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

Monday, October 29, 2007

Visit to the JHU Dynamical Systems and Control Laboratory


Last Friday at the student seminars the JHU Dynamical Systems and Control Laboratory introduced its projects and people. After the presentations we were given a chance to visit their lab. They are involved in several research topics, e.g. haptics and proprioceptive perception, and they have developed several surgical robotic arms in cooperation with the ERC CISST. Presently they are occupied with their JHU ROV, an autonomous underwater exploration robot. What was most surprising, a 195.000 liter water tank in the lab for on-site testing. We could see the UAV robot in action, performing some navigation tasks. For further information visit this site.

Steady-hand robots for microsurgery



Several new robots have been developed here to assist microsurgery. This JHU Steady Hand Robot has innovative structural design, and it can augment the surgeon's skills by reducing hand tremor, and cooperatively guiding surgical tools. Further details can be found here and a presentation is here.
Another robot is particularly for eye surgery. When an artery is blocked within the retina, the plaque can be dissolved by adding special vasodilatating chemicals locally. However, this means that the surgeon has to hit the targeted blood vessel, and keep the needle inside it. The steady-hand robot can grasp a needle and move it carefully in tandem with the surgeon in a technique called cooperative manipulation. In tests of the device, the researchers have successfully injected a liquid into a chicken embryo's blood vessels, resembling structures in the human eye. This robot will hopefully reach clinical phase within a few years.


Saturday, October 27, 2007

NeuroSurgery Project



One of the projects of Professor Peter Kazanzides is the installation of a skull base surgery robot. They use a NeuroMate robot to assist the drilling procedures. Skull base surgery treats leisions such as acoustic neuroma, cerebral aneurys. Providing a robot-mounted drilling and milling tool this application can reduce surgical error and procedure time. They have a NeuroMate robot in Johns Hopkins Hospital, downtown Baltimore, that has a 6DOF force/torque sensor mounted above the tool. (Pictures on the setup.) The idea of the application is to integrate imaging and robot control to improve the accuracy of the surgery. First the patient goes into the CT scan, along with fiducials. These help to determine the coordinate system of the CT based 3D model. It is processed with the open-source 3D Slicer. The area of the drilling is determined on the model called virtual fixtures. During the surgery the surgeon holds the drilling instrument mounted on the robot. The robot applies counter-forces whenever the surgeon would leave the pre-define virtual fixtures. This makes the operation safer and faster. Two PhD students have been working on this robot so far: Tian Xia and Babak Matinfar.

For safety reasons, there is an additional optical tracking system, the StealthStation. It can determine the spacial position of the robot's end effector and the patient with the help of the mounted markers. The importance of the system is to give a real time feedback of the relative positions during the procedures, as it is crutial to monitor any changes to the pre-registered relative position of the robot to the patient. My role will be to improve the effectiveness of this optical tracking system. Its effectiveness has to be improved along with the robustness. From the engineering point of view, the problem is that we have a very accurate relative position measuring (from the incremental encoders of the robot) and a less precise absolute measuring from opto-tracking. We have to achieve the best results possible. We are planning to introduce Kalman filtering and other methods to reduce noise.

Inside the laboratory


The CISST Lab is ran by several professors. Prof. Taylor, the director is basically involved in everything. Prof. Kazanzides focuses more on surgical assistant workstations for teleoperated robots, on small animal radiation and neurosurgery. Prof. Fichtinger moved to Queens University in Kingston, but his group is still working here on prostate brachytherapy. Prof. Hager works on modeling and visualization, and Prof. Okamura on haptics. All the professors have their own PhD and undergrad students working for them, sometimes in different projects parallel. The lab has great hardwares. Beside an opened up da Vinci, that has been built a new controller, several endoscope-holder robots, micro-surgery setups, a snake-like robot prototype and other mobile robots can be found. Those robots that are in actual trial phase (first cadaver then animal and finally clinical) are moved to the JH Hospital. I will try to introduce each project I come across.

CISST


The Engineering Research Center for Computer-Integrated Surgical Systems and Technology (CISST) was founded in 1998 with seed funding from NSF within the LCSR under the directorate of Professor Russel H. Taylor. The mission of the ERC is to
  • Reduce surgical costs substantially
  • Improve clinical outcomes
  • Make healthcare delivery more efficient
The CISST has several research programs organized along three main threads: modeling and analysis of patient and surgical procedures, interface technology connecting the virtual reality and actual reality and system science. This includes surgical CAD/CAM, surgical assistance systems and infrastructures. To make team and project work more effective a new building was built in 2007 to accommodate scientists and engineers of the different fields. To fit into the landscape of the other buildings they imported the 2500 marble stones (for decoration) from Italy. There is a big lab (app. 500m2) called the ''Robotorium" in the basement of the Computational Science and Engineering Building where several robots are installed and 10 lab pods serve the 20-30 students and visiting researchers.

Friday, October 26, 2007

Johns Hopkins University


When Johns Hopkins died in 1873 he donated an enormous sum of 7M USD to fund several institutions, among the Johns Hopkins University (JHU), Johns Hopkins Hospital and the Medical School. The first President of the University Daniel Coit Gilman imagined a research university and from 1876 he managed to direct a new and prosperous institute. Present JHU has app. 4500 undergrad students and 2000 postgrads. This is one of the richest and highest ranked university in the States. G.W.C Whiting School of Engineering is one of the nine academic devisions of JHU, under which there is the Laboratory for Computational Sensing and Robotics (LCSR).

Thursday, October 25, 2007

Preambulum

This blog was created to give a personal coverage on the world of surgical robotics, especially on the happenings and project work at Johns Hopkins University Computer-Integrated Surgical Systems and Technology Engineering Research Center.