"The future of surgery is not about blood and guts; the future of surgery is about bits and bytes.”
/Dr. Richard Satava/

Wednesday, May 25, 2016

Video Wednesday


Demo at Hamlyn.

Monday, May 23, 2016

iSYS teams with Medtronic

Medtronic is quite busy these days. Recently, they also closed a cooperation deal with iSYS. The "sandwich robot" has been typically used with Medtronic navigation systems, and now they are forging closer ties:
"The Austrian medical device manufacturer iSYS Interventional Systems (iSYS) is on a joint venture with Medtronic, a worldwide leading manufacturer of medical technology. The aim of the joint venture will be to facilitate the development of robot-based operating instruments for navigated neurosurgery. Quarton International supported the entire transaction process and advised iSYS Interventional Systems in all phases of the negotiation."

In the meanwhile, Medtronic's CEO also sees a possible future partnership with Google's Verb Surgical: "They [Verb S] bring a different capability compared to what we bring, whether that will create a competitor or partner is tough to say, and it could be both."

Medtronic should coming out soon with its own system: "Medtronic's plan involves tying Covidien's interventional surgical devices to robotic equipment under development, with a launch hoped for later this year."

iSYS 1 main features:

  • 4 degrees of freedom: alignment adaptability
  • High positioning accuracy: relative: 0.02mm, absolute: 0.1mm
  • Modularity and compatibility:works with all CBCT/Fluoro C-Arms
  • Compact flat robot design: Can be used in cases of tight clearance margins
  • Unique metal-free needle guide design:No imaging artifacts
  • Stable table adaptation via various table adapters or carbon fiber boards
  • Set up configuration flexibility
  • Setting up the system: In just a few steps the iSYS1 is attached to the treatment table and ready for use
  • 3D imaging and planning is done with the ConeBeam-CT Workstation.
  • In one simple step the sterile needle guide is attached to the needle guide extension on the robot
  • After gross postioning of the robot - the marker inlay is inserted into the needle guide.
  • Micro-positioning of the needle guide is done remotely from a safe distance using the joystick
  • After attachment of the needle insert, the iSYS1 allows stable and precise guidance along the planned trajectory.
  • Verification and quality assurance: Needle insertion under fluoroscopic guidance ("progression view")
  • The correct needle position can be verified before, during, and after treatment.

Sunday, May 22, 2016

Mazor and Medtronic team up


Medtronic is buying into Mazor - gradually. A multi-stage agreement was agreed earlier this week, anticipating a higher share acquisition of Medtronic in the Israeli company, at an estimated company value of 280m, three times as much that TransEnterix paid for the ALF-X
"Mazor Robotics (NSDQ:MZOR) said today that it inked a 2-phase deal with Medtronic NYSE:MDT) for its robot-assisted spine surgery technology that includes a co-promotion agreement and an equity investment that could see Medtronic wind up with a 15% stake in the Israeli company for as much as $42 million.
Caesarea, Israel-based Mazor said the 1st phase of the deal calls for Medtronic to acquire 15 Mazor systems this year. It also makes Medtronic Mazor’s sole partner for developing and commercializing robot-assisted spine surgery devices; if both meet their milestones by the endof 2017, the deal is slated to progress to the 2nd phase. Mazor said its already working with Fridley, Minn.-based Medtronic on the development of “synergistic” spine products “and will begin working closely together to meet designated sales targets through a defined methodology for cooperation.”
The 2nd phase involves a 3-step equity investment by Medtronic, in which the world’s largest pure-play medtech maker would 1st pay $12 million for a 4% stake in Mazor. The 2nd tranche, triggered by Mazor achieving operational milestones, would see Medtronic acquire a 6% stake at the 20-day average share price for MZOR stock. In the 3rd tranche, triggered by the 2nd tranche and the execution of a global distribution agreement – but executed at Mazor’s discretion – Medtronic would buy another 5% stake, again at the 20-day MZOR average. Mazor said Medtronic can cap the 2nd and 3rd tranches at $20 million apiece.
Mazor said it plans to stay independent and will still market its Renaissance robot-assisted surgery platform.
MZOR shares jumped 26.2% to $13.41 apiece in pre-market trading today."

Source: Mass Decive

Friday, May 20, 2016

ICRA Tutorial on Medical Robotics

A great new feature at this IEEE ICRA is the invited tutorials. A half-day-long tutorial on medical robotics. If you are around, stop by in room A2! 

"Tutorial Content

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.
The tutorial consists of a set of four lectures:

08:00 - 8:10 Introduction (slides)
08:10 - 9:00 Lecture 1 : Design Considerations for Medical Robots (slides)
Allison Okamura
9:00-9:50 Lecture 2 : Kinematics and Control of Medical Robots (slides)
Allison Okamura
9:50 - 11:10 (coffee break will be from 10:20-10:40 am) Lecture 3 : Image-Guided Therapy (slides)
Nobuhiko Hata
11:10 - 12:10 Lecture 4 : Collaborative Robots for Mobility Assistance and Rehabilitation (slides)
Etienne Burdet
12:10 - 12:30 Conclusion (slides)

Lecture 1 : Design Considerations for Medical Robots

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.

Lecture 2 : Kinematics and Control of Medical Robots

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.

Lecture 3 : Image-Guided Interventions

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."

Lecture 4 : Collaborative Robots for Mobility Assistance and Rehabilitation

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.


Software

Resources

References
  • 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.
  • G. Fichtinger, P. Kazanzides, A. M. Okamura, G. D. Hager, L. L. Whitcomb, and R. H. Taylor. Surgical and Interventional Robotics Part II: Surgical CAD-CAM Systems. IEEE Robotics and Automation Magazine, 15(3):94-102, 2008.
  • G. S. Guthart and J. K. Salisbury, Jr. The IntuitiveTM telesurgery system: overview and application. In Proceedings of the IEEE International Conference on Robotics and Automation, pp. 618-621, 2000.
  • N. Hata, J. Tokuda, S. Hurwitz, and S. Morikawa. MRI-Compatible Manipulator With Remote-Center- of-Motion Control. Journal of Magnetic Resonance Imaging, 27:1130-1138, 2008.
  • N. Jarrasse, T. Charalambous, and E. Burdet. A Framework to describe, analyze and generate interactive motor behaviors. PLoS ONE 7(11): e49945, 2012. doi:10.1371/journal.pone.0049945
  • 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."
Look for more on the tutorial's website!

Wednesday, May 18, 2016

Monday, May 16, 2016

Synaptive


Synaptive Medical has long been involved with imaging, image guided surgery. Now they released their image-guided camera handling robotic arm:
"BrightMatter Drive offers exceptional accuracy when delivering the optical component where and when the surgeon needs it. This highly maneuverable surgical scope solution possesses a small footprint and a range of positioning options to support a variety of surgical environments.
Control, including component positioning, is accomplished with the foot pedal, leaving the surgeon’s hands free. The system has multiple optical component options, and boasts the integrated OverView Camera that enables a global view of the surgical field."

Read more about it on their website.
Watch Dr. Delashaw talking about the clinical use of the system.

Sunday, May 15, 2016

Summer School on Control of Surgical Robots (COSUR 2016) - 2nd Call

Altair Robotics Lab, in collaboration with the IEEE Robotics and Automation Society (RAS) Technical Committee on Robotic Surgery and the European project MURAB (MRI and Ultrasound Robotic Assisted Biopsy), organises the

1st Biannual Summer School on Control of Surgical Robots (COSUR 2016)

5-9 September 2016
Department of Computer Science
University of Verona, Italy
The school is partially funded by the IEEE Robotics
and Automation Society, MURAB project, the Italian Ministry of Foreign Affairs (ROBIOPSY – Italy-USA collaboration project), the Doctoral Program in Computer Science of the University of Verona.
logo-ras CMYK_print-01logo_ufficiale_maeciA-Logo_Univr_Rettore_2016-02di_logo
The main objective of COSUR2016 is to introduce PhD students and Post-Doctoral fellows to the multidisciplinary research field of surgical robotics, with particular focus on the control algorithms used in robotic surgery and the impact of cognition in directing the control. We will offer lectures, hands-on laboratory experience, and opportunity for informal interaction with clinicians and leading experts from academia and industry. The school will go beyond the current approach of doctoral schools and will give trainees an in depth understanding of cognition and control in robotic surgery.

Important dates
Application deadline: 1 June 2016
Acceptance by: 8 June 2016
Registration deadline: 1 July 2016

TECHNICAL PROGRAM

The main themes faced during the school include:
  • Control and Sensing in robotic surgery
  • Teleoperation and Haptics
  • Image-guided robotic surgery and interventions
  • Human-Robot Interaction and Cooperation
  • Partially autonomous tasks in robotic surgery
Besides the technical aspects, the lecturers of the school will present the medical context in which robotic surgery is being used and the research perspective given by relevant EU-funded projects.
The school will include tutorial presentations on the technical topics, medical scenarios presented by clinicians, research perspectives given by the coordinators of recently funded EU-projects, and laboratory sessions that will let students apply the concepts introduced during the lectures.
The school will end with a team project, which will be evaluated by the school lecturers. Students will receive a certificate of attendance, to obtain credits in their universities.
The list of international speakers includes:
  • Prof. Paolo Fiorini, Università degli studi di Verona
  • Dr. Riccardo Muradore, Università d egli studi di Verona
  • Prof. Arianna Menciassi, Scuola Superiore Sant’Anna
  • Dr. Leonardo Mattos, Istituto Italiano di Tecnologia
  • Dr. Elena De Momi, Politecnico di Milano
  • Prof. Tamas Haidegger, Óbuda University
  • Prof. Mirko D’Onofrio, University Hospital in Verona
  • Prof. Marco Zenati, Harvard Medical School
  • Prof. Stefano Stramigioli, Universiteit Twente
  • Prof. Chris de Korte, Radboud University Medical Centre
  • Prof. Philippe Poignet, Université de Montpellier
  • Prof. Joel Burdick, Caltech
The school is held the week before the workshop on Computer and Robot Assisted Surgery (CRAS 2016) that will be held in Pisa on September 12-14, 2016. The students of the school will have the opportunity to present the results of their team projects at the workshop in a dedicated poster session. To register for the workshop the school attendees will receive a special COSUR2016 registration fee.