The hinotori Robotic-Assisted Surgery System
"The hinotori by Medicaroid, which was formed as a joint venture by Kawasaki and Sysmex Corporation, endeavors to enter the market monopolível safety, and maximum maneuverability. The size was reduced to fit the relatively small operating rooms in Japan, and the robotic arms were designed to match the width of the human arm, which had the favorable effect of not overwhelming the patient. However, this compactness was a hurdle to the development project.
Although it is a robot, the hinotori never moves autonomously. The system’s four arms and the instruments at the tips of the arms are tools that act as the surgeon’s eyes and hands to see, explore, grasp, cut, and suture. Each arm provides an eight-axis configuration, which means the degrees of freedom are greater than ordinary industrial robots with six and the human arm with seven. On top, the four-axis motion control of each instrument is added for a total of twelve axes that can achieve smooth, flexible motion.
Meanwhile, when the four compact arms can move freely, the risk of interference increases. A collision of the arms followed by a system stop during surgery may have serious consequences. Therefore, elaborate control of the arms was considered a crucial requirement.
On December 14, 2020, a press conference was held at ICCRC on the success of the initial surgery using the first domestically produced robotic-assisted surgery system, the hinotori. Dr. Masato Fujisawa, dean of the Kobe University Graduate School of Medicine (present-day president of Kobe University), who had been an advisor in the development of the hinotori system, operated the system for a total prostatectomy.
Subsequent to the more than four hours of surgery, Dr. Fujisawa commented to the press, “I’d score the manipulation perfect,” and said that he was extremely moved by the fact that they had achieved societal implementation of a new medical device.
The system also enjoyed success at a second facility, Wakayama Medical University, and a third, Tokushima University Hospital as well in April 2021. Where in the world is the hinotori going to fly for more records of accomplishment? Tojo foresees future possibilities, “We still have many issues to resolve, including virtual pre-operation simulations incorporating CT-scan images, the automation of simple suturing, and the inheritance of experienced surgical skills.”
Regarding the prospective evolution of surgical robots, Yamaguchi of the ICCRC reports that three navigational features will be subject to critical improvements: “One will be to enhance the level of procedural precision using accurately visualized images of the surgical field obtained by injecting fluorescent dye. Another will be to accumulate and analyze data from robotic surgeries performed by expert surgeons so that their expertise can be leveraged as best-practice examples. Finally, the advancement of telesurgery using 5G and 6G (5th- and 6th-generation) communication systems is also vital.” Some parties now positively encourage verification tests for real-time transmission of 8K images with the 5G communication system. Once the next-generation high-speed communication networks are popularized more broadly, telesurgery would be possible between remote locations without a time lag.
As the first step in proving this idea, on April 16, 2021, Medicaroid announced the initiation of the first demonstration experiment in the world to remotely control the made-in-Japan robotic-assisted surgery system via commercial 5G networks. The idea is that high-definition 3D surgical images and robot control signals are transmitted in real-time by means of NTT Docomo’s commercial 5G and cloud services, and the first target is to realize telesurgery support through this system, in other words, the doctor on-site uses the surgical support robot to carry out a procedure with the assistance of a skillful surgeon in the robot cockpit from a remote location.
The 5G technology and the hinotori system intend to create a society where everyone can receive equal quality healthcare services. Widespread, societal implementation of surgical support robots will bring advanced surgical practices to towns without specialists and borderlands isolated by the ocean. If trips to the Moon are common in the future, a travel agency brochure might contain an exciting copy: Take it easy! Doctors on Earth will take care of you if you get sick on the Moon."
Although it is a robot, the hinotori never moves autonomously. The system’s four arms and the instruments at the tips of the arms are tools that act as the surgeon’s eyes and hands to see, explore, grasp, cut, and suture. Each arm provides an eight-axis configuration, which means the degrees of freedom are greater than ordinary industrial robots with six and the human arm with seven. On top, the four-axis motion control of each instrument is added for a total of twelve axes that can achieve smooth, flexible motion.
Meanwhile, when the four compact arms can move freely, the risk of interference increases. A collision of the arms followed by a system stop during surgery may have serious consequences. Therefore, elaborate control of the arms was considered a crucial requirement.
On December 14, 2020, a press conference was held at ICCRC on the success of the initial surgery using the first domestically produced robotic-assisted surgery system, the hinotori. Dr. Masato Fujisawa, dean of the Kobe University Graduate School of Medicine (present-day president of Kobe University), who had been an advisor in the development of the hinotori system, operated the system for a total prostatectomy.
Subsequent to the more than four hours of surgery, Dr. Fujisawa commented to the press, “I’d score the manipulation perfect,” and said that he was extremely moved by the fact that they had achieved societal implementation of a new medical device.
The system also enjoyed success at a second facility, Wakayama Medical University, and a third, Tokushima University Hospital as well in April 2021. Where in the world is the hinotori going to fly for more records of accomplishment? Tojo foresees future possibilities, “We still have many issues to resolve, including virtual pre-operation simulations incorporating CT-scan images, the automation of simple suturing, and the inheritance of experienced surgical skills.”
Regarding the prospective evolution of surgical robots, Yamaguchi of the ICCRC reports that three navigational features will be subject to critical improvements: “One will be to enhance the level of procedural precision using accurately visualized images of the surgical field obtained by injecting fluorescent dye. Another will be to accumulate and analyze data from robotic surgeries performed by expert surgeons so that their expertise can be leveraged as best-practice examples. Finally, the advancement of telesurgery using 5G and 6G (5th- and 6th-generation) communication systems is also vital.” Some parties now positively encourage verification tests for real-time transmission of 8K images with the 5G communication system. Once the next-generation high-speed communication networks are popularized more broadly, telesurgery would be possible between remote locations without a time lag.
As the first step in proving this idea, on April 16, 2021, Medicaroid announced the initiation of the first demonstration experiment in the world to remotely control the made-in-Japan robotic-assisted surgery system via commercial 5G networks. The idea is that high-definition 3D surgical images and robot control signals are transmitted in real-time by means of NTT Docomo’s commercial 5G and cloud services, and the first target is to realize telesurgery support through this system, in other words, the doctor on-site uses the surgical support robot to carry out a procedure with the assistance of a skillful surgeon in the robot cockpit from a remote location.
The 5G technology and the hinotori system intend to create a society where everyone can receive equal quality healthcare services. Widespread, societal implementation of surgical support robots will bring advanced surgical practices to towns without specialists and borderlands isolated by the ocean. If trips to the Moon are common in the future, a travel agency brochure might contain an exciting copy: Take it easy! Doctors on Earth will take care of you if you get sick on the Moon."
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