WHERE DO WE STAND TODAY IN ROBOTICS – PRACTICAL USES

Abstract

Robotic systems for computer assisted surgery have gained a lot of initial interest and several systems to support surgical inventions have been developed over the past ten years. While almost all systems are tailored to specific applications, the technology used may be divided into different groups. One part of the proposed solutions is essentially based on industrial robots, whereas the part relies on specific designs for medical applications. A particular approach which will not be discussed in this contribution is represented by tele-manipulator systems like the daVinci system from Intuitive Surgical Inc. for cardiac applications, and robots for endoscope guidance in abdominal surgery. The operation of these systems is controlled manually by the surgeon based on the visual information of the operating area which he gets by endoscopic cameras.

Robotic application in computer assisted surgery, in contrast to tele-manipulator approaches, is based on pre-operative planning and intra-operative registration of the patient anatomy. They principally offer additional advantages compared to pure navigation systems, such as

• No problems due to tremor or unintentional slipping of the tool. Surgery will exactly achieve pre-operatively planned targets, resulting in very good reproducibility

• Precise drilling or reaming. Overcome ergonomic problems, like difficult hand-eye-coordination or frequent changes of viewing the direction

• Definition of “safe areas” – robot will not move tool beyond

• Use of novel tool systems which cannot be guided manually

• Essential issues: operating mode & “added value” of a robot

It is a major challenge for new solutions of surgical robot system to exploit this potential while avoiding the drawbacks some existing designs which have not gained wider clinical acceptance. The “added value” of robotic systems must be obvious. Important features to achieve this objectives include interactive operating modes which turn the robot into a powerful and versatile assistance system instead of fully automatic system operation.