,
heart failure and other heart-related complications.
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ablation catheter central workstation
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Results
• In a recent series involving 40 patients undergoing AF ablation with
additional AFL ablation in 23 cases, acute procedural success, defined as PVI
plus additional isolation of the superior vena cava, was achieved in all
patients.
• Acute PVI (Peripheral Vascular Intervention) success rates and procedure
times were in line with manual AF ablation data, but total fluoroscopy
times were longer.
• Overall system has demonstrated feasibility of remote-controlled
catheter ablation but still require technological refinements to
improve their applicability and to demonstrate noninferiority to
manual procedures.
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3- Robotic-arm assisted total knee
arthroplasty is associated with improved B. Kayani,
early functional recovery and reduced time S. Konan,
J. Tahmassebi,
to hospital discharge compared with
J. R. T. Pietrzak,
conventional jig-based total knee F. S. Haddad
arthroplasty
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Results
• Overall, robotic-arm assisted TKA demonstrated
several benefits over conventional jig-based TKA,
including reduced postoperative pain, decreased
analgesia requirements, improved postoperative
hemoglobin levels, shorter time to straight leg raise,
decreased need for physiotherapy sessions,
improved knee flexion at discharge, and shorter
hospital stay
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Section 3
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Kinematic design considerations for
minimally invasive surgical robots:
an overview
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Introduction
•Kinematic Design: Kinematic design is crucial in
developing robotic manipulators for MIS. Key considerations
include safety, accuracy, ergonomics, and dexterity. These
considerations are translated into design
tasks such as mechanism configuration, workspace
optimisation and isotropy to meet surgical requirement
•Kinematic Design Goals: The paper aims to identify
common kinematic design goals, requirements, and
preferences for MIS robots. It discusses fundamental design
issues and tasks, including the use of the remote center -of-
motion (RCM) mechanism to overcome challenges in MIS
robots.
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Materials and Methods
• Accuracy
• Ergonomics
• Dexterity
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Kinematic design considerations
• Pivoting Motion: Design requirements include ensuring the end-effector has 36four
DOFs and that the translational DOF points along the direction of insertion or
.
Remote center-of-motion
•mechanisms
Motivation for RCM Mechanisms:
MIS robots need to manipulate
surgical instruments with precision
and safety. RCM mechanisms allow
for manipulation with a fixed
rotational center located outside the
robot's structure, reducing the risk of
collisions with the patient .
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• Decoupled RCM Mechanisms: These mechanisms reduce
control complexity and enhance manipulation convenience. They
separate rotational and translational degrees of freedom (DOFs),
allowing for more rapid manual positioning.
• Non-mechanical and Passive RCMs: Non-mechanical
RCMs use coordinated control of multiple joints, while
passive RCMs utilize the incision itself as a mechanical
fixture to constrain tool motion. Mechanical RCMs are
considered safer
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Results and
Discussion
• 4-DOF 3R1T RCM Mechanisms: These mechanisms are discussed in
the context of providing pivoting rotations for surgical instruments. The
integration of translational DOFs into RCM mechanisms can lead to
increased payload and static problems. Different approaches, including
serial and parallel robots, are considered for providing additional DOFs
while minimizing payload issues.
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• Task-Oriented Fully-Isotropic Design: A fully-isotropic RCM
mechanism, which would provide confidence in safety, simplified joint
coordination, and sensing of reaction forces, is considered desirable
but has not yet been achieved for MIS applications.
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Conclusion
•
and Future
Perspective
Conclusion
• In conclusion, robotics plays a pivotal role in advancing precision surgery, offering transformative
benefits to both surgeons and patients.
As 3 Case Studies shown that it provide below advantages
• improved patient outcomes,
• shorter hospital stays,
• reduced postoperative complications
• faster recovery times
Disadvantages
• Cost
• Training
• Safety
Furthermore ,The integration of advanced imaging and navigation technologies further augments
surgical precision, allowing surgeons to navigate complex anatomical structures with greater ease and 43
confidence
Future perspective
• As discussed in development chapter, , RCM mechanism, motion decoupling and isotropic
design are future design goals for improved performance.
• Additionally, the integration of artificial intelligence (AI) and machine learning algorithms into
robotic systems promises to enhance surgical precision, optimize decision-making processes
and personalize treatment approaches based on individual patient characteristics.
• Furthermore, the convergence of robotics with other cutting-edge technologies such as
augmented reality, 3D printing, and telemedicine holds the potential to redefine the surgical
landscape, enabling remote guidance, collaborative interventions, and personalized surgical
planning on a global scale.
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Thank You
Questions?
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