ES159/259Surgical Robotics

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ES159/259IntroductionSurgical robotics is a classic application of manipulator design and controlMotivations: why do we want to use robots in a surgical application?Repeatability (precision)Smaller incisions (less trauma)Versatility (surgeon doesnt need to be in the same room)Procedures on active organs (i.e. potentially a beating heart)Lower costsCurrent drawbacks:Lack of dexterityLack of sensory informationForce feedbackTactile feedbackVisual feedbackHigh cost

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ES159/259Robot-Assisted SurgeryThoracicEpicardial lead Placement Chondroma Esophagectomy IMA Harvest IMA Takedown Lobectomy Lung Biopsy Nodulectomy Thymectomy Tumor resection

UrologyDonor Nephrectomy Prostatectomy Ureter Harvest

VascularAortic Abdominal Aneurysm Vena Cava Tumor

CardiacAtrial Septal Defect Repair Mitral Valve Repair TECAB - Totally endoscopic coronary artery bypass

GeneralAdrenalectomy Cholecystectomy Esophagatomy Gastric Bypass Heller Myotomy Nissen Fundoplication

GynecologyCystocele Repair Hysterectormy Tubal Ligation Tubal Reanastomosis

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ES159/259IntroductionOutlineIntroduction to minimally invasive surgeryTeleoperationExamplesHaptics and tactile feedback

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ES159/259Minimally invasive surgeryAlso called laparoscopic surgeryThe process of entering the body through small ports rather than large incisionsReduced traumaReduced overall costTypically involves at least three ports: one for a camera and two for manipulators

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ES159/259Minimally Invasive vs. Open Cholecystecomies (Thousands, U.S., 1996)> 80% Cholecystecomies done with MIS!(likewise for many other surgeries)

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ES159/259Minimally Invasive SurgeryOperations through small incisionsReduced trauma to healthy tissueLess pain, shorter hospital stayReduced cost -- Patient returns to work sooner However, more difficult technique due to reduced access, dexterity, and perceptionLimited dexterity due to only having 4 DOFReduced force feedbackNo tactile feedbackReduced hand-eye coordinationProblems in spatial planningMany procedures cannot be performed with current MIS technology or are extremely difficult

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ES159/259Overcoming MIS LimitationsReplace the surgical instruments with robotic manipulators controlled by the surgeon through teleoperationIncrease dexterity by added DOFs

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ES159/259TeleoperationTeleoperation means simply to operate a vehicle or a system over a distanceDistance can vary from tens of centimeters (micro manipulation) to millions of kilometers (space applications)(fancy word for remote control)Operator (master): human operator is the person who monitors the operated machine and makes the needed control actionsTeleoperator (slave): the teleoperated machine. A sophisticated teleoperator can also be called as telerobot

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ES159/259DefinitionsMechanical manipulationThe control commands are transmitted mechanically or hydraulically to the teleoperator. Visual feedback can be straight or via monitor.This is typical for manipulation of dangerous materials as well as micro manipulation

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ES159/259DefinitionsClosed loop control (Direct teleoperation): The operator controls the actuators of the teleoperator by direct (analog) signals and gets real-time feedback. This is possible only when the delays in the control loop are minimal.Coordinated teleoperation: The operator again controls the actuators, but now there is some internal control - remote loop - included. However, there is no autonomy included in the remote end. The remote loops are used only to close those control loops that the operator is unable to control because of the delay. Supervisory control: low-level control is at the teleoperator end (compare coordinated teleoperation). The teleoperator can now perform part of the tasks more or less autonomously, while the operator mainly monitors and gives high-level commands. The term task based teleoperation is sometimes used here, but it is more limited than "supervisory control".

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ES159/259Closed loop/Supervisory control

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ES159/259Multi-Fingered HandIntegratedYaw & Pitch(Single Joint)5 DOFMIS end effector concepts

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ES159/259MIS end effector concepts (cont)

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ES159/259Input devices

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ES159/259Example: Unimanual Telesurgical System

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ES159/259Example: surgical arm

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ES159/259Robot ArmMaster input}{CanulaIdenticalKinematicsMatched Robot Arm Kinematics

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ES159/259Telesurgery Concept

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ES159/259Da Vinci SystemFDA - approvedInsite Vision SystemEndowrist InstrumentsVideo Tower

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ES159/259Da Vinci CartEndowrist instruments3-4 robotic armsInterchangeable end effectors

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ES159/259Da Vinci Console3D visionStereoscopic Maser controlsCamera controls

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ES159/259Da Vinci SystemVideodisplaypatientsurgeonRobot armsconsole

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ES159/259Master controller controls the motion of the end effector wristDa Vinci SystemMaster inputSurgeon at console

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ES159/259Da Vinci SystemMultiple robotic armsFor camera control and end effector control

Stereo endoscope7DOF endeffector

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ES159/259Example surgeryPatients chest is distended with CO2 to give room for the manipulators to operatePorts calledtrocars

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ES159/259Example surgeryConnection between the robotic arm and the patientRobotic arm enters the patient through the trocar

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ES159/259Example surgeryCamera view:

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ES159/259hapticsSensory information pertaining to touchInvaluable to surgeons performing laparoscopic surgeryTactile v. force feedbackForce feedback: gross forces transmitted to masterTactile feedback: detailed surface forces transmitted to master

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ES159/259Tactile feedbackteletaction concept: tactile feedback from catheter

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ES159/259Tactile displaysVarious morhpologies:Normal contactPneumaticPin-basedSMAShearingpiezoelectric

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ES159/259Next classOutline of active research areas Mobile robot navigationSensors and actuatorsComputer visionMicroroboticsSurgical roboticsGrasping

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