Скачать презентацию Robotics in surgery Patrick A Finlay Ph D Скачать презентацию Robotics in surgery Patrick A Finlay Ph D

bc7e70f4ba5e47abbc5d53793e82b02d.ppt

  • Количество слайдов: 61

Robotics in surgery Patrick A Finlay Ph. D CEng Director and Chief Technical Officer, Robotics in surgery Patrick A Finlay Ph. D CEng Director and Chief Technical Officer, Prosurgics Ltd

History of Robotics 800 BC Homer describes walking tripods 1921 The term History of Robotics 800 BC Homer describes walking tripods 1921 The term "robot" invented by Karel Capek 1938 Mechanical arm for spray-painting. 1942 Isaac Asimov: Three Laws of Robotics. 1961 First commercial robot 1965 CMU creates Robotics Institute 1973 Wabot built at Waseda University Tokyo 1982 Int’l Advanced Robotics Programme 1986 First surgical robot

Surgical Robotics: current status § ~ 1200 surgical robots in regular clinical use worldwide. Surgical Robotics: current status § ~ 1200 surgical robots in regular clinical use worldwide. § Surgical robotics globally worth ~ $2 B § Annual growth ~ 50% per annum § Small number of specialist companies § R&D in progress at over 100 universities world wide,

Commercial surgical robotics MEDICAL ROBOTICS Surgical Robotics Telemanipulators Non surgical Image guided surgery Commercial surgical robotics MEDICAL ROBOTICS Surgical Robotics Telemanipulators Non surgical Image guided surgery

The two branches of robotic surgery Telemanipulator (master-slave) Image guided (true robot) The two branches of robotic surgery Telemanipulator (master-slave) Image guided (true robot)

Telemanipulators Master Slave systems Telemanipulators Master Slave systems

Single arm telemanipulators endoscopic camera control Single arm telemanipulators endoscopic camera control

Single arm camera holder Endo. Assist, Prosurgics Ltd Single arm camera holder Endo. Assist, Prosurgics Ltd

Single arm camera holder Clinical benefits Position anywhere around the table Does not obstruct Single arm camera holder Clinical benefits Position anywhere around the table Does not obstruct operation Entry port can be in any position Endo. Assist, Prosurgics Ltd

Head movement control Pan, zoom or tilt the camera with a head gesture Head movement control Pan, zoom or tilt the camera with a head gesture

Miniaturised camera holder Free. Hand, Prosurgics Ltd Miniaturised camera holder Free. Hand, Prosurgics Ltd

Miniaturised camera holder in use No obstruction of surgical access or screen sightline Miniaturised camera holder in use No obstruction of surgical access or screen sightline

Multi arm telemanipulator Da Vinci Intuitive Surgical Inc Multi arm telemanipulator Da Vinci Intuitive Surgical Inc

Multi-arm telemanipulator Motion scaling to micro-wrist Da Vinci, Intuitive Surgical Inc Multi-arm telemanipulator Motion scaling to micro-wrist Da Vinci, Intuitive Surgical Inc

Multi-arm telemanipulator Surgeon operates robot from a remote console Multi-arm telemanipulator Surgeon operates robot from a remote console

Telesurgery Surgeon in New York Patient in Strasbourg Pictures from Computer Motion Inc Telesurgery Surgeon in New York Patient in Strasbourg Pictures from Computer Motion Inc

Telesurgery applications Telesurgery applications

Image Guided Robots Example: Neurosurgery Image Guided Robots Example: Neurosurgery

Robotic neurosurgery Robotic neurosurgery

Image-guided surgery 1927 arteriography 2007 MR image Image-guided surgery 1927 arteriography 2007 MR image

Fusion of image modalities MRI CT Angiography Fusion of image modalities MRI CT Angiography

Fused images and Brain Atlas Fused images and Brain Atlas

The neurosurgeon’s quest § how to reach the target I’ve pinpointed on the scan The neurosurgeon’s quest § how to reach the target I’ve pinpointed on the scan § with the same accuracy that I can see it. . . § . . . but with minimal collateral damage. . . § . . . and simply, with a short procedure time. . . § . . . and without costing a fortune

Registration: key to accuracy Registration: key to accuracy

Stereotactic frame Stereotactic frame

Stereotactic frame targeting arc Stereotactic frame targeting arc

Fiducial markers Fiducial markers

Testing prior to surgery Skin Markers used as artificial targets for confirming accuracy Testing prior to surgery Skin Markers used as artificial targets for confirming accuracy

Neurosurgery robot registration Camera and light ring camera in the robot’s wrist scans the Neurosurgery robot registration Camera and light ring camera in the robot’s wrist scans the patient computer matches camera and CT scans

Sterile environment control Sterile environment control

Deep Brain stimulation Deep Brain stimulation

Brain tumour biopsy Robot guided biopsy needle insertion. Multiple biopsies are possible along a Brain tumour biopsy Robot guided biopsy needle insertion. Multiple biopsies are possible along a single trajectory

Epilepsy Robotic 3 -D positioning of depth electrodes to determine focus of epileptic seizure Epilepsy Robotic 3 -D positioning of depth electrodes to determine focus of epileptic seizure

Grid pattern tumour treatment Magnetic nanoparticles Modified virus Stem cells Interstitial radiotherapy Convection enhanced Grid pattern tumour treatment Magnetic nanoparticles Modified virus Stem cells Interstitial radiotherapy Convection enhanced delivery New pharmaceuticals

 Image Guided Surgery Applications outside Neurosurgery Image Guided Surgery Applications outside Neurosurgery

Early beginnings Robo. Doc Femoral reaming ISS Inc Early beginnings Robo. Doc Femoral reaming ISS Inc

IGS trajectory control Orthrobot Dynamic hip screw placement Armstrong Healthcare (now Prosurgics Ltd) IGS trajectory control Orthrobot Dynamic hip screw placement Armstrong Healthcare (now Prosurgics Ltd)

IGS path control Machining of femur and tibia for total knee replacement CASPAR orthopaedic IGS path control Machining of femur and tibia for total knee replacement CASPAR orthopaedic robot URS Gmb. H

Active-constraint IGS Total knee replacement robot allows the surgeon to operate freely in the Active-constraint IGS Total knee replacement robot allows the surgeon to operate freely in the safe zone, but prevents entry elsewhere Picture from Imperial College London

Active constraint IGS Total knee replacement Photographs: Imperial College London Active constraint IGS Total knee replacement Photographs: Imperial College London

Surgical Robots: The next generation Surgical Robots: The next generation

New generation surgical robotics MEDICAL ROBOTICS Non surgical Strategic Surgical robots Micro mobile robots New generation surgical robotics MEDICAL ROBOTICS Non surgical Strategic Surgical robots Micro mobile robots with autonomy Tactical Surgical Robotics Telemanipulators Image guided surgery (Dual guidance)

Miniaturisation powered and passive Do. Fs Pedicle screw guidance Parallel structure Praxiteles Spine. Assist Miniaturisation powered and passive Do. Fs Pedicle screw guidance Parallel structure Praxiteles Spine. Assist Praxim SA Mazor Surgical Technologies Ltd

Probe tip tracking Electromagnetic tracking Ascension Technologies Inc Probe tip tracking Electromagnetic tracking Ascension Technologies Inc

Motion compensation Low inertia, high payload, force control robot Kinemedic DLR Motion compensation Low inertia, high payload, force control robot Kinemedic DLR

Real time imaging and modelling University of Verona Real time imaging and modelling University of Verona

New types of surgery “NOTES”: Natural orifice transgastric endoscopic surgery New types of surgery “NOTES”: Natural orifice transgastric endoscopic surgery

New types of surgery CAD CAM dental implant Vancouver Institute for Advanced Ceramics Custom New types of surgery CAD CAM dental implant Vancouver Institute for Advanced Ceramics Custom hip implants SCP Norway

Free-roaming camera (pre-robotic) Given Imaging, Israel swallowable camera 2 frames/s for 6 hours Free-roaming camera (pre-robotic) Given Imaging, Israel swallowable camera 2 frames/s for 6 hours

Crawling microrobots Roaming robot with camera and biopsy needle NOTES surgery of the abdomen Crawling microrobots Roaming robot with camera and biopsy needle NOTES surgery of the abdomen swallowable camera with 6 -legged propulsion CMU/ Korean Intelligent μsystems centre University of Nebraska

Swimming microrobots Swimming robot Autonomous Swimmer. Eyeball cavity, CSF, urinary system Subarachnoid space of Swimming microrobots Swimming robot Autonomous Swimmer. Eyeball cavity, CSF, urinary system Subarachnoid space of spine. Pushmepullyou swimmer Carnegie Mellon University Technion University

Multi-segment snake arms 23 Do. F holonomic snake arm Nuclear maintenance OC Robotics. Ltd Multi-segment snake arms 23 Do. F holonomic snake arm Nuclear maintenance OC Robotics. Ltd Tube crawling concertina snake Experimental flexible endoscopic manipulator Johns Hopkins University Disaster rescue Carnegie Mellon University

Biomimetics Biomimetic lobster Wood wasp ovipositor goal–achieving behaviour Artificial muscle actuators Robot carp: serpentine Biomimetics Biomimetic lobster Wood wasp ovipositor goal–achieving behaviour Artificial muscle actuators Robot carp: serpentine motion Northeastern University MA Essex University

Intelligence I-SWARM Co-operating robots 21 Do. F fault tolerant snake arm for Space vehicles Intelligence I-SWARM Co-operating robots 21 Do. F fault tolerant snake arm for Space vehicles Kahlsruhe University (leader) NASA JSC Evolutionary learning bipedal locomotion Chalmers University

A new safety paradigm Old approach: “rigid design for accuracy; active control for safety” A new safety paradigm Old approach: “rigid design for accuracy; active control for safety” New approach: “intrinsically safe design; control for performance” LE 3 robot DLR

“Dependability” § Safety § reliability § maintainability § Availability § legibility – “the psychological “Dependability” § Safety § reliability § maintainability § Availability § legibility – “the psychological ability of a user to understand what the robot is intending”

Architecture § Classical: “sense > plan > act” § Deliberative (eg NASA): “reason > Architecture § Classical: “sense > plan > act” § Deliberative (eg NASA): “reason > model > react” § Subsumption (Brooks): behaviour based § Hybrid: high level deliberator <> mediator <> low level reactive executive

Intrinsically safe robot inertia DM 2 robot structure Duplicated actuators Stanford University Intrinsically safe robot inertia DM 2 robot structure Duplicated actuators Stanford University

Future surgical robots: in summary § Miniature § Physiologically registered § Sensuate § Dependable Future surgical robots: in summary § Miniature § Physiologically registered § Sensuate § Dependable § Autonomous §. . . and Ubiquitous NASA NEEMO

Today’s surgical robots are already Clinically beneficial Cost effective Improving patient outcomes Improving Safety Today’s surgical robots are already Clinically beneficial Cost effective Improving patient outcomes Improving Safety Lowering Costs Enabling New procedures New surgical robots will be § SMALL, including intrabody. § Intelligent and sensuate § Semi- autonomous § Ubiquitous in surgical procedures

Robotics in surgery Patrick A Finlay Ph. D CEng Director and Chief Technical Officer, Robotics in surgery Patrick A Finlay Ph. D CEng Director and Chief Technical Officer, Prosurgics Ltd