ICRA 2016 Tutorial on
Stockholm, Sweden, May 20, 2016
Harvard Medical School
Imperial College London
Robot-assisted minimally invasive surgery (RMIS) was used for over 570,000 abdominal and pelvic procedures worldwide in 2014, and for approximately 2 million procedures since commercial products were launched in 2000. The da Vinci Surgical System is the most prominent commercially available robot for abdominal and pelvic surgery in the world, but even wider proliferation of RMIS is expected in the coming decade as many companies launch new platforms. We recently counted 14 new RMIS systems that have been launched as products or announced as being under development. RMIS offers advantages over traditional manual minimally invasive surgery by increasing dexterity, allowing motion and force scaling, and providing an unprecedented opportunity to collect data to understand and impact how a surgery is performed. However, significant concerns remain regarding the safety, efficacy, and cost-effectiveness of RMIS systems -- and new design, control methods, and applications need to be identified by the robotics community.
Minimally invasive surgery typically assumes that there is natural and fairly direct optical observation of the surfaces of tissue and elements of the environment. In contrast, a large class of medical procedures are image-guided interventions, in which medical imaging modalities (e.g. MRI, CT, ultrasound) are used to see through tissue. This enables helpful visualization, but physical access to many locations remains a challenge. Robots can help with these procedures by effectively controlling needles (or catheters or other small devices) inside tissue, rather than just exposing and manipulating a surface.
Recent years have seen a surge in robots that physically interact with human voluntary movements. Collaborative robots have been developed to facilitate the handling of objects and tools in manufacturing; Assistive robots are aimed at increasing mobility; Rehabilitation robots target movements training for physically or neurologically impaired individuals; Dedicated devices have been designed to carry out neuroscientific investigations. These robots have in common that they should smoothly and efficiently interact with human movements. Therefore, they should consider the users' safety, neuromechanics and sensorimotor control, as well as the requirements of the environment in which they will be used.
In this tutorial, we will study of the design and control of robots and associated technology for medical applications, focusing on surgery, interventional radiology and neurorehabilitation. The tutorial is aimed toward through in the fields of engineering and computer science; no medical background is required. The tutorial expects a solid background in dynamic systems modeling, knowledge of introductory controls, and an understanding of basic robotics, including forward and inverse kinematics, use of the Jacobian, and workspace.
|08:00 - 8:10||
|08:10 - 9:00||
Lecture 1 : Design Considerations for Medical Robots (slides)
Lecture 2 : Kinematics and Control of Medical Robots (slides)
|9:50 - 11:10 (coffee break will be from 10:20-10:40 am)||
Lecture 3 : Image-Guided Therapy (slides)
|11:10 - 12:10||
Lecture 4 : Collaborative Robots for Mobility Assistance and Rehabilitation (slides)
|12:10 - 12:30||
Medical robots must be safe, biocompatible, and (where appropriate) imaging-compatible. Here we discuss the design challenges for medical robots that enter the body of a patient, focusing on the robot specifications as well as the therapy delivery method.
Existing robots for medical interventions share important design and control features that allow them to perform minimally invasive techniques while keeping the human operator in the loop. This lecture will present (commercially) successful surgical robot kinematics and explain how human-in-the-loop control is achieved through telemanipulation and cooperative manipulation.
In image-guided interventions, the clinician uses intra-operative image guidance for visualization while placing a medical instrument, typically a needle or catheter. A robot can similarly use visual information to carry out a procedure partially or completely autonomously. In this lecture, we will discuss the different types of imaging modalities available to clinicians (and robots), as well as how robots use those images in the process of performing an intervention. The lecture will also highlight how to run a successful translational research group using open source software, deploy medical robots clinically, and use your clinical experience to foster commercialization of the robot.
In this lecture we will present and discuss the requirements and solutions for robots that physically interact with the movements of their users. We will illustrate these on the design of collaborative wheelchairs, on rehabilitation devices to train the upper limb in neurologically impaired individuals, and on dedicated robots to investigate the neural control of movements. We will study how knowledge of human sensorimotor control can help systems provide an intuitive control and efficient learning.
Open IGT: http://www.openigt.org
Human motor control modelling and interactive control: http://www.imperial.ac.uk/human-robotics/software/
Advanced Multimodal Image-Guided Operating (AMIGO) suite is the clinical translational test-bed for research at the National Center for Image Guided Therapy (NCIGT): http://ncigt.org/amigoprocedures
I-Corps at NIH (training for project teams at NIH-funded small businesses overcome key obstacles along the path of innovation and commercialization): https://sbir.cancer.gov/programseducation/icorps/webinar
H. Choset, M. Zenati, T. Ota, A. Degani, D. Schwartzman. Enabling Medical Robotics for the Next Generation of Minimally Invasive Procedures: Minimally Invasive Cardiac Surgery with Single Port Access. In J. Rosen, B. Hannaford, and R. Satava, Eds., Surgical Robotics - Systems, Applications, and Visions, pp. 257-270. Springer, 2011.
S. M. Farritor, A. C. Lehman, and D. Oleynikov. Miniature In Vivo Robots for Notes. In J. Rosen, B. Hannaford, and R. Satava, Eds., Surgical Robotics - Systems, Applications, and Visions, pp. 123-138. Springer, 2011.
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A. J. Madhani, G. Niemeyer, and J. K. Salisbury, Jr. The Black Falcon: a teleoperated surgical instrument for minimally invasive surgery. In Proceedings of the IEEE/RSJ International Conference on Intelligent Robots and Systems, pp. 936-944, 1998.
J. Marescaux, J. Leroy, M. Gagner, F. Rubino, D. Mutter, M. Vix, S. E. Butner, M. K. Smith. Transatlantic Robot-Assisted Telesurgery. Nature, 413:379-380, 2001.
G. Niemeyer, C. Preusche, G. Hirzinger. Chapter 31: Telerobotics. In Springer Handbook of Robotics, pages 741-757, 2008.
A. M. Okamura. Haptic feedback in robot-assisted minimally invasive surgery. Current Opinion in Urology, 19(1):102-107, 2009.
R. H. Taylor and D. Stoianovici. Medical Robotics in Computer-Integrated Surgery. IEEE Transactions on Robotics, 19(5):765-781, 2003.
Z. Yaniv, and K. Cleary. Image-Guided Procedures: A Review. CAIMR Technical report TR-2006-3, 2006.