Robot Assisted Cardiac Surgery

oregontrimmingAI and Robotics

Nov 2, 2013 (3 years and 9 months ago)

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Robot Assisted Cardiac
Surgery


Course:

Cardiovascular Imaging

Submitted by:

Alper Yaman

Instructor:

Assoc. Prof. Dr. Cengizhan
Öztürk


What is robot assisted
surgery?

Application of computer assisted
robotics to enhance surgeon’s capability
to carry out various
“minimally invasive”
surgical procedures.

The advantages of robotic
surgery


Faster, easier and steadier surgery

More accuracy

Enhanced visualisation, zooming

Minimally invasive [1].

The advantages of robotic
surgery 2

Less pain to patient

Shorter recovery time

Shorter hospital stays [1]

Robot Assisted Surgery
Approach

Perception & imaging by sensors and cameras

to monitor the heart

Robot Assisted Surgery
Approach 2

Arms and wrists for clamping, suturing, and severing.

Control Panel

Technical Information

Registration

Preoperative images
(CT or MRI) are
registered both to
stabilize target point
images on the monitor
and to guide the
manipulators [2].

Imaging


Fast video cameras are
used to obtain
operative images.

Technical Information 2

Robot Positioning




Optimal position of the
robot should be provided
concerning with degrees of
freedom of the manipulator
[2].

Technical Information 3

Port Placement:

Entry
points are selected by
images on the port.

Robot is registered to the
patient.

Ports are expressed in the
robot coordinate frame
and used to guide the
surgeon [2].

Heart Beat Synchronization

“Motion Cancelling Robot System”

Visual Synchronization: Provides
stabilized target point images on the
monitor.

Motion Synchronization: The slave robot
is synchronized with the heart beat.

Master


Slave Control: Transfers the
master motion to control the slave robot
[3].

Heart Beat Synchronization

“Motion Cancelling Robot System”

[3]

Haptics and Augmented
Reality

Haptics


Applying tactile
sensation and control to
interaction with computer
applications.

Augmented Reality


Computer graphics are
superimposed or
composited with real
images.


Haptic Virtual Fixtures

Software
-
generated force and position
signals applied to human operators.

To improve the safety, accuracy, and
speed of manipulation tasks.

Integrates robots accuracy and
precision with human intelligence [4].

Haptic Virtual Fixtures 2

Guidance Virtual Fixtures: guides the
robot along desired paths (a).

Forbidden
-
Region Virtual Fixtures: Keep
the robot out of forbidden regions (b).
[4]

[4]

An example to robots

“Da Vinci Surgical System”

Intuitive nature of the surgeon’s hand
movements

Components:


A surgeon console


Patient
-
side cart


Instruments


Image processing equipment

An example to robots

“Da Vinci Surgical System” 2

Benefits For The Surgeon:

Improved dexterity

Enhanced 3D visualisation and
magnification

Greater surgical precision

Increased range of motion

Better ergonomics

An example to robots

“Da Vinci Surgical System” 3

Robotic articulated instrumentation daVinci prototype 1997 [5]

An example to robots

Leipzig 1998 [5]

Current Operations with daVinci

Atrial septal defect closure

Internal thoracic artery take
-
down

Endoscopic coronary bypass

LV bipolar pacing lead placement

Mitral valve repairment and replacement

Ablation of atrial fibrillation [5]

Current Operations with daVinci 2

[5]

Current Operations with daVinci 3

[5]

Transmyocardial
Revascularization

Laser is used to open tiny holes
(transmyocardial channels) on
myocardium.

Angiogenesis: Laser stimulates new
blood vessels to grow.

Channels heal on the outside but
remain open on the inside. [6]


Transmyocardial

Revascularization 2

[6]

Results and Discussion

Robot assisted cardiac surgery is combining
various disciplines: robotics, computer vision
and biomedical engineering. It’s advantages
are:

Faster, easier and steadier surgery

More accuracy

Enhanced visualisation, zooming

Minimally invasive

Less pain to patient

Shorter recovery time

Shorter hospital stays


References

1.
E. Adams, Bibliography: Robotic Surgery, Technology Assessment
Program, Office of Patient Care Services, Boston, March 2004.

2.
`E. Coste
-
Mani`ere and L. Adhami. Optimal Planning of Robotically
Assisted Heart Surgery: Transfer Precision in the Operating Room.
The International Journal of Robotics Research, Vol. 23, No. 4
-
5,
539
-
548 (2004).

3.
Y. Nakamura, K. Kishi, and H. Kawakami. Heartbeat
Synchronization for Robotic Cardiac Surgery. Proc. of the IEEE.
International Conf. On Robotics&Automation, pp. 2014
-
2019, 2001.

4.
J. J. Abbott, P. Marayong, and A. M. Okamura, "
Haptic Virtual
Fixtures for Robot
-
Assisted Manipulation
," 12th International
Symposium of Robotics Research, 2005. (accepted).

5.
W. R. Chitwood. Robotic Cardiac Surgery. 90th Annual Clinical
Congress , American College of Surgeons, New Orleans, 2004.

6.
Cleveland Clinic Heart Center web page,
http://www.clevelandclinic.org/heartcenter/pub/guide/disease/cad/TM
R.htm

Thank you

for your attention!