SurgRob

The IRCAD-IEEE course rolls on

2012-02-13T07:35:00.000-08:00

The IRCAD-IEEE course on innovation in MIS has reached its next phase: the engineering sessions. The first two lectures are already available for everyone from the IRCAD student website:

More exciting lectures are to follow! In addition you are all cordially invited to the LIVE engineering in MIS session of the course that will take place FEBRUARY 23, 4.30PM GMT+1 at IRCAD, and streamed online. The distinguished lecturers will be:

Prof. Michel de Mathelin on Automation and Control Challenges in the OR
Prof. Arianna Menciassi on the Future of Robotic MIS

Learn more about it from the newsletter.

Register now!

IARP meeting on Cognitive Surgical Robotics

2012-02-10T11:55:00.000-08:00

At the end of January, the International Advanced Robotics Programme (IARP) held a 2-day forum on Cognitive Surgical Robotics in Heidelberg. The program featured renowned scientists from all around the world, who presented the state of the art in their region. Talks covered Europe in general, Germany, Korea, the UK, Japan, France, Spain, Poland and the US with Canada. (Probably the most exciting part in Ron Kikinis' presentation was when he introduced all the free medical imaging platforms based on a Nature Methods article, and derived why Slicer in the only good solution out there.) The next session was covering key companies/centers working in the area, such as DLR, KUKA and Force Dimension. Next, the current/recent major FP7 project s were introduced, such as Robocast, Active, EuroSurge, Safros. Participants also got an insight to what certain groups have roadmaped for the future. Cognition was also addressed on the sideline, although more questions were raised than answers given. Finally, a panel was brought up where an interesting discussion emerged, where the distinguished fellows expressed their anticipation for the future:

expect to see evidence-based robotic surgery
SILS/NOTES on a higher scale
affordable MIS tools
all kinds of guidance for procedures.

Adjoin, participants were given an organized tour to the medical robotics labs of KIT in Karlsruhe, and I also got a private tour to the labs of dkfz's Division of Medical and Biological Informatics. (Reports will come later.)

Call for IEEE RAS student reviewer mentors

2012-02-07T14:35:00.000-08:00

A good year ago we started a new initiative, the IEEE Robotics and Automation Society's Student Reviewing Program (SRP). It aims to introduce students to the reviewing process step-by-step, in a controlled and supervised way. Within the SRP, some specific goals have been formulated:

Collect and create instructive material that students can refer to for help in the reviewing process,
Organize a training and supervision process for students to become a better reviewer,
Create a community of talented and devoted students,
Provide a database with experienced and motivated students that editorial boards can refer to,
Raise awareness about this program in the community.

The first year of the SRP closed with a successful pilot round, where 13 RAS student volunteers were involved in the reviewing procedure of the upcoming ICRA2012 conference under the guidance of Program Chair Prof. Lynne Parker (University of Tennessee).

Now we are looking for new mentors for the SRP class of BioRob2012, which will be held in June in Rome. If you are a senior graduate student or beyond with experience in reviewing papers (especially for IEEE)--within the field if medical robotics, biorobotics--we cordially inite you to become a mentor for the SRP!

If you are interested, apply by sending an email to ras-srp.coordinator@ieee.org, with the following information:

your name an email address;
a one-paragraph motivation;
one keyword that describes your field of expertise;
your PaperPlaza PIN, if you have one.

Learn more about the SRP program here (next call for IROS2012 will open in March), or check out our previous articles in the RAS Magazine:

L. Visser and T. Haidegger, “The Reviewing Process: an Introduction for New Reviewers”

The EuroSurge project

2012-02-05T07:43:00.000-08:00

There is a new EU FP7 collaboration project, EuroSurge that aims to collect and organize all available information on European Surgical Robotics Research. (Previous FP projects are here.)

This regard, there is also the MERODA (Medical Robotics Database) from Heidelberg, based on Dr. Pott’s original CAS publication “Today’s state of the art in surgical robotics”.

Learn more about the EuroSurge here, where you can see immediately the list of participating institutions. To support the networking efforts of the group, I'm spreadding here there call for registration. Help us crating something great, register yourself, if you are applicable!

Distributing their call for collaboration:

In the framework of the European coordination action EuroSurge, we are in the process of collecting information (see the this excel file for details) about laboratories that carry out research in the field of robotic assisted surgery. This information gathering is the first step to achieve the main objectives of EuroSurge:

1. Technical: understand the breadth of robotic surgery research in Europe, develop a framework for integration and sharing of research results, and develop a common language for the field in terms of a glossary/ontology.

2. Organizational: give researchers the opportunity to participate in a network of laboratories that would: stimulate new ideas and proposal writing, organize specific events, be instrumental to researcher mobility, share knowledge and educational activities, and help in the development of new standards.

3. Legal: provide support to researchers from the point of view of non-technical issues affecting robotic surgery, e.g. patent, ethical, regulatory and legislative questions.

We kindly ask you to help us making the map of the laboratories whose researchers are involved in all the aspects of robotic surgery. The results of this survey, together with the other project results will be made available on the EuroSurge portal that will provide technical and non-technical support to the researchers. We will also create a mailing list to facilitate the information exchange in the robotic surgery community.

The first event of the project, in which we will describe the project and its first activities, will be a workshop (proposed) at the EURobotics forum in Odense on March 5-7. This will be a great opportunity for all the members of the community to actively participate to the planned activities and shape their development.

Please, complete the attached form by January 30th 2012 so that we can prepare a first draft of the research map by the Odense meeting. We are available for any further information you could need, and will appreciate the indications of a contact person (email address) that could be involved in the further steps of data gathering. The indication of other laboratories in Europe, working on the same topic, you know is welcome.

Thank you very much for your kind attention and your precious contribution.

The EuroSurge team."

Surgenius--another pretender

2012-02-03T01:53:00.000-08:00

I have long wanted to write about the Surgenius robot, a teleoperated system developed by Surcial Robotica S.p.A. in cooperation with the University of Verona (but they asked me not to do so). The beta prototype is ready for more advanced trials, getting the CE mark within a month. The group has been developing the robot for over 3 years, and now looking for strategic investors. The main advantage claimed are the compact size, the modularity of the system, the strerilizable tools and the price--of course.

The development of Surgenius technically dates back to the mid-'90s, when Paolo Fiorini was working with Antal Bejczy at NASA JPL on the RAMS system. The Robot-Assisted Micro-Surgery (RAMS) system consisted of two 6 DOF arms, equipped with 6 DOF tip-force sensors, providing haptic feedback to the operator. It used a kinematically identical master controller; however, the operator sits right next to the slave arms. The robot was originally aimed for ophthalmic procedures, especially for laser retina surgery. It was capable of 1:100 scaling (achieving 10 micron accuracy), tremor ﬁltering (8–14 Hz) and eye tracking. Interestingly, it was only initiated as a side project, using some left-over funds in the robotics lab, Tony and his team developed the system within a year relying on Steve Charles basic ideas. (Learn more about it here.) When they were ready, Intuitive got interested in the technology, and acquired all the documentation (in return of the placement of one of the furst da Vincis in a nearby military hospital.) The original RAMS prototype rested idle at JPL (as of 2008), since the project was discontinued. However it got licensed by a company in New Mexico, but not much happened... Until Paolo picked up the thread, and developed the Surgenius with his team; and now they also have a Medical Center to collaborate with.

The robot got merit at the euRobotics Technology Transfer Award in 2011; you can read more here.

From SurgRob

More news to come!

Credit: Surgica Robotica

EAES Winter Symposium

2012-02-01T17:59:00.000-08:00

The European Association for Endoscopic Surgery renewed its former tradition to give a half-day open symposium to discuss recent issues, challenges and opportunities in modern MIS technology. This year, the meeting was on January 16, in Brussels. The program included 3 invited lectures from high-profile robotics surgery professionals.

Session 1. Robotic Surgery beyond 3D and 7DOF Sir Alfred Cuschieri, UK

Sir Alfred gave a very up-to-date overview of the state of the art regarding da Vinci surgery, he explained his own concerns and wishes for further system development. Recently, he visited Titan Medical in Canada, and according to his opinion, already the current version of the Amadeus prototype is really fine, and very promising. (Now they are developing a human hand-like small-manipulator for the slave side.) He also talked about some long anticipated development in materials sciences, motors, electronics and sensing. He called for operational policies for the cost effective use of surgical robots.

Session 2. Da Vinci surgery : realism after the preliminary enthusiasm Guy Cadière, Belgium

Dr. Cadière talked about the early years of the research, when they were developing master-slave systems for telesurgery even before the da Vinci system. Their group was therefore a natural location for the very first clinical trial. He explained that the only randomized clinical trial with the da Vinci was in Mexico, 1998; involving 120 patients. (Ed.: Second opinion, anyone?)

Session 3. Novel robotic systems integrated with novel imaging platforms - the smart operation of the future? Andreas Melzer, UK

At last, Andreas Melzer talked about various research initiatives across Europe to push the frontiers of MIS robotics.

In the lunch break, the ALF-X Telelap system was introduced by its developers. (See prior posts here and here.)

IFAC BMS conference deadline extended!

2012-01-29T16:55:00.000-08:00

Good news for the late-comers: we pushed back the Biological and Medical Systems Symposium's paper submission deadline to March 4. Please consult the official website (http://bms.iit.bme.hu/) for more information, and submit your paper for a wonderful treat in August in Budapest!

Looking forward to seeing You here!

CIS news

2012-01-24T00:17:00.000-08:00

Gesture-based control praised
Prostatectomy videos
Intuitive Surgical: cutting the mustard
Their Q4 results are also out: 27% increase in procedures and revenues, 2132 robots sold
But for some, this is simply disappointing
Da Vinci Si is now cleared for single-site surgery
Report of a da Vinci boot failure
A site for gynecological da Vinci procedures
A more generic article about robots in healthcare
First robotic HIPEC treatment for ovarian cancer
Video on MAKO surgery
Robot with pneumatic force sensing from Tokyo
Karolinska University Hospital in Stockholm bought a ROSS simulator
India gets its first robotic training center (more details about it)
Japan also gets it in the spring
Plus (Public software Library for UltraSound imaging research) open source tracking libraby form the Queens folks
European medical device regulation under fire

Not so new, but the LapMan laparoscope holder is out there
Confocal Laser Endomicroscopy
Brain bleed detection device wins FDA approval
The wireless future of Healthcare
3D scanning and planning system for maxio-facial and dental procedures
Paula is looking for contribution for her book "The Complete Guide to Medical Device Careers"
Finally, GE Healthcare is also getting involved in robotics
The previous editions of the IRCAD BEST course are available
IRCAD Brasil is already half year old!
New lectures on Single Port Surgery and Flexible Endoscopy available at IRCAD student
Get access to US hospital report up to 2009
Free IGSTK user meeting at SPIE in San Diego
The next edition of the Hungarian NOTES conference is coming
NESA innovation days in September on Palma

And finally two nice videos about SRI's M7 robot and some smart neuro-tools:

Photo credit: Tokyo Institute of Technology

AVRA Surgical's new robot

2012-01-22T14:29:00.000-08:00

AVRA Surgical claims to have a surgical robot (for vascular applications) receiving CE mark very soon. However, nothing is really known about it. Their chairman is Barry Cohen. Also, Dualis MedTech GmbH, a DLR spin-off and subsidiary of AVRA Surgical has just recently made an agreement with HeartWare to develop ventricular assist devices with wireless, transcutaneous energy transfer system (TETS) technology. Since Allaboutroboticsurgery.com has become a media partner of AVRA, more news might come from them.
"AVRA Surgical, Inc. is developing a surgical robotic system of a modular construction which offers a portable lightweight and maneuverable robotic solution not available in any system in hospitals today. We expect CE approval early in 2012 and will commence clinical trials in mid-2012. The company´s approach to robotic surgery does not stop at the robot alone. The AVRA method is to design the operating room specifically for robotic surgery and to coordinate the design of the operating table, lighting systems and surgical instruments as a single intuitive operating environment. At AVRA Surgical, our goal is to improve the economics, efficiency and patient outcomes for all AVRA clients."

Breaking news: mystery solved. :) Updates will come soon.

Source: AVRA

RAVEN 2

2012-01-21T06:08:00.000-08:00

The media is loud again from the Raven. Hannaford's group is now building 7 copies of the Raven robot that will be distributed to:

Harvard
Johns Hopkins University
UC Berkeley
UCLA
University of Nebraska-Lincoln
besides UW (Hannaford's lab) and UC Santa Cruz (Rosen's lab).

This is really exciting for the whole community, since Raven will be the only robot besides da Vinci that can collect data from multiple institutions and from various groups and procedures. Its open architecture will allow better access to data.The story was featured by Medgadget, MSNBC and The Economist as well.

Follow the Raven 2 Dev Blog!
Source: UW press release, UCSC press release

ALF-X Telelap getting commercial

2012-01-17T04:58:00.000-08:00

The engineers at SOFAR do not rest these days, as the ALF-X Telelap robot received CE mark in December, and now getting on the market. Recent public events revealed more details about the system. The master console—called the surgical cockpit—is centered around a comfortable seat allowing open view on the operation theater. Tool control is realized through laparoscope-like input devices and a 3D stereo vision with polarized glasses. It incorporates a full eye‐tracking system that acts as:

1. Safety system: robot is stopped when the surgeon’s gaze is not fixed at the operation site
2. Activation of any given instrument just by gazing at its respective icon on the screen
3. Zoom function by approaching/retracting the head
4. Every point the surgeon looks at moves to the center of the screen

The system aims to overcome the space limitation of the da Vinci (that it takes up too much space right next to the patient) by the base of the manipulators being a little further from the bed (~80 cm), allowing the nurse to walk around the patient (although risking to be hit by one arm by the surgeon). For this reason some areas are still forbidden for assistants during the operation.
The SOFAR people patented a solution to measure tip-to-tissue forces from entirely outside the patient, allowing a realistic tactile sensing capability:

level of sensitivity: 35 g
maximum load: 2 kg
force feedback scale: 1:1

The system is coming with a variety of tools, which can be sterilized up to many times. Also, the base price of the robot is planned to be set around 2/3 of the da Vinci to acquire some market share.
There have been around 20 animal trials with the system, and it was approved for human trials as well.

From SurgRob

Check the trade mark claims of the ALF-X.

Source: VII Journada de robotica

Stay tuned for more!

Previous post on the system.

Intuitive's fairy tale--every story has a beginning

2012-01-12T18:34:00.000-08:00

A little bit of nostalgia never hurts. Especially if the story has a happy ending and some morals. Take this enchanting business study case as a goodnight reading for today! (Compulsory for all ISRG affiliates.) Next time you meet the founders, ask them how they ended the deal!

Source: Harvard Business School

And once nostalgia hit:

CIS news

2012-01-08T01:56:00.000-08:00

Titan Medical sold another package of shares: 4,880 K units at a price of $1.55 each for gross proceeds of $7,564 K.
Intuitive Surgical got FDA 510 k clearance for endowrist one vessel sealer
ISRG Investors' conference call for Q4 2011 set for January 19.
I missed it this time, but there was another da Vinci surgery in Hungary: a prostatectomy at Honvéd Hospital. More pics.
Magnetic Catheter Guidance System CE marked
Nice video with the HARP robot
Cryoabalation is taking off
Trials on UCLA’s Robotic Training Device Postponed
Learn more about DARPA's 2012 medical budget
Lockheed and Hopkins are to Transform the ICU
Robotic Pharmacy at UCSF
3D Anatomy fo the NYU students
DNA robots on IEEE Spectrum

Yet not too late to submit something to CARS until Jan. 10. (July, Pisa)
Or visit us in Budapest! IFAC BMS in August, orgaized by my lab
Or to BioRob; Jan 31. (June, Rome)
Or to IROS; Febr 15. (September, Portugal)
Then comes MICCAI; March 1. (October, Nice)
Then the European Robotics Forum (March, Odense)
Don't forget about the Hamlyn Symposium either (July, London)

Call for the Wyss Technology Development Fellowships in Biologically Inspired Engineering

Image credit: Magnetecs Inc.

Visiting the ALTAR Robotics lab in Verona

2012-01-04T06:21:00.000-08:00

A Laboratory for Teleoperation and Autonomous Intelligent Robtos (ALTAIR) is led by Prof. Paolo Fiorini within the CS department of the University of Verona. It was founded in 2000, and now full of smart and extremely nice people doing cutting edge robotics research. (They are also fun.) Part of them are working in the university spin-off Surgica Robotica.

"The aim of this laboratory is to lead research and development on non-conventional robotic systems that can interact with the surrounding environment in multiple ways, from teleoperation to autonomous behaviours. The research focuses mainly on applications for service robotics and field robotics, including all robotic systems that are not concerned with manufacturing operations."

They are involved with many EU FP7 projects, such as:

SAFROS: Its goal is to address the development of technologies for patient safety in robotic surgery. Its aims are to define patient safety metrics for surgical procedures; to develop methods that abide by safety requirements; and to demonstrate that a properly controlled robotic suergery carried out in accordance to our safety criteria can improve the level of patient safety currently achievable by traditional surgery.
ACCUROBAS: Its goal is to address the development of technologies for patient safety in robotic surgery. Its aims are to define patient safety metrics for surgical procedures; to develop methods that abide by safety requirements; and to demonstrate that a properly controlled robotic suergery carried out in accordance to our safety criteria can improve the level of patient safety currently achievable by traditional surgery.
RoSta: The objective of RoSta is to take the initiative proactively on the definition of formal standards for robotics and to establish de facto standards in the field of robotics -- especially service robotics.
I-SUR: To explore the feasibility of automated surgery, in this project we develop general methods for cognitive surgical robots capable of combining sensing, dexterity and cognitive capabilities to carry out autonomously simple surgical actions, such as puncturing, cutting and suturing. Learn more about it here.
They are closely cooperating with the Center for Experimental Surgical Robotics and the

Personally, I really liked thier laparoscopic VR Surgical simulator (more video) and the full-room tracked hybrid image-guided biopsy/cryoablation setup.

Learn more about their work from the publications.

Medical Robotics Symposium in Taiwan

2011-12-31T00:40:00.000-08:00

The 2011 International Symposium in Minimally Invasive Surgery and Medical Robotics took place in Taipei, at the National Taiwan University and at IRCAD in Changua with a focus on the broader field of CIS and MIS. Lectures were organized along three topics: Clinical Applications, Industry Update, Technology Development and Innovation Roadmap. The first day was mostly attended by a mixed crowd to engineers, medical professionals and politicians, while the second day was targeted at the medical staff of AITS. The speakers came from all over the world to given an overview of their projects and the state-of-the-art:

Robotic Surgery in Hepatobiliary and Pancreas; Dr. Michael Li
What we have been learning from Robotic Urology Surgery-Experience of 472 cases for six years at Taichung Veterans General Hospital; Dr. Yen-Chuan Ou
History, Present, Future of Robotic Surgery; Robert Lee
Innovative Products for NOTES & Associated Procedures; Anna Fritz
Future trends and opportunities in Robot Assisted Minimally Invasive Surgery; Tamas Haidegger
The State of the art of Surgical Robotics; Chin-Hsing Kuo
Overview and Trend of Medical Robotics Research in Japan; Kitaro Yoshimitsu
Experiences and future developments in EU FP7 projects in MIS technology; Mauro Sette
Market analysis in MIS and Medical Robotics; Eva Tsai
Regulation affairs of Medical Robotics; Sandy Liu
Vesalius Robot: a seed for the future; Hsiao-Wei Tang

The presentations were followed by a Strategy Forum where national leaders and decision makers shared their views and discussed development directions for Taiwan. All praises to Hsiao-Wei Tang for flawlessly organizing this great event.

Season's Greetings

2011-12-24T23:12:00.000-08:00

Wishing a merry Christmas/ happy Holidays to all readers!
Here is something more thematic from the Altair lab in Verona. Cute!

Play the video here!

Updates on the Vesalius/Huatuo robot

2011-12-21T13:36:00.000-08:00

The Vesalius robot's idea came from Dr. Tang, who dreamed for an easy toolholder robot. During his years at K.U. Leuven, he completed the project, and just a month ago, he presented the second, market-ready prototype in Taiwan, ready to go to hospitals for further trials. This second version--named Huatuo--was designed and manufactured in a record time, just in time for the Taiwan Technologies of the Future Exhibition. "The new version, which was developed at a cost of about $50,000 US, is more compact, and its position is more adjustable, according to Tang. The prior version weighed about eleven kilograms. Tang also said be hopes one advantage of a Taiwanese-made device would be its affordability- less than $12,000, Tang speculated."

The timeline of the system development:

2000 Kick off Robot Assisted Surgery Group in K.U.Leuven
2002~ Demonstration IWI/DWI laser ablation
2004 Comparison test, Animal test
2006 IDO project funded by K.U.Leuven (4 years)
2008 Laser Surgical Robot Task Force (LSRTF)
2009 LSR named VESALIUS
~ ARCM patent application
~ VESALIUS first debut in UZ Leuven
~ VESALIUS Robot BP version 1
2010 Best commercial BP in Start Academy
~ VESALIUS Camera holder animal test
~ VESALIUS Robot BP version 2
~ VESALIUS Robot incubation plan
~ VESALIUS Robot in ICT2010
VESALIUS branches three ways:

A brief comment on Huatuo: “The IP belongs to the University of Leuven. Now they are preparing to sign the the memorandum of understanding with me” Tang explained.

Older post on the robot

Source: ICEMR, Vesalius.com, Medical Robotics blog

CIS news

2011-12-15T16:37:00.000-08:00

Now that Titan has finished the pre-production of the Amadeus console and the video-tower, signed a MoU with an Indian partner, they released a new concept design for their robot. The scary black color fainted a little. Note the significant change in the slave setup: not any more KUKA LWRs, rather smaller arms with a kind-of RCM mechanism. Looking forward to seeing it becoming real!
ALF-X trademark published for opposition
In the mean time, Accuray stocks are on the rise
SILS Hysterectomy and Partial Nephrectomy with the da Vinci. Who said it cannot be made?
Mazor's Renaissance got FDA clearance, and now got its first customer
Good old Hopkins friends all around in the news with their NASA teleoperation project
The EU FP7 project EuroSurge may finally bring some consensus on taxonomy and research targets
ROBOCAST on Gizmag andanother article: Dr Robot, brain surgeon. See also their EU FP7 page
Get some wise thoughts from Deam Kamen
A nice slideshow on the hospital of the future from FastCompany
Robotics is helping the paralyzed
A roadmapping forum organized by the European Assoication of Endoscopic Surgery in January
The call for BioRob is armed!
Also, prepare a nice October week with MICCAI in Nice!
Call for workshop proposals for the European Robotics Forum 2012

Are you interested in a publication on physicians-engineers collaboration? Fill this questionnair!

Image credit: Titan Medical Inc.

Humans-robots-humans: Who is operating who?

2011-12-09T08:15:00.000-08:00

I was given the honor to talk within the frames of the Shanghai Lectures, an online, really global lecture series on cognition, robotics and artificial intelligence ran by Prof. Rolf Pfeifer, head of the AI lab at University of Zürich.

My talk was preceeded by a lecture from Dr. Pfeifer and from Barbara Webb on bio-inspired robotics. I tried to briefly summarize the most important things about CIS, and intriducing some of the trends and research initiatives that will drive the field in the near future.

The video and the slides are accessible here.

Take a look at the other lectures as well, really fascinating!

CIS news

2011-12-03T11:55:00.000-08:00

Titan is ready with the beta prototype of the Amadeus Composer robot
You can read more about Titan's Q3 financial results here
The ALF-X system's Trade Mark (and another version)
Always exciting to see what are the latest 510(k) approvals coming out for Intuitive Surgical. A few recent examples:

Rather old article on Duke's US robot. Here are some more details, and another press coverage.
Hand gesture-controlled scrub nurse robot
Nice review on the 35 years history of FDA's 510(k)
Medical robotics market analysis published
Full HD capsule endoscopy
Appendectomy via LESS was not found better than performed classically with 3 ports
Kinect in the OR
Get dressed by your robot!
Looking for a realistic human phantom? Check here!
Learn the human anatomy via Visible Body
Imperial College is looking for a research associate for 2 years on the development of a Soft Tissue and Neurosurgical Guide
A postdoctoral position is available at the Robotics, Automation, and
Medical Systems (RAMS) at U. Maryland under Prof. Desay, on Robotics and MEMS for breast tissue specimens' assessment
2 post-doc positions related to robotic surgery are available at the Dept. of Advanced Robotic at the Italian Institute of Technology on - Novel user interfaces for robotic microsurgery and - Surgical robotic system design

Image credit: Duke University

IRCAD France // Taiwan

2011-11-28T16:31:00.001-08:00

"It all began in 1985, when the first cases of successful implementation of minimally invasive cholecystectomy were done. Minimally Invasive Surgery means to have a smaller wound, less bleeding, reduced risk of infection and reduced postoperative pain. Most often MIS comes with faster recovery, increased utilization of hospital beds in medical institutions, therefore it was predestined to gradually replace traditional open surgery." (Yet to see...)

IRCAD stands for Institut de Recherche contre les Cancers de l'Appareil Digestif (so, the Institute for Research into Cancer of the Digestive System). It was founded by Prof. Jacques Marescaux in 1994, and has quickly emerged to be the world's No 1. MIS training center. Just to mention a few milestones, the Lindbergh operation took place here in 2001, the first documented NOTES procedure was done, and they have been running the extremely useful Websurg webite/online university. (Not to mention their most recent MIS student course, covered here.)

IRCAD, in consortium with the University of Strasbourg, also runs a couple of engineering and research programs, such as their Image Sciences, CS and Remote Sensing Lab. They are about to start their own interdisciplinary engineering MS program. Interesting...

"In 2008, the Asian long-range minimally invasive surgery center (IRCAD--Taiwan, AITS) was founded in Changua with the direct support and control of the French IRCAD. "It was planned to become the world's top MIS teaching institute: organize and implement intensive classroom training, enhance Taiwan's minimally invasive surgery with the world, but also allow Taiwan to become the clinical knowledge of minimally invasive surgery and technology high ground". The goal is "that in 2020 Taiwan advanced minimally invasive surgery became a leading national technology and equipment." Just last week, the International Symposium of MIS and Medical Robotics was orgnaized there. (This will be covered in the next post.)

Currently, they have no da Vinci, due to it's price, but there are a total of 9 robots in Taiwan.

Also, the International Medical Center of Excellence on Medical Robotics was founded here. (This will be introduced later in more details.)

We were extremely happy to be given a personal tour by our host, Prof. Hsiao-Wen Tang (will cover the event later). We were shown the training facilities of IRCAD, and then to the Show Chwan Health Care, where the private section is really lile a 5* hotel. IRCAD-Taiwan is probably the biggest operating simulation room in the world with 22 stations to provide excellent equipment. (Also available for rent.)

ARTAS hair transplant robot

2011-11-22T00:11:00.000-08:00

Hair transplantation has been a time consuming and tidious procedure, therefore very expensive. According to the classical method, skin stripes are cout out from the hairy part, grafts are collected from it and then reiserted in tha bald area. This has been partially rpelaced with the newer technique, the individual collection of folliculi. However, this requires advanced skills and great practice--therefore it calls for robotization!

The ARTAS system was first reported in 2003, and this spring it has finally received FDA approval. It is capable of automatically identifying the individual folliculi and cut some out randomly, in a minimally invasive manner. Reportedly, it is possible to achieve 500 grafts/hour with the robot, which is practically double the speed of manual harvesting. (Still takes hours to perform a complete session of 1500-2500 grafts.) Also, the robot reduces the proportion of dead (i.e., cut, injured) folliculi to around 10%.
One robot is already at work at Brenstein Medcial Center.

The US patent was granted to Dr. Gildenberg in 2003. Interestingly, it was described on a Neuromate robot.

Back in time, a French company also tried to come up with a similar system, but apparently they never got commercial.

IRCAD MIS course #2

2011-11-18T17:46:00.001-08:00

Yesterday, we had the second event of the IRCAD B.E.S.T. course with Prof. Errol Lobo (USA) on Airway Management and Prof. Joel Leroy on Trocar Insertion: complications & preventions.

If you missed, you can take a look at last week's lecture and the adjoin materials here.

See you next week!

CIS news

2011-11-15T05:24:00.000-08:00

Old and new, here we go with some nice CIS news:

Da Vinci's new NIR camera allows a lot deeper insight into tissues
More good news for Intuitive: the firefly fluorescence imaging system is flying well
Heart operation with the LEAR technique
TORS getting more and more popular
First randomized study for robotic prostate surgery to come
UCSD opens a $70M medical trianing center
A different view on the necessity of robotic surgery--from Pakistan

Mazor starts to sell the Magellan system
An ARTAS hair implantation robot has been installed at a Denver clinic and in a Beverly Hills hospital
Kinect to manipulate medical datasets
Magnetically Guided Colonoscopy from Vanderbilt
Toyota's new patient transportation robot
High hopes for ROBODOC in Korea
Hitachi's robot won prizes in 2007. Any news since?
Canon Medtech award -- I especially like the VeinViewer
Robot contrtolling a human arm

Call for the 3rd IPCAI meeting (deadline: Nov. 25.)
The Dept. of Advanced Robotics at the Italian Institute of Technology invites applications for post-doc positions
Got published: my thesis on CIS algorithms

IRCAD MIS course #1

2011-11-11T05:09:00.000-08:00

The first B.E.S.T. Innovation in MIS event was really great: Dr. Barry introduced the history of MIS briefly. Next session willl be Nov. 17. 5 PM (CET):

Basic Management of Airway (Prof. Errol Lobo, USA)
and
Trocar Insertion: complications & preventions (Prof. Joel Leroy, F)

You will be able to watch it live on this site, after registration.

Into Intuitive financials

2011-11-08T07:00:00.000-08:00

Q3 results are out, stocks are at their very best (above $430), since there are over 2000 da Vincis world wide! It’s time to take a closer look at Intuitive’s financial situation (which is getting better and better). They have achieved (yet again) around 30% increase in revenues, sales and procedures:

133 da Vincis sold in Q3 (up from 105 a year ago), 29 dual consoles sold along with 98 simulators.
14 classic and 21 da Vinci S systems were upgraded to Si-s
total revenue was $447 million, up 30% over Q3 2010
revenue from instrument and accessoriec: $176 million, up 38% over Q3 2010
total recurring revenue (from service fees and so): $248 million, up 34%
net income: $122 million, up 41%
operating profit of $214 million, up 32%
Intuitive hired 76 people bringing the total team to 1,845 employees
total revenue for the first 9 months of 2011 was $1.26 billion, up 23% from last year
procedures grew app. 30% , mostly driven by gynaecology
quarter ended with $1.9 billion in cash and investments

Prior studies typically underestimated Intuitive's performance (like this 2008 study from Leeds), yet bidding on it against other med tech companies:

CIS news

2011-11-05T07:43:00.000-07:00

CIS news are back:

Now there are over 2000 da Vincis around the world! Bumm!
Dr. Patel is over 5000 da Vinci surgeries. That's experience!
With Hyundai's financial support, and Yakult share-purchase, ROBODOC is now supposed to be in the serial manufacturing phase
Have fun reading these comments and speculations on Titan Medical vs. Intuitive
Actively Compliant End-effector for robotic US
A TMS robot from France
New produc from Mazor: Renaissance
A Hungarian news post on Rick Satava's latest visit
A video on the Korean SR-1 setup
RFID-based intra-operative tracking technology
On robotic gyn and shorter hospitalization
On the feasibility of cataract surgery, and plans for the first case
A nice article on Robotic Surgery Techniques
More brainbraining on effectiveness of the da Vinci
Interested in clinical trials?
Second opinion on HIFU
Intl. Symp. on Minimally Invasive Surgery and Medical Robotics (Nov. 21-22., Taiwan)
Call for the 3rd IPCAI (deadline: Nov 25.)
Workshop on Medical Image Analysis (dealine: Nov 10.)
The Intl. Center of Excellence in Medical Robotics in Taiwan is seeking for visiting researchers
Find more jobs here

Image credit: da Vinci at TORS

Eye surgery system from Univ. Eindhoven

2011-11-01T07:56:00.000-07:00

"Researcher Thijs Meenink et al. at TU/e has developed a smart eye-surgery robot that allows eye surgeons to operate with increased ease and greater precision on the retina and the vitreous humor of the eye." It consists of a custom developed dual-joysticked master unit (from Ron Hendrix) and a two-armed "slave" robotic module. Basic features include:

Tremor filtering
1:10 motion scaling
Haptic feedback
RCM mechanism
Tools of a diameter of 0.5 millimeter (forceps, scissors and drains)
Fast instrument changing

You can see a short video on the range of motions here. Or learn about the system through Thijs' publications.

Source: TU/e, Gizmag
Ed.: Since I've know Thijs for a while, more details to come soon.

B.E.S.T. Innovation in MIS course from IRCAD

2011-10-31T05:39:00.000-07:00

This is your great chance: the IRCAD Student group is organizing a great event on technology and innovation in Minimally Invasive Surgery. The course will consist of online lectures and then a week-long on-site training at IRCAD for the best students, and all that for free. Apply now, since the program starts very soon.

You can learn more about it on the official website, or check the flyer of the program.

Da Vinci for SILS

2011-10-26T04:50:00.001-07:00

The community has been long fascinated with the idea how to use robotic manipulators--and especially the da Vinci--to compensate for the ergonomic difficulties in NOTES.

In the early experiments, groups tried to arrane the da Vinci robot in a twisted way to perform NOTES, e.g. "A single 12-mm trocar was placed in the midline, and two 12-mm standard laparoscopic ports were placed into the abdomen via the vagina and the colon. The robotic ports were then telescoped into the 12-mm ports, and the daVinci S robot was docked. Dissection was performed using the Hot Shears and the ProGrasp instruments. The robotic camera was placed via the midline port and held by an assistant. " (Box et al., 2008).

"Haber et al. adopted a different approach toward robotic NOTES in the porcine model, placing the robotic camera lens and one arm through the umbilicus, with the other robotic arm inserted through the vagina. Desai et al. performed transvesical robotic RP in a cadaver model with the a Kaouk et al reported in 2009 the first successful series of single-port robotic procedures in humans, including RP, dismembered pyeloplasty, and radical nephrectomy [86]."

Since classical tool manufactures started to come out with roticulators, steerable cameras and other pre-bent instruments (Dhumane et al., 2011), it was desired to create the same tools for the da Vinci as well.

The first solutions were published by Joseph et al.: "Cholecystectomy and nephrectomy were performed utilizing the chopstick technique: where the instruments are crossed at the abdominal wall so that the right instrument is on the left side of the target and the left instrument is on the right, preventing collision of the external robotic arms." The control on the consol has been switched as well.

The newer setup is the VeSPA tools from Intuitive for the SI system, and numerous experiments have been conducted on the porcine by Haber et al.: "The conﬁguration of the current IS3000 da Vinci Si was modiﬁed with the intent to perform R-LESS surgery. The console and the slave remain the same and only arms 1 and 2 were used in addition to the camera arm. A newly designed prototype multichannel port (Intuitive Surgical) allowed the placement of an 8.5-mm scope, a 12-mm cannula for the assistant, and, more importantly, 2 crossing curved cannulae for the robotic instruments. The VeSPA instruments and accessories are of similar construction to existing da Vinci Si EndoWrist instruments, except for the shaft that is semirigid, allowing them to be inserted through curved cannulae. In addition, the instruments do not have a wrist at the distal end of the instrument. The VeSPA instruments and accessories include needle driver, Cadiere grasper, right-angle Maryland retractor, curved scissors, hook, clip applier, and suction irrigator."

Beyond robotics, some hand-hel devices also pushed the boundaries of SILS/LESS tools, such as SPIDER, USGI's Transport, or Direct Drive from Boston Dynamics. However, they are facing the same issues with the increased complexity and towering costs of the devices.

Image credit: European Urology, Haber et al.

CIS news

2011-10-20T00:23:00.000-07:00

Surgical robot purchase increases prostatectomy rate
Titan's Amadeus updates: first test results of the console & Amadeus got a decent display and system integration deal
Learn more about the da Vinci simulator! It's getting very popular. (So does ROSS.)
A nice article on the $98K MIMIC trainer form 2010
Happend over a year ago: spine surgery robot put into trial in China
Old news, but still fun: MIT student design competition on surgical robots
Journal Impact Factors for CAS Research
ROBIO (December, in Phuket) is still accepting Late Results contributions
Post-doc position in the Italian Institute of Technology
Postdoctoral position in Bioinspired Robotics and Medical Device Design at Harvard
MechE professor position at Hopkins

Image credit: People Daily

8th IFAC Symposium on Biological and Medical Systems

2011-10-16T02:25:00.000-07:00

Our lab has the pleasure to organize the upcoming IFAC BMS Symposium. The last edition was in Aalborg, DK in 2009. The conference will take place in downtown Budapest, 29-31 August, 2012.

"The Symposium provide a forum for the presentation of new developments in the important interdisciplinary field of biomedical systems involving the application of concepts, methods and techniques of modelling, informatics and control of complex biomedical systems. The Symposium address problems in biomedicine, physiology and biology related to:

model formulation,
experiment design,
identification and validation,
biosignals analysis and interpretation,
developments in measurement,
signal processing,
tracer kinetic modeling using various,
imaging systems,
biomedical system modeling,
simulation and visualization,
decision support and control."

You are most welcome to enter a submission before Febr. 3, or propose a special session within the next week. If you are interested in attending, let me know, and we could put together a SS on surgical robotics.

Looking foward to seeing you here!

Brochure of the Symposium is here.

MICCAI in Toronto

2011-10-12T17:48:00.000-07:00

This was my third MICCAI, and absolutely the best one! The chairs (Drs. Fichtinger, Peters and Martel) did a great job, and the program was very relaxed, leaving space for a lot of discussions. There were numerous workshops and sessions dealing with robotics, although, as typical for MICCAI, CAI was underrepresented relative to MIC. There were many CIS relevant sessions and workshops, e.g.,

A couple of the more exciting talks:

Distance Measurement in Middle Ear Surgery using a Telemanipulator
Unified Detection and Tracking in Retinal Microsurgery
MR-based Real Time Path Planning for Cardiac Operations with Transapical Access
Interventional Radiology Robot for CT and MRI Guided Percutaneous Interventions
and many more...

You can access the entire proceedings here.

Visiting Intuitive

2011-10-06T15:19:00.000-07:00

At the end of September I was privileged to get a semi-private tour to Intuitive Surgical’s headquarter in Sunnyvale California. (Eventually, two of my friends from Hopkins joined the program.) Intuitive is located in Silicon valley, close to the Caltrain on Kifer road. The main facility was acquired from HP, and has been extended significantly. Currently, there are app. 5-600 employees on site, the other 1300 are located at the strategic logistic centers around the world, travelling for sales, or sitting in another Intuitive building along Kifer road. People at the “campus” are divided between the manufacturing, support, sales departments, the engineering research center and the management.
Simon DiMaio, applied research manager, devoted much of his time to guide us around. First, we went to the dry demo room in the main building (beautifully decorated with a lot of tools), where they have a dual consol setup (sometimes touring around the country) equipped with the simulator module. We did some simple tasks with dual-console cooperation, and were able to try some of the MIMIC skill training programs. These were developed in collaboration, and through them we will be able to far better understand human learning in surgical procedures. Intuitive has a couple of “wet” operating room as well to train surgeons (and they were all busy at the time of visit.) The main building also features a huge map with all the da Vinci systems’ location (quite busy in some parts of the world), and a wall with hundreds of granted patent placards—quite impressive.
(I gave a lunch seminar talk—mostly about the emerging da Vinci competitors—which you can access here.)
The next part of the tour was to the new manufacturing facility, the first Intuitive building raised from scratch. (It was opened by Rep. Jackie Speier, Mayor Melinda Hamilton this summer.) All manufacturing (assembly) take place here on the first floor, while supply chain management and support is on the second floor. The rooftop is entirely covered with solar panels, making it the largest array in the area. Intuitive has a separate plant for tool manufacturing in Mexicali, Mexico established in July 2008 with 60 workers, and later enlarged significantly.
The current throughput of the main factory in Sunnyvale is enough to serve the demand (over 350 units/year) in one work-shift. The complete integration of a da Vinci Si takes two days, but they are ready to sell and install a robot anywhere in the world within 24 hours of purchase.
In the plant, first, they test every pre-manufactured part (~30K) incoming from various partners form all around the world:

Customized optical stereoscopes from Germany,
High-definition video display monitors are from Philips' Femi Division,
Image-acquisition tool from Toshiba and Panasonic,
Harmonic shears (for US tissue cutting) are from the Ethicon Endo-Surgery division of Johnson&Johnson
motors in the da Vinci are from Maxon, Switzerland (read more about them here)
etc.

The assembly of the arms is done entirely by hands, cabling, soldering, integration is done by the skilled workers (also trained to replace each other if need be). There are approximately 80 working cells, and some steps take up to 1-3 hours.
Having seen all of that what’s under the panel increased a lot my appreciation for the designers. It’s also true that the Si version incorporates a lot of upgrades and tweaking unseen to the user, but making e.g., servicing of the robot much easier.
Thorough testing follows every stage for mechanics, electrical functionality and capability. Once the parts of the arms are assembled, they are undergoing a controlled motion cycle (overnight) that moves all arms all around the workspace to identify any malfunctions. It’s like a dance of the robot, and looks very cool, since the arms stretch a lot further than during regular operation. Naturally, all software procedures are also tested on the actual system.
Last comes packaging, which makes the system look really big! There were like a dozen boxes waiting to get loaded into trucks. "Our sales cycle is not smooth. We sell the majority of units in the last month of a quarter," explained Dr. Major, manufacturing director of Intuitive in an interview given to Forbes.
The back section of the plant is a “medical grade clean room”, where the manufacturing and test of new tools is happening. Inspection of returned robot and retrofitting of the older models also take place in the building.

Image credit: obviously, I was not allowed to take pictures in the plant, this is all I got (from Forbes.com) I could dig out of the Internet. The Mexicali one is from Maquila Watch, and the opening is through Sunnyvale News. Simon DiMaio.

If you have more info about the manufacturing of the da Vincis, let us know!

CIS news

2011-10-02T04:14:00.000-07:00

A quick survey on what is going on in our beloved field:

KidsArm: MDA is planning to develop a pediatric MIS robot

$4.7 M secured by FedDev Ontario and CFI
a project of the Centre for Image-Guided Innovation and Therapeutic Intervention (CIGITI) at SickKids Hospital in Toronto

IMRIS and MDA announced a special IGS joint program, to support the development of the neuroArm robot
"Is Hansen Medical a Takeover Target?"

Hansen is running on Intuitives patent portfolio, under Fred Moll's directorship (also founder of Intuitive)

A nice set of article reviews on different surgical deployment of the da Vinci

That was found on a French blog, mostly containing references to older materials

12 advances in medical robotics (Informationweek HealthCare)
Weird stuff: "Equipe your surgical robot with a smelly armpit"

Want to learn more? Get enrolled in the Shanghai Lectures, or at Stanford's AI courses
New mobile X-ray from Streamcare
New US guideance technique from Ultrasonix
Job opportunity for medical robotists at SRI, Menlo Park
PhD scolarships in medical robotics at Polimi
Research Assistant in the Medical Engineering Group - Imperial College London
Tenure-track Mech-e faculty position in interdisciplinary robotics at Hopkins
Post-doc position on MR-guided robot development at Hopkins

Micro Hand A--China's bet in robotic surgery

2011-09-28T11:22:00.000-07:00

Micro Hand A (妙手A) has been developed jointly by Tianjin University, Nankai University and Tianjin Medical University General Hospital. The first animal trials were conducted July 2010 in the university hospital, and since then, it is said to be deployed in some local hospitals.

Further patrners are the Southern Medical University, Computer Research Institute of Surgery by the Southern Medical University, South China University of Technology, Shanghai Jiaotong University, National Defense University and Waseda University in Japan. The first phase of research was realized with 10 million yuan investment. They claim to be 3 years from becoming market-ready.

The Micro Hand A's main features include:

3D vision system
360 deg articulated inctruments
0.1 mm accuracy claimed
4 patents (6 pending)

You can find some related publiations here, and also the system was presented at the latest ICRA. A video of the first animal trial can be found here.

The etalon da Vinci system was first introduced in China in 2006, and received SFDA approval in July 2008.

Source: Tianjin University

Conference proceedings--EMBC

2011-09-21T13:28:00.000-07:00

This September is full of exciting conferences. We saw lately the IEEE EMBC happening in Boston. (See previous editions: 2010, 2009.) While major emphasis of the conference was rehabilitation robotics, various surgical applications and systems were presented:

On surgical robotics: FrA2.2, FrA2.3, FrA2.5, FrA2.6, FrB2.3, FrB2.5, FrB2.6, SaA2.1, SaA2.2, SaA2.4, SaA2.5, SaA2.6, SaA27.1, SaA27.2, SaA27.3, SaA27.4, SaA27.5, SaP111.1, SaP111.2, SaP111.3, WeP27.4, WeP27.6, WeP28.2, WeP28.4, WeP28.5, WeP28.8
Haptics in robotic surgery : FrA2.1, SaA2.3, SaA2.6, ThC1.1, ThC1.4, ThC1.5, ThC1.6, WeP28.4
Motion cancellation in surgical robotics: FrA1.4, SaA27.2

You can access the whole program here. Full papers will be made available through IEEE Xplore soon.

Furthermore, you can now browse the full proceedings of the Hamlyn Robotic Symposium from June.

Updates on the Alf-x robot

2011-09-17T11:15:00.000-07:00

As time goes on, more details have leaked from SOFAR about the development of the ALF-X system., and apparently it has also been used in clinical trials. While the website of the robot is not fully functional yet, a newly released brochure tells more details about its capabilities. Some of the more interesting features:

sensorized classical laparoscopic tools as master controllers
trocars can be located anywhere on the patient, depending on the procedure, the patient’s positioning or the inclination of the operating
the basic setup alreaday contains 4 robots (they all have mobile platforms, with range scanners for basic safety)
the forces applied by the instruments are finely controlled and limited, thus avoiding the risk of breaking the thread during knot tying
it is equipped with an eye- tracking system to efficiently control the endoscopic view by moving any viewed area to the centre of the screen.
The eye-tracking system also enables activation of the various available instruments by merely looking at their respective icons on the screen.
quick docking and the quick displacement of the manipulators.

Source: NES Academy
Updates on the system
Previous post on the system.

Amadeus Composer and Maestro

2011-09-11T23:38:00.000-07:00

Updates for the Canadian Amadeus system!

Titan Medical's investor presentation

from August shows some interesting data.

There will be two systems developed: first the Amadeus Composer, then the Maestro. They see the opportunity to place 6000 of the Composers world wide, each consuming 2-300 tools a year. (Supposedly that means 2-3000 operations, which is a little optimistic IMHO.) Amadeus will primarily target ENT, thoracic and general surgery, with app. 1.5M cases annually in the US.

Titan plans to offer maintenance and servic contract for $150K/year, which is pretty much equivalent to Intuitive's current model. Titan has 3 US patents, and 6 other pending. They aim to get into human trials in late 2013, and submit FDA 510(k) application in late 2014, when some of Intuitive's key patents expire.

Some of the advanced features thought to provide competitive edge:

Snake-like flexible tools
TCP/IP based communication for telesurgery
Full HD 3D vision system
Force feedback
Simulator for training.

Titan Medical (TMD) went public in June at TSX Venture, and raised $9.5M funding (to support its monthly >$1M expenses). Current stock prices are at $1.59., estimated market value is $90M (versus Intuitive's $14.4B). Nowadays, Titan is hiring its Sicentific Advisory Board.

Some more articles about the robot and here.

Picture credit: Titan Medical Inc.

Older news on the system.

Visit at WPI

2011-09-07T22:12:00.000-07:00

We were distinghuished with a guided tour to the WPI AIM (Automation and Interventional Medicine Robotics) Research Laboratory in Worcester by Dr. Fischer. Greg started to build the lab and to develop a high-class robotic program at WPI three years ago, after graduating form Hopkins. His group is focusing on:

Medical robotics and Image-guided surgery
Robot-assisted prostate cancer therapy and stereotactic neurosurgery
MRI compatible mechatronics (sensors, actuators and control systems)
Haptics and telesurgery
Human-robot interaction

Relying on collaborations with Hopkins, Harvard and Queens, they have quickly advanced to the lead in MR compatible percutaneous robotics.Their current projects are:

Learn more about their work through their publications.

AMIGO at Harvard

2011-09-02T23:52:00.000-07:00

"The Advanced Multimodality Image Guided Operating (AMIGO) Suite is an innovative surgical and interventional environment that is the clinical translational test bed of the National Center for Image-Guided Therapy (NCIGT) at the Brigham and Women’s Hospital (BWH) and Harvard Medical School. The AMIGO is an integrated, 5,700 square foot area divided into three sterile procedure rooms in which a multidisciplinary team will treat patients with the benefit of intra-operative imaging using multiple modalities. In AMIGO, real-time anatomical imaging modalities like x-ray and ultrasound are combined with cross sectional digital imaging systems like CT, MRI, and PET. Molecular image-guided therapy will be pioneered with the use of multiple molecular probes, such as PET, optical imaging, and targeted mass spectrometry, to increase the sensitivity and specificity of cancer detection."
Drs. Song and Tokuda gave us an in-sight tour to the AMIGO facility that opened this spring after a few years of planning and construction. Currently two rooms are fully equiped and operational, (with lights, controls, navigation system, C-arm, etc.) providing the unique opportunity to surgeons to invoke intra-operative MR imaging to support critical neuro-procedures. In other cases, the three interconnected ORs will be able to function separately, like they do now for performing e.g., prostate biopsies with MR control. From autumn, the third OR will be also ready providing the PET-CT imaging capability.

CIS News

2011-08-26T23:59:00.000-07:00

Cancer treatment with da Vinci and imaging

Femtosecond laser eye surgery--early clinical experience form India. (Femtosecond lasers gained FDA clearance last year.)

Medrobotics--on the rugged way of business

ENDOCAS--Center for Computer Assisted Surgery is involved with various robotic surgery projects.

MAKOPlasty video on CBS

RIBA patient transport robot

J. of Medical and Biological Engineering and Computing special issue on rehab robotics

Postdoctoral Fellow Position Radiation Physics Division Department of Radiation Oncology Stanford University

Photo credit: CBS

Robotic surgery presented biased

2011-08-21T14:32:00.000-07:00

In mid May, an article was publishe in the Journal for Healthcare Quality, "Robotic Surgery Claims on United States Hospital Websites". It got fairly big media attention, discussed as "Hospitals Misleading Patients" (here and here as well).

The study provided the analysis of "400 random U.S. hospital websites as of June 2010. Data was collected on the presence and location of robotic surgery information on a hospital’s website; use of images or text provided by the manufacturer; use of direct link to manufacturer website; statements of clinical superiority; statements of improved cancer outcome; mention of a comparison group for a statement; citation of supporting data and mention of specific risks." It got to some interesting results:

"Forty-one percent of hospital websites described robotic surgery. Among these, 37% percent presented robotic surgery on their homepage, 73% used manufacturer-provided stock images or text, and 33% linked to a manufacturer website. Statements of clinical superiority were made on 86% of websites, with 32% describing improved cancer control, and 2% described a reference group. No hospital website mentioned risks."

They concluded that:

Many hospital websites overestimate the benefits and underestimate the risks of robotic
surgery, potentially misinforming patients and encouraging them to undergo robotic surgery.
The prominent placement on a hospital website and the use of emotional appeal obscures
the lack of support for clinical claims.
The widespread use of manufacturer-provided images and text raises concerns about conflicts of interest. Stock materials, produced for advertisement purposes, can be understandably one
dimensional, even claiming that robotic surgery is the ‘‘most effective’’ or ‘‘ideal’’ therapeutic option for patients.

And some recommendations:.

Hospitals should be conscientious of their role as a trusted medical adviser, and ensure that information provided on their website represents the best available evidence.
Hospitals should make it transparent when they are using materials provided by a manufacturer and avoid endorsing brand-name medical technologies.
If hospitals are unable to provide patient-friendly, objective information about a certain treatment option, they should direct patients to a third-party source of information and encourage patients to learn about alternatives.
Hospital websites should present balanced medical information, accurately stating risks and benefits.

FDA has recently started to look into these issues, and primarily aims to improve the clearance procedures. Naturally, some voices raised in favor of robotic surgery, urging for better information sharing. Due to the recent installation of data-collection boxes with certain da Vinci robots and the wide-spread use of the system, we should see large-scale, evidence-based studies on robot surgery benefits rolling out in the near future.

Source: J. for Healthcare Quality

ROBODOC advances--the story of an FDA approval

2011-08-15T13:44:00.000-07:00

I was happy to cover the FDA approval of the ROBODOC almost 3 years ago. Since then, a lot of effort has been put into the field. It's time to look back on this historical event.

The clearance procedure of the system was quite long and full of edifying stories. It was the first system that tried to get through the clearance procedure, and it was forced into the PMA category, since no equivalent technology existed.

October 1992, the FDA granted an IDE approval to conduct limited clinical trials (at Sutter General Hospital in Sacramento).
November 7., the world’s first robotic joint replacement surgery was performed .
A biomedical engineer for the FDA outlined comprehensive investigative testing designed to test the safety of the robotic control software.
In 1993, ISS began the PMA clearance procedure. The ROBODOC software and hardware had to comply with robust motion control restrictions to prevent accidental tissue and bone damage.
In 1996, it received the European CE mark and approval for Total Hip Arthroplasty (THA) procedures.
In 2002, the FDA re-assigned the ROBODOC system to its 510(k) path. Unfortunately, by this time, ISS no longer had sufficient capital to support the procedure.
By 2004, the significant R&D cost related to further testing and re-submission caused ISS to cease operations.
In November 2007, all assets and IP were transferred Curexo Technology Corporation, and $12M were invested to continue the business.
The fresh money allowed to finish trials, and to complete the robot’s commercialization via FDA 510(k).
In August 2008, the system finally received a 510(k) clearance from FDA.

Throughout these years, all the FDA-cleared surgical robots (e.g., da Vinci, NeuroMate, CyberKnife, ROBODOC, MAKO Arm, SpineAssist) went down the 510(k) procedure, proven to be substantially equivalent to existing technologies. FDA’s emphasis has gradually shifted from the robotic technology itself to approving the results of the use of the robotic systems. It is now believed that the equivalence stands between the already-approved surgical techniques and the results attained through robotic interventions.

ROBODOC advances--historical timeline

2011-08-11T11:23:00.001-07:00

The ROBODOC was the first robot to perform automated procedure on humans. Despite it clinical relevance and advanced features, it had not sold well enough to sustain the business of ISS. Now, with CUREXO's investment and effort, it may finally get into a competitive shape. The first concept of the new design can be seen on the right. A timeline of the V1 system development:

1986		Dr. Paul and Dr. Bargar develop the baseline ROBODOC concept.
05/90		Dr. Paul performs joint replacement surgery on canines using ROBODOC.
11/90		IBM invests $3M (USD) in ISS.
06/92		ISS development team receives prestigious Computerworld Smithsonian Award for Innovation in the Arts and Sciences for Medicine.
10/93		Clinical trials of the ROBODOC system begin.
10/96		Dr. Paul and Dr. Bargar receive the Joseph F. Engenberger Award.
11/96		ISS company goes public (NASDAQ, Small Cap Market).
01/97		ISS sells 2 ROBODOC systems to Austria.
02/97		ORTHODOC Pre-operative Planning software, receives FDA approval.
10/02		Dr. Lee's hospital in S. Korea purchases a ROBODOC system, the first in Korea. With this system, Dr. Lee's hospital becomes one of the five leading joint replacement surgery hospitals in Korea.
10/03		Kangdong Catholic Hospital in Korea purchases a ROBODOC system.
2004-2006		ISS operational hiatus period (due to lack of operating capital)
2006		Choennam University, Kyeoung Hee University, Ulsan Hospital, (all in S. Korea), purchase ROBODOC systems.
2006		Curexo Inc. purchases all ISS assets.
11/07		Curexo Inc. establishes CTC (Curexo Technology Corporation) and transfers all ROBODOC assets, including IP and technology, and retains major shareholder position. CTC begins re-hiring previous key ISS employees. CTC submits ROBODOC system for FDA 510(k) approval.
02/08		CTC receives $12M (USD) additional funds to continue operation.
08/08		FDA approves ROBODOC THA systems for U.S. sales under 510(k) rules.
2008		Curexo and IBM enter into a major patent Cross licensing agreement.
03/2009		Curexo receives the NSAI Certificate of Registration of Quality Management System to I.S. EN ISO 13485:2003
06/2010		Curexo raises $13.2 million of funding.

More history of the ROBODOC at Curexo's website.
Source: Curexo

No-scar surgery with the MASTER robot

2011-08-06T11:07:00.000-07:00

Please welcome the first guest-editor of the blog: Kurt Sun Zhenglong, PhD candidate at Nanyang Technological University's BioRobotics lab.

The MASTER system has been under development for over 6 years, and now it's in the clinics. See the video coverage of the first trial here. (An earlier paper and a presentation on the sytem here.)

Flexible endoscopes can be used to inspect, diagnose and treat various pathologies in the upper or lower gastro intestinal (GI) tract. A typical endoscope includes an ultra compact Charged-Coupled Device (CCD) camera, light source and a channel for infusing or withdrawing liquid or gas from the patient’s body. The tip of the endoscope is steerable so that the endoscope is able to transverse through the winding channel of the GI tract faster, safer and giving less pain to the patient. The endoscope also provides tool channels for instruments to go through which enable the endoscopist to perform a variety of treatments such as biopsy, polypectomy, marking, haemostasis, etc. Commercially available manually operated endoscopic tools often only provides for up to two Degrees of Freedom (DOF) for mostly grasping actions. This limited DOF still prevents state-of-the-art tools from performing complex tasks such as ESD (endoscopic submucosal dissection). The loss of depth perception, tactile and force sensations adds to the difficulty in performing dexterous maneuvers using a flexible endoscope.
The MASTER system has been developed by a research group lead by Associate Professor Louis Phee of Nanyang Technological University (NTU) and Professor Ho Khek Yu of National University Hospital (NUH), to tackle these problems. The system consists of a master console, a telesurgical workstation, and a slave manipulator which holds two end-effectors, a grasper and a monopolar electrocautery hook. With a total number of 9-DoFs in two robotic arms, the system enables the surgeon to perform complex surgical procedures which could hardly be achieved in a non-invasive manner. The system would be operated by an endoscopist and a surgeon. The former would traverse and maneuver the endoscope while the latter would sit in front of the master console to control the slave manipulators.
Recently, using this technology, surgeons at AIG, Hyderabad, India, have successfully performed tumor removal for 3 patients suffering from gastric cancer, which is possibly the world-first to be performed on stomach cancer patients—said Singapore doctors. It cuts surgery time for stomach cancer patients to 17 minutes from eight hours, does reduces the length of hospitalization, and allows patients to undergo surgery without having to bear scars.
Associate Professor Louis Phee, head of the Division of Mechatronics and Design at NTU, said: "With this robotic system, you're giving a lot of maneuverability and dexterity to the endoscopist such that he can act and perform like a surgeon. It becomes possible to manipulate tissues, to cut and in the near future, to suture wounds inside the stomach."
While the gadget has reaped benefits during its trial stages, experts say there is still room for fine-tuning. Professor Ho Khek Yu, senior consultant at the Department of Gastroenterology and Hepatology at NUH, said: "Currently, we can only do procedures on early stomach tumors because the robotic arms are fashioned to do this procedure only. This procedure is challenging and needs a certain period of training. We need to adapt the robotic arms further to allow us to do more complicated procedures such as obesity surgery and anti-reflux surgery in future."

By Kurt Sun Zhenglong

Read about it on MedGadget as well, and on their research page.

CIS news

2011-08-02T02:01:00.000-07:00

NSF page on Hopkins' Eye robot
Insight: why called da Vinci?
Read about the origins of the da Vinci system
Intuitive’s Q2 earnings are impressive again
Also, ISRG is selling shares to emplyees
Optical fiber tracking might be the next big thing in CIS. Intuitive and Phillips are betting on it.
Neuroarm is building up experience with different surgeries (the first clinical trial was back in 2008)
Robotic surgery takes off in Bulgaria
Sterilization baskets for robotic tools
The first picture of the Amadeus console appeared along an inteview, and also the robot now has some people to develop the video capabilities
Plato's Cave--an interactive pre-op image platform
Nanoma--an FP7 project on nano-medicine
Robots helping out humans
IRCAD now has a student initiative, also addressing surgical roobotics
World's smallest endoscopic cameras

Image credit: TheSpec.com

Origins of surgical robotics

2011-07-28T02:31:00.000-07:00

I was always wondering who had first the idea to use robots for surgery. Many of the famous people started their work towards their robotic surgery system in the late '80s, early '90s, inspired by some physicians. But apparently, the idea dates back a lot earlier.

Arthur D. Alexander III, from NASA Ames Research Centerpublished a few articles in 1972-73 around the topic "Impacts of Telemation on Modern Society". What is really impressive that he had already had a clear concept how a master-slave teleoperational robot system should look like, and also envisioned dedicated medical-purpose comm stellites. (See the figure on the right.) Below, excerpts from the 1973 publication. Should you have any furher information, please, let us know!

"A 90-day study was made of teleoperators, robotics, and remote systems technology in the United States. The purpose of the study was to survey state-of-the-art technology in this field, determine major user needs in medicine, mining, and oceanography, and suggest initiatives where federal research and development funding would most significantly impact the application of this technology to the alleviation of explicit national social problems. Following a review of the findings of this study commencing with user needs, speculation is made on impending developments in the application of telemation to remote emergency medical care and remote mining systems. " Source: CSA

"Use of Manipulators for Remote Medical Emergency Care Recent advances in the technology of human extension by remote manipulation, concepts derived largely from the U.S. space program, make possible professional medical care, including surgery, in situ at the emergency site and remote from an environmenrspecializing in acute care (such hs a hospital emergency facility or Clinic). Figure 2 illustrates such a remote surgical system. A proposal, currently under consideration, suggests the use of human extension through remote manipulation to upgrade the quality of medical care at both remote and accessible areas and to make the most effective use of scarce skilled medical practitioners

throughout this nation and the world for the relief of human suffering. This proposal is directed specifically to a pilot study of the use of human extension by remote manipulation for extended medical care at the emergency site. It includes a survey of on-site remote medical care capability, the

design of an emergency care package, and a pilot research demonstration of remote surgery for one or

more procedures.

Initially assuming a modular concept, a proven minimum requirement for remote patient treatment is

a two-way color TV/voice communication system (Massachusetts General Hospital's Logan Airport Emergency Room) that enables skilled doctor/patient interfacing. Next, in order of importance, basic diagnostic equipment is required at the emergency site:

respirometer,
sphygmomanometer,
remote stethoscoper,
fluoroscope,
image intensifier radiography,
EKG machine,
possibly EEG capability.

All such equipment must be remotely operable through reliable telemetry, which state-of-the-art technology presently permits. The ultimate modular design would provide remote treatment capability, thus eliminating the need for trained paramedical personnel to be in attendance at the remote emergency site. Envisioned for this purpose would be a pair of master/slave manipulator arms remotely extending the doctor's manipulative, tactile (touch), visual (stereo TV or fiberoptic telemetry at terminal "hands"), and listening (stereosonic) capability. Adjunct treatment equipment would provide for remote maintenance of life-support functions and might include respirator, heart stimulator, blood flow control apparatus,anaesthesia equipment, and skeletal support systems.

In summary, an idealized modular remote care system must provide the attending physician with reliable two-way communication, diagnostic and treatment capability in that order. Each of the preceding concepts represents a distinct and measurable improvement over existing emergency care procedures.

As remote emergency care is demonstrated to be feasible, and as the concept becomes accepted domestic medical practice, a number of international implications will become evident. As emerging

nations place greater emphasis on developing technology (greater use of machinery, cars, etc.), they

will encounter an increasing accident frequency--a frequency they may be unable to deal with effectively unless they are able to educate and develop concurrently a medical staff adequate for their needs. A practical interim solution would be to draw upon medical staffs in the developed nations to provide that care using remotely operable facilities linked by dedicated medical communication satellites.

Further, these remotely operable emergency care facilities, when not in direct use, could be used for

medical education purposes, linking the outstanding medical centers of the world to the most remote

regions, providing access to the most advanced medical techniques and procedures available."

So thus surgical robotics was born...

A couple of the early patents citing this: SRI1, SRI2, SRI3, SRI4, SRI5, SRI6, Intuitive, Intuitive1 , Intuitive2, Intuitive3.

Update:
Learn more about in-space surgery capabilities from this old but very detailed NASA report.

Source: Alexander AD, "Impacts of telemation on modern society," Proc. of the 1st CISM-ITOMM Symposium. New York: Springer, Wein, 1972; pp.121–36.
~ in Proc. of the Annual Meeting of Human Factors and Ergonomics Society, vol. 17, no. 2, Santa Monica, CA, 1973, pp. 299–304.
~ Human Factors Society, 17th Annual Meeting, Washington D.C.; 16-18 Oct. 1973. pp.299-304. 1973

SmartMove: a TMS robot

2011-07-24T15:22:00.000-07:00

Although it has been around for a while (3+ years), the SmartMove got some publicity recently. "Robotized TMS is a novel approach in the application for image guided transcranial magnetic stimulation (TMS).
SmartMove allows planning of a complete stimulation session ahead by defining stimulation sites based on anatomical MRI information and functional information like fMRI, PET or EEG/MEG. During the execution of the TMS stimulation sequence, the system places the coil at the predefined target positions and keeps the coil in place even if the head of the patient/subject moves."

The system includes an NDI Spectra camera for tracking, and relies on point-based registration to the pre-op MR. Learn more about it from their leaflet, or watch some videos.

Key features include:

Accurate&automatic positioning of TMS coil
Easy target and grid definition
Placement of the coil tangentially to the head
Head movement compensation
Defining of entire stimulation protocols
Repetition of previous stimulation target positions
Online mapping of evoked responses
Compatible with all TMS stimulation.

According to their disclaimer, it is only iontended for research use (as of now): "This products is not sold as Medical Device as defi ned in EU directive 93/42/EEC. The product is not designed or intended to be used for diagnosis or treatment of disease."

Source: ANT Neuro, MedGadget

The new ALF-X robot

2011-07-19T05:17:00.000-07:00

The first news about the Telelap ALF-X system “Advanced Laparoscopy through Force-. RefleCT(X)ion” leaked out some three years ago, indicating that SOFAR S.p.A., (a pharma company in Milan) started to use retrofited industrial manipulators to create a da Vinci competition. They art supported by an EU joint effort, and operating under the academic assistance of the New European Surgical Academy (NESA). Next, they teamed up with Immersion Corp. to ensure a good haptic interface (TouchSense) for their robot, and they tried to patent it (US prov. pat. 20100204713, 20090024142).

Features include:

Preoperative simulation
Force controlled tools (US prov. pat. 20100094312)
Automated fulcrum point identification
Real-time patient monitoring to enable VR overlay
Laser scanners for safe robot positioning
The main application would by gyneacology
Target: 1.5 mm clinical accuracy, <60 ms latency
Severel trials on porcine models have been done
Preclinical trials with the robot included: hysterectomy, salpingo oophorectomy, myomectomy, partial and radical nephrectomy, total pelvic exenteration and cholecystectomy. Current trails focus on:

1. The use of the newly designed handles, surgical arms and instruments
2. Haptic force transmission
3. Ergonomic aspects
4. Safety and reliability
5. The 3D Stereo Vision system
6. Docking time
7. Durability of the re-usable instruments
8. Capability of complex surgical steps
9. Economic aspects (all elements are reusable)

This year, they have already had a presentation of the system at the MIRA congress, the Italian SICT, and will be featured in Leueven, as the SERGS as well.

FYI! "The system is called Telelap rather than a robot in order to avoid any misunderstanding, as it is manipulated by the surgeon rather than through artificial intelligence." /Tinelli et al./

Updates on the robot are here.

SCATh Workshop in Graz

2011-07-14T01:20:00.000-07:00

SCATh (Smart CATheterization) is an EU FP7 project, led by KU Leuven, spanning across the whole continent, and focusing on the development of advanced navigation techniques for intravascular procedures.

The project is half way down the road, and they held an international joint workshop on on New technologies for Computer/Robot Assisted Surgery in Graz, this week. There were many great people attending, great keynotes, and a lot of old and new friends. The proceedings is open access, with topics reaching a long beyond catheters (excerpts):

CIS News

2011-07-09T09:30:00.000-07:00

AIG doctors perform world's ‘first' robotic endoscopy surgery
"Rush to robotic surgery raising flags"--judge it for yourself!
Sutter Hospitals starts to use ROBODOC
The rise of the ROBODOC
More ROBODOC stories
Dental robot phantom
Einstein Vision 3D-HD Robotic Laporoscopy System
A new swimming capsule endoscope
Simulated Surgicals Inc. has sold about a dozen of the $125,00 simulators

TUM--PhD Position in Medical Robotics and Computer Vision
Some nice and fresh talks from the ICAR conference
AdvaMed Code of Ethincs for those, who care

Image credit: Schölly Fiberoptic

CIS Workshop presentations and videos

2011-07-02T16:54:00.000-07:00

Our first International CIS Workshop ended with great success, everyone was enthusiastic about the lecturers presenting. They were kind enough to share their materials, so now you have a wonderful set of powerpoint presentations and videos. Enjoy, and comment, if you like it!

The abstract booklet is still under editing, and the presentations are gradually uploaded. You can check the original program here.

CIS Workshop presentations and videos
0	Haidegger: Origins of CIS
1	Bejczy: The dawn of robototic surgery at NASA--a personal experience
2	Kazanzides: Evolution of surgical robotics
3	Cleary: Computer-Aided Interventions and Medical Robotics in Interventional Radiology
4	Kronreif: Robot Systems for Percutaneous Needle Placement
5	Fichtinger: Pre-operative to intra-operative image guidance for prostate brachytherapy
6	Maier-Hein: Intra-operative registration for computer-assisted medical interventions
7	Pernus: Image registration: 2D/3D problems (article at Srpinger)
8	Fichtinger: Radiation Oncology
9	Pongrácz: Video Tracking in Clinical Environment
10	Benyó: High-speed, high-performance multi-modal imaging
11	Lassó: MR-guided prostate brachytherapy
12	Kovács: Telesurgery: a control theory approach
13	Meskó: The future patient
14	Takács: Anatomical ultrasound
15	Emirdağ: Collecting Environment Data during Surgery
16	Coban: Four channel double hand coil for MRI
17	Mironov: An estimation of inaccuracy in dosimetric data smoothing
18	Hanganu: System-on-Chip Solutions for Portable Medical Applications
19	Groch: In-vitro Evaluation of 3D Surface Reconstruction Techniques
20	Wéber: The modern tools and education of surgery
21	Haidegger: New trends in surgical robotics
22	Szaniszlo: In vivo mass spectroscopy for tissue analysis
23	Sirokai: Electromagnetic tracking in the medical environment
24	Pajkanovic: Proposed algorithm for wireless control of electric wheelchair by head movement
25	Nonnis: Blood cells extraction, recognition and counting using Matlab
26	Zukic: Haptic paddle in virtual reality applications
27	Verhagen: The advantages of new, computer based techniques of surgery
28	Albrecht: Carbon Nanotube Sensors
29	Nagy: Technical solution to support sterilization in the medical environment

LEGO in surgical robotics

2011-06-26T07:38:00.000-07:00

LEGO is a universal toy, form of art and research tool as well! Even in surgical robotics you can find great use cases.

Take this complete tutorial from Harvard, for image-guided LEGO therapy with Slicer3D, or the LEGO surgery competition at Hopkins in 2003 (also featured at NIH).Recently another robotic needle insertion project was initiated at Hopkins for high-school students.

Picture source: http://seankenney.com/. Must be Accuray's Cyberknife at a trade show.

If you know of further LEGO surgrob projects, put them into the comments.

CIS news

2011-06-21T03:07:00.000-07:00

Near-Infrared Fluorescence Imaging Guidance for the da Vinci
Robotic Ultrasound Technology at BK Medical Show
i-Snake from Imperial College
World's first intubation robot (also featured on MedGadget)
A nice TED talk on neurosurgery
Mazor's spinal robot has been upgraded
SpineAssist is now selling in Italy and the Netherlands
MAKO is getting better and better financially
Robotic-assisted angioplastyű
Desposable robot for biopsy
FDA approval for a Hair Restoration System
The global market of surgical robots is to reach $1B by 2014
Physcient is to create more gentle surgical tools
This year's BMEidea competition winners

Conferences:

IROS Surgical Robotics workshop is still calling for submissions
Or the M2CAI workshop at MICCAI
RoBio will take place on the magnificent island of Phuket
The Intl. Assc. of Clinical Robotic Surgery (CRSA) announced a "Clinical Virtual University"

Positions:

postdoc is seeked at the Robotics, Automation, and Medical Systems (RAMS), University of Maryland, College Park
Senior System Analysist is wanted at Intuitive
PhD position at ETH Zürich on surgical robotics

A little da Vinci madness from Seattle at the end:

Picture credit: Mazor

Using Robots to Train the Surgeons of Tomorrow

2011-06-14T01:26:00.000-07:00

A nice series of artricle has started in IEEE Spectrum's Automation blog on sugrical robotics. The first issue is from Carol and Dr. Hager on various Hopkins projects. Happy reading!

Picture credit: Kelleher Guerin

ROSA--surgical assistance robot

2011-06-09T10:20:00.000-07:00

There is a new robot on the market, built along an old concept: assistance with needle guidance. ROSA is created by MedTech, a French company that created the BRIGIT robot previously (commerzialized and sold to ). The CEO being Bertin Nahum, experienced at Computer Motion, ISS and IMMI, supported by some people from the LIRMM lab in Montpellier.

The robot is aimed for typical needle-based neuro procedures: brain tumor biopsies, resections, locations of deep brain stimulation electrodes, SEEG, epilepsy Surgery, cerebral cortex stimulations, etc.
One of the main feautures is that it can be force-controlled as well.
Registration is automated through a laser surface scanner.
It has CE mark, FDA clearance, Health Canada approval and ISO certificats
ROSA was first tried this April in a Cleveland clinic, than in Canda CHUS, and claimed to have at least another few human trials.
You can watch a couple of procedures and videos about the setup.
It sells for $600,000.
NewFund investment owns 27% of the company.

If you have more information, please comment!

Video ROSA 2011 Stereotactic Surgery von medtechsurgical

Introduction to Surgical Robotics (HUN)

2011-06-04T13:58:00.000-07:00

I was honored to be the guest speaker of the Budavár Rotary Club last week meeting. My presentation ("March of the robots, the first 25 years of surgical robotics") was very well received, so now I'm making it available here for the Hungarian-speaking community (to be).

You can download the slides here, and the presented videos here.

Updates on the Amadeus surgical robot

2011-05-28T00:40:00.000-07:00

Unfortunately, not a whole lot of information is leaked regarding the development of the Amadeus system in Canada, aimed to compete with the da Vinci. Some of the news allows us to sketch the way of their development.

In April, Titan Inc. announced that they will use KUKA's lightweight arm for the setup. This is the commercialized version of the DLR III arm, with amazing capabilities and functions (7 DOF, fully sensorized, compliant). The LW is preferred solution for other surgical robotic setups as well (e.g. the Active FP7 project). It is also important feature that the KUKA robot does not use cable-drive, therefore does not collide with Intuitive's patents on that technology.
Back in March, the first prototype of their console started its user-tests.
Earlier, they outsourced some of the development tasks to Sagentia Inc.
Recently, the first concept-designs and images were released on Titan's website (see above), and now the company claims to have its first working prototype.
Strategic agreements have been made with Canadian hospitals for the trial of the system, once they have a clinically applicable prototype (within 12-24 months).
In an interview with founder and CEO (Dr. Rayman), he expressed their effort to make Amadeus more useful in telemedicine services, including education and informationsharing between sites. They can rely on their massive experience from CSTAR. He believes the robot will be superior to da Vinci due to the redundant and compliant KUKA manipulators and to the use of more flexible tool shafts. (Which however, may also cause some problems in control--ed.) They plan to target bowel surgery and mitral valve repairs beyond the typical abdominal and urulogical procedures.
In the mean while, the financial news from the company reveal that they will need huge investment very soon to continue.

Updates: - first external image on the consol of the Amadeus
       - Titan partners with D&D video for advanced camera system development
       - More recent news on the system
   - Older article

The iSYS robot, descendant of the B-ROBs

2011-05-22T16:09:00.000-07:00

Researchers at the recently introduced ACMIT center (originally working for IMA, and before at Seibersdorf) have earned the merit for developing a compact and practical needle holding robot, historically called B-Rob, the biopsy robot.

The original one was developed for CT and ultrasound-guided biopsies by the robotics laboratory of ARC Seibersdorf Research (Austria). The first B-Rob prototype was a 7 DOF robot integrated on a mobile rack. A 4 DOF positioning stage was used to direct the needle to the desired skin entry point. The complete system was thoroughly tested on needle-penetrable phantoms, where its application accuracy was 1.48 ± 0.62 mm, which was shown to be better than the traditional free-hand technique [Cleary et al., 2006].

The development of the second prototype was motivated by the aim to provide a modular setup for a broad variety of clinical applications, easy integration with other systems, reduction of technical complexity and costs. The robot was equipped with a Needle Positioning Unit (NPU) for fine orientation. The first gel phantom tests of the B-Rob II showed 0.66 ± 0.27 mm application accuracy in IG positioning. In-vitro trials with ultrasound guided biopsy specimen harvests followed, where the mean deviation of the needle tip from the center of the target was 1.1 ± 0.8 mm.

The latest version of the robot got new controllers and, a decent design, and receiving clearance these days under the branding of the iSYS company.There are a handful of the devices around the world by now, used routinley in reseach.

Another Summer School on Surgical Robotics

2011-05-16T01:46:00.000-07:00

With only a few days left until the deadline of our CIS workshop, there are other initiatives worth a note.

The LIRMM lab in Montpellier has earned a world-wide reputation for their very successful surgical robotics summer school, that has been bringing together young talents since 2003. The next, 5th edition is coming soon, you should consider it!

"The highly interdisciplinary nature of surgical robotics requires close cooperation between medical staff and researchers in mechanics, computer sciences, control and electrical engineering. This cooperation has resulted in many prototypes for a wide variety of surgical procedures. A few robotics systems are yet available on a commercial basis and have entered the operating room namely in neurosurgery, orthopedics and MIS.

Depending on the application, surgical robotics gets more or less deeply into the following fields: multi-modal information processing; modelling of rigid and deformable anatomical parts; pre-surgical planning and simulation of robotic surgery; design and control of guiding systems for assistance of the surgeon gesture. During the Summer school, these fields will be addressed by surgeons and researchers working in leading hospitals and labs. They will be completed by engineers who will give insight into practical integration problems.

This course is addressed to PhD students, post-docs and researchers already involved in the area or interested by the new challenges of such an emerging area interconnecting technology and surgery. Basic background in mechanical, computer science, control and electrical engineering is recommended."

The lectures will be organized in four parts:

• Fundamental aspects of surgical robotics (2 days)

• Applications (2 days)

• Industrial forum (1 day)

• Future trends (1 day)

See the official website or their flyer for more information. Also, you can look at the previous editions (2003, 2005, 2007, 2009).

LIRMM is currently looking for a post-doc in surgical robotics for the ARAKNES project.

CIS Workshop in Budapest

2011-05-09T10:09:00.000-07:00

Finally, we are organizing a CIS Workshop in Budapest (May 17-24.), with the old fellows from MAVE (EESTEC LC Budapest), and the Biomed Lab at BME. All young colleagues' submissions are welcome! 10 more days to go. Accommodation, food and fun is all included in the very modest registration fee.

You can find the description, the application form and the preliminary program on the official website: eestec.hu/cis.

We are lucky to have a very strong international team of lecturers:

Dr. Gábor Fichtinger (Queens University)
Dr. Kronreif Gernot (ACMIT)
Dr. Peter Kazanzides (Johns Hopkins University)
Dr. Kevin Cleary (Children's National Medical Center, USA)
Dr. Wolfgang Birkfellner (Medical University of Vienna)
Dr. Lena Maier-Hein (German Cancer Research Center)
Dr. Franjo Pernuš (University of Ljubljana)

The main sponsor of the event is SIEMENS Healthcare, ACMIT and Contact Singapore are also supporting.

Apply today!

CIS news

2011-04-28T13:00:00.000-07:00

Look around the world, and see what's news in CIS!

SRI robot technology goes back from OR to battlefield
The first dedicated robotic transducer: ProART
Philips is to integrate the CorPath 200 cath lab robot
Gesture recognition robotic nurses to help surgeons
New throat surgery technique
iPod used in orthopaedic surgery
Mini 1.5T MR scanner from GE (Optima MR430s)
MRI-Compatible Cannula Receives FDA cleared
An innovative anatomical educational tool from Hungarian developers
Submarine sonar technology to detect stroke

Internship at Siemens Corporate Research in medical imaging

ACMIT - the new focus point of CIS research in Austria

2011-04-22T14:16:00.000-07:00

The ACMIT (Austrian Center for Medical Innovation and Technology) was founded a year ago, supported by an Austrian national grant for at least 4 years to

"ACMIT is the Austrian competence center for research & development in medical technologies, focusing on minimally invasive surgery and procedures. We are working on new "active" surgical instruments and highly accurate positioning systems for these tools. Our expertise concentrates in MIS instruments, medical robotics, sensors and work-flow analysis.
ACMIT is a neutral R&D-platform offering various services. Their robotic-related projects include:

Robot-Assisted and Needle-Based Tumor Treatment
Remote-Controlled Tool Holders for "Minimally Invasive Procedures"
Integrated System for Minimally Invasive Autopsy
Image Guided Patient Positioning and Immobilization for Effective Therapy
"In-vivo" Robot Systems for Clinical Use

"The research group at ACMIT center has more than 10 years of experience in the development of robot systems for needle based percutaneous interventions. One cornerstone of development has been the B-Rob I and II robot systems. Together with national and international research partners various applications based on this robot system have been developed and successfully evaluated both in vivo and in vitro." An upcoming post will deal with the B-Robs.

Dr. Satava in Budapest

2011-04-13T05:55:00.000-07:00

We were extremely pleased and honored to have Dr. Richard Satava visiting Budapest, as the BME Technical University President's guest. He gave two lectures, and for the first time in history, his powerpoint presentation is available in Hungarian (from here). The English version is also available.

The presentations included a general overview of the recent change of paradigm in medical care: shifting the focus from materials to information and energy. One of the most promising technologies down the road is HIFU (high-intensity focused ultrasound). Since the technology is already existing, it will only take time to see the holomer concept coming to the every-day use, where we will all have a complete medical record of our body to carry around at all times. Probably the best part of the talk was about disruptive technologies that are already around the corner and will certainly change the world as we know it. The message to take home was that "technology is neither good or evil. It all depends how we use it, therefore we must get prepared to become wise and careful users of the new, powerful tools we are developing. The responsibility is ours."
More Satava presentations are available here.
One of his great talks from 2009.

CIS news

2011-04-08T09:47:00.000-07:00

Wonderful video from Carol and Tom, students at Hopkins, playing overnight with the da Vinci
Robotic autopsy is around the corner--the ACMIT center is also working on it
CMU's HARP robot updates
More origami with the da Vinci
UW BioRobotics Lab's Kinect hack is getting some attention
Have some time? Dig down for some quality Hopkins publications
Latest exoskeletons from Cyberdyne
Volumetric Interactive 3D for surgical education and training
Old as it can be: X-ray machine from the attic
Watson to be used for health care
And a new, mobile one from SIEMENS
Boston University's BioRobotics lab is hiring.
Awesome job offerings at Intuitive.

Hopkins Updates

2011-04-01T16:51:00.000-07:00

It is great to see how projects are evolving at the CISST/LCSR lab every time I get back. In recent times, the cisst software library has seen major improvements. Now it includes advanced virtualization and shared control features, allowing to interact with various devices (robot, camera, tracker, etc.) in a dynamically changing environment. cisstStereo also got a decent tutorial from Balázs.

"The cisst package is a collection of libraries designed to ease the development of computer assisted intervention systems. One motivation is the development of a Surgical Assistant Workstation ( SAW), which is a platform that combines robotics, stereo vision, and intraoperative imaging (e.g., ultrasound) to enhance a surgeon's capabilities for minimally-invasive surgery (MIS). All software is available under an open source license, which can be found here. The source code can be obtained from our Subversion (SVN) repository."
The CISST people has already passed a human trial with the Ultrasound support system, and the SAW was popularized lately by Intuitive at the SPIE conference.
The other flagship project is the Eye robot. "The Steady Hand Eye Robot cooperatively shares control of a surgical tool with the surgeon while meeting the performance, accuracy, and safety requirements of microsurgery."

Almost all of the CISST projects are relying on the cisst, e.g. our neurosurgical project used cisstVector and cisstDevices heavily.

Source: cisst site

BioRobotics at the upcoming EMBC

2011-03-19T21:45:00.000-07:00

The 33rd IEEE Engineering in Medicine and Biology Society Conference (EMBC 2011) is calling for contributions in the theme BIOMECHANICS AND ROBOTIC.

Paper Submission Deadline: March 26, 2011
Notification of Acceptance: June 6, 2011

The conference will take place at the Boston Marriott Copley Place Hotel in Boston, Massachusetts, USA. August 30 through September 3, 2011. The conference main topic is "Integrating technology and medicine for a healthier tomorrow". It will cover diverse topics ranging from biomedical engineering to healthcare technologies to medical and clinical applications. The conference program will consist of invited plenary lectures, symposia, workshops, invited sessions and oral and poster sessions of unsolicited contributions, just as in the previous years. To learn more please visit the IEEE EMBC 2011website.

Conference Tracks within Biomechanics and Robotics Theme are:

1) Orthotic Biomechanics and Robotics
2) Prosthetic Biomechanics and Robotics: Artificial Organs/Limbs
3) Rehabilitation Robotics and Biomechanics: Therapy, Assistance and Clinical Evaluation
4) Human-Robot Interaction and Robot-aided Living for a Healthier Tomorrow
5) Sports, Exercise and Games: Biomechanics and Robotics
6) Robot-aided Surgery
7) Biologically Inspired Robotics and Micro-(bio)robotics
8) New Technologies and Methodologies in Medical Robotics and Biomechanics
9) Neural Control of Movement and Robotics Applications
10) Applied Musculoskeletal Models and Human Movement Analysis

More details are available here.

CIS news

2011-03-12T16:48:00.000-08:00

New MIS laser suturing device from Fraunhofer (Also on Medgadget)
Disposable MIS cameras from Fraunhofer
Recent status update on Singapore's lung robot.
Singapore's Mona Lisa prostate robot (Earlier version of the robot)
Intuitive's 2010 results are public. Double digit sales increase reported.
Ace of cakes with the da Vinci
A new study on prostatectomy experience levels

Picture credit: ST Photo

A surgeon's view on CIS, presentation at SPIE

2011-03-02T16:34:00.000-08:00

The annual SPIE Medical Imaging conference was held in Orlando this February. It featured a good amount of technical talks, lectures and poster presentations. One of the highlights of the conference week was Duke Herrell’s (Vanderbilt University) keynote titled “Engineering solutions in the operating room: a surgeon’s perspective”. The abstract did not reveal too much: “While the promise of genomic biology and “personalized” medicine may revolutionize disease care and diagnosis in the coming decades, the operating room continues to offer a fertile ground for innovation.
Engineering solutions such as image-guided surgery (IGS), robotics, functional and tumor targeted imaging, and tissue ablation hold promise to potentially revolutionize surgery and improve patient outcomes. Key to the development of successful solutions is a close collaboration between development engineers and surgeons. Utilizing a trans-institutional collaboration of engineers and surgeons, solutions such as incorporation of IGS into robotic and kidney surgery, advanced robotic and ablative technologies, and new imaging modalities are being explored at our institution and will be reviewed.”, but in fact, the talk gave a good overview of the emerging technologies (pros and cons), such as:

Registration and tissue deformation models
Tracked robotic instruments
Laser Range scanners in open surgery for model generation
LESS/single incision (e.g. with magnetic anchoring, NOTES robots)
Image-guided ablation techniques (Cyroablation, RFA, Microvawe, HIFU, Histotripsy (high intensity pulsed US) )
Robotic radiation-therapy (CyberKnife)

He summarized the future needs of the field, innovations deriving from the close cooperation of surgeons and engineers:

Smart instrumentation (e.g. tissue-specific markers)
Patient specific simulation and education
Miniaturization of instruments with autonomous functions
Imaging integration (augmented reality).

Probably the best part was how he talked about surgeons’ adaptation to new technologies. He compared it to adaptation to defeat or death, described with the U-shaped curve by psychology. According to [Wilson 2006], the characteristics of newly adopted surgical technologies are:

Compatibility of current practice, support by available facilities
Surgeons can observe procedure
Modification of an existing procedure, or easy to learn
Offered for trial period before fully embraced
Case volume and expected demand justify learning required
Procedure will appeal to patients.

He compared advanced surgical technology to drones for the military, and concluded with the wish to have the very best “pilot and plain” duet for surgery.

Seminar talk at Hopkins

2011-02-23T14:00:00.000-08:00

I was offered the unique chance and honor to give this week's ERC/LCSR seminar talk at Hopkins. You can access the full presentation here. My talk summarized three research projects I was mostly working on towards my PhD:

Stochastic method for error propagation: In certain critical surgical procedures, physicians extensively rely on the help of navigation systems, with accuracy metrics provided by the manufacturers. Depending on the setup, inherent system errors can accumulate and lead to significant deviation in position. It is crucial to determine and display the overall task execution error-the registration and tracking errors enlarged by multiplying imperfect homogeneous transformations. The stochastic approach presented offers an easy and straightforward solution to map and scale the error propagation.
Detection and compensation of intraoperative motion: One of the major challenges with integrated surgical robot systems is to maintain the accuracy of the pre-operative registration procedures, and to ensure that all motions of the hardware setup or patient are promptly noticed. By applying a deterministic approach (similar to behavior-based control), it becomes possible to accurately monitor and compensate for any spatial changes with a selective algorithm. The concept developed was tested on a neurosurgical prototype system built at the CISST ERC at the Johns Hopkins University. The new technique can be used with various image-guided systems, offering new ways to enhance their capabilities.
Control architecture for telesurgery: Error compensation and guidance of surgical devices are gaining importance in the evolving field of long distance telesurgery. Effective control requires the appropriate handling of the latency in the communication, while ensuring the stability of the devices. A control structure was designed and tested in simulations for telesurgery, relying on empirical controller design methods.

CIS news

2011-02-20T10:25:00.000-08:00

CIS news from around the globe:

Job opportunities:

Kevin Cleary is hiring 8 post-docs to get involved in the development of IGSTK. Apply for the open positions!
Intuitive Surgical is offering various positions at their website
Faculty and research positions at Hopkins
Positions advertised at MICCAI

Events:

Joint Workshop on New technologies for Computer/Robot Assisted Surgery deadline extended to March 1 (Graz)
Workshop on Surgical Robotics at EU Robotics Forum 2011 (Vasteras)
Summer School on Dynamics and Control Problems in Medical Robotics (Delft)
ICRA11 Workshop on Mechanisms for Sugical Robotics (Shanghai)
Medical Robotics Special Symposium at IROS. Submit papers here.
IEEE Conference on Healthcare Informatics, Imaging, and Systems Biology (San Jose)
International Prostate Cancer Symposium (New York)

Picture credit: University of Tokyo

Da Vinci news

2011-02-14T21:19:00.000-08:00

Folks at the Holmes Regional Medical Center played around with the da Vinci:

While Dr. Hager and his students hooked up the robot with the Kinect:

A nice paper in the set of the da Vinci assessment: Towards image guided robotic surgery multi-arm tracking through hybrid localization

As of last week, Intuitive's Fluorescence Imaging on the da Vinci Surgical System for Intraoperative Near Infrared Imaging got FDA approve.

Looking for a job at Intuitive? Look around at their website! They also have various internships.

IGSTK User Group Meeting

2011-02-12T14:47:00.000-08:00

The 3rd User Group Meeting for the Image-Guided Surgery Toolkit (IGSTK) [I-G-stick] was held before the SPIE conference in Orlando.

"IGSTK is an Open Source software toolkit designed to enable biomedical researchers to rapidly prototype and create new applications for image-guided surgery. This toolkit provides functionalities that are commonly needed when implementing image-guided surgery applications, such as integration with optical and electromagnetic trackers, manipulation and visualization of DICOM datasets":

a method for registration of the preoperative image to the physical space of the patient,
tracking for intra-operative localization of instruments,
user interface that displays images and the position of instruments,
a workstation that runs and connects the applications.

The meeting was run by Kevin Cleary, and besides, a lot of the users gave a brief intro from neuro to brachy and pediatric applications. The presentations are available at the event's site.

You can learn more about IGSTK at its wiki.

If you are interested in getting more involved in the development of IGSTK, apply for the open positions!

Single-incision robotic surgery is taking off

2011-02-02T03:09:00.000-08:00

Single-incision laparoscopic surgery (SILS), also called single-port access (SPA), or single-site (LESS) have been widely popularized recently, having claimed less pain and faster recovery. Robotic fans threw themselves at the technique, and the da Vinci has been used for several human procedures, mostly through the umbilicus:

In the mean time, fierce criticism has emerged, emphasizing the lack of objective comparable studies. If you know of any, share with us!

CIS news

2011-01-24T05:06:00.001-08:00

Interventional medical technology news from around the world:

CISST ERC featured on Science Nation
Surgical Laser Introduced for the da Vinci
Kids playing on the da Vinci at LSC
Da Vinci surgery for head and neck cancer shows promise
Haptic lapar training instrument rom TUDelft
The nice official tutorial for Slicer users
CyberKnife OR to be set up in Bahrein
Cyberdyne's HAL exoskeleton moves forward
Philips's new PET/MR combo arrives to Europe
Fraunhofer's Bionic Handling Assist robot awarded
Still time to propose some surgical robotic sessions for the upcoming EU FET11 event, or submit your work to be presented in Budapest, May 2011
Deadline extended for the MIRA conference
Call for the Hamlyn Symposium on Robotics, June 2011
Chance to go to wonderful Phuket, without getting married: RoBio2011

Image credit: UAB

Intuitive's da Vinci simulator

2011-01-13T18:59:00.001-08:00

Having realized the potential in robotic surgery training, Intuitive has released its portable da Vinci Skills Simulator, which can be attached to a da Vinci Si system.

"The straightforward set-up allows users to practice unassisted or with supervision, according to their preference.
Built-in metrics enable users to assess skills, receive real-time feedback and track progress.
Administrative tools let users structure their own curriculum to fit with other learning activities in their institution.
The open architecture of the system software allows for the future development and incorporation of additional practice modules."

The exercises include:

EndoWrist Manipulation
Camera handling and Clutching
Fourth Arm Integration
System Settings
Energy and Dissection
Full exercise list is here

A short video of the simulator can be found here. The official brochure is here.

Sofie

2011-01-11T03:12:00.001-08:00

The "Surgeon’s Operating Force-feedback Interface Eindhoven" (Sofie) is a surgical robot developed at the Eindhoven University of Technology.

TU/e researcher Linda van den Bedem developed a compact surgical robot (with the Dept. of ME), integrating force feedback to allow the surgeon to feel what s/he is doing. Tactile feedback is provided in the master side joysticks. This counter pressure enables a surgeon to feel exactly what force he applies when making a suture or pushing aside a bit of tissue. Sofie is quite compact, and hence less of an obstacle in the operating theater and above the patient. Its small dimensions come with an added bonus: the slave can be mounted on the operating table. This averts the need of resetting everything when the operating table and the patient are moved or tilted. Further, Sofie makes it possible to approach an organ from different sides and can even operate 'around the corner'.

Short video on the robot.

Sources: Science Daily, Eindhoven University

CIS news

2011-01-03T17:18:00.000-08:00

New year, new news.

Other issues:

Guys at Dr. Hannaford's lab got some fun with the Kinect
Hiring at DLR! To the highest rank in the Robotics Institute
ME post docs are needed at Harvard's Biorobotics lab
2 post doc positions are open at U Twente in Medical Robotics, @MIRA/SEG under Sarthak Misra.
Computation Vision and Medical Image Processing Conference in Portugal
You can publish your research free of charge this month with the Journal of Robotics
Did you invent something remarkable? Apply to the IEEE RAS Award!
Or apply for the Medical Design Excellence Award 2011

Photo credit: Mazor

Symposium proceedings

2010-12-27T03:50:00.000-08:00

Recently, I came across two surgical robotics meetings' proceedings that are freely available:

the 3rd Hamlyn Symposium on Medical Robotics, held in May in London and
the Workshop on Enabling Technologies for Image-Guided Robotic Interventional Procedures, held in Zaragoza, within the frames of the RSS conference in July

Speakers included Paolo Dario (Scuola Superiore Sant'Anna), Jur van den Berg (UC Berkley), Sylvain Martel (Montreal Polytech), Gregory Fischer (WPI), Robert Howe (Harvard), Philippe Poignet, Rogerio Richa (LIRMM), Robert Webster (Vanderbilt), F. Rodriguez y Baena (Imperial College), Helen Xu (Queens University) and many more.

Worth to take a closer look!

Image credit: Hamlyn Symposium

Season's greetings

2010-12-24T16:40:00.001-08:00

Merry Christmas / happy Holidays to all my dear Readers!

CIS news

2010-12-19T08:34:00.000-08:00

We are just flooded with exciting CIS news, here is the next does:

Further interesting stories:

Picture credit: MIROS group

Da Vinci inside--insight

2010-12-12T16:52:00.001-08:00

Manipulation precision comes at a price, but nothing is too high when it comes to surgery.

"Each da Vinci S HD System contains 39 maxon motors. Intuitive engineers have designed in over thirty maxon motors, including "RE 25" motors, some with and some without encoder feedback; RE 13 mm motors equipped with GP 13 series gearheads and 13mm magnetic encoders; and RE 35 series motors with third party encoders.
Maxon motors are designed with rare earth magnets in their stators and incorporate an ironless rotor de-sign, thus eliminating magnetic cogging. Especially at slow operating speeds, this represents a considerable advantage compared to conventionally designed motors. The slave side, or manipulator motors, require the precision of the master side, but also need to be able to be backdriven while an assistant surgeon moves the end effectors into position. The motors exhibit low hysteresis at the instrument tips.
All of the data communications on the da Vinci robotic surgical system is acquired via TCP/IP using NI's USB-6009 data acquisition board to connect to the electromyography system and electrogoniometers. These connections acquire physiological measurements, such as muscle activations and joint angles, from the surgeons. Mostly velocity controllers (some position controllers ) are used with velocity control algorithms. Primary module performs control tasks and secondary module has 2-3 filters. Redundant sensors, hardware watchdogs and real-time error detection ensures fail-safe operation of the controller in all its states. Filter in its forward path to attenuate master input commands that may cause instrument tip vibrations.
Computer capable of fully interconnected control of 48 degrees of freedom at update rates exceeding one thousand cycles per second (1.5 kHz sensory loop).There are 48 encoders and 96 analog input channels are supported by parallel floating point DSP architecture with a peak computational power of 384 MFlops and a sustained processing power of between 128 and 256 Mflops. The robot has a network of 24 micro-controllers and integer DSPs performing data transfer and health watchdog functions.
The da Vinci features an Insite® Vision and Navigator Camera Control with two 3-chip cameras and 2 separate optical channels generate 2 images delivered separately to each human eye viewing the binocular viewer. It gives 1000 frames of the instrument position per second and filters each image through a video processor that eliminates background noise."

Based on Intuitive's Q3 results, the company is doing better than ever, although ISRG stock prices are decreasing since April. (Learn more about the financial status of Intuitive here.) Some interesting facts about their selling: as the da Vinci was cleared in Japan end of last year, you can see the rise of the system, there are already 19 robots installed. Romania also got high appetite for it, and after the first 3 devices installed many years ago in military hospitals, now they have 5 more. The Qatar robotic surgical center put the Middle East on the map with their 3-unit-purchase. While the Zeus was popular in Canada, there are only 11 da Vincis in operation. Future market reserve remains in South America (with 13 robots total) and Africa (currently untouched).

Source: maxon, more about the maxon motors, design news article, da Vinci details,

CIS news

2010-12-05T16:04:00.001-08:00

There are many interesting robotic trials, new systems and updates these days. Keep following!

First all-robotic surgery with the McSleepy system incorporating a da Vinci
First remote catheter ablation at Glenfield Hospital. Learn more about the Amigo robot
Robotical opening of the sternum with the novoSurge system
SOFI or Surgeon’s Operating Force-feedback Interface from University of Eindhoven
Technical Challenges of Virtual Surgical Simulation
Catheter-Based Microrobotic Vascular Surgery
Patient washing robot at GeorgiaTech
Finally, a whole da Vinci was on sale at eBay
Intuitive's Q3 results are out. They sold 105 systems. The financial crises is over!
Surgeons about robotic prostatectomy
Robotic tongue tumor removal

Conferences ahead:

The NextMed MMVR in Newport Beach and the SPIE in Orlando are coming up next
Few days left to submit something to the top-scale IPCAI (to be held in Berlin, along with CARS)
Two weeks left to submit something the MIRA in Athens
Joint Workshop on New technologies for Computer/Robot Assisted Surgery in Graz
Propose a tutorial or workshop for MICCAI

Further news:

Picture credit: Catheter Robotics, Inc.

Teleoperation research at Keio University

2010-11-27T16:54:00.001-08:00

Last week I was given a chance to visit Prof. Ohnishi's lab at Keio University. His laboratories stretch across three campuses of the University, and addresses research focusing on humanoid robotics, flying robot control, complex haptic feedback projection and bilateral teleoperation. This latter one is including a surgical robot setup for basic tissue manipulation. (See the video on the system.) The pure position encoder-based (acceleration measured) haptic feedback is very life-like, and offers great options for scalability.

"We recently launched the development of the surgical robot. In this project, we have successfully established the control law (Acceleration Based Control), which can reproduce the touch of environment in the operator side vividly. We also conducted an experiment using a couple of teleoperation robots over Internet with our partner institution in Europe. We apply our control method, which was initially developed mainly for the use of a surgical robot, to other teleoperation robots as well. For instance, the XY bilateral table pictured above allows an operator to feel “rubbing” and “cutting” actions. Combining various teleoperation robots mentioned above, we are eagerly conducting our research activity to achieve our aim, the development of a novel surgical robot system."

You can find more information about their work in the recent publications:

Source: the Ohnishi Lab website

Update:
A similar research from UPenn

Extend the control of your brain!

2010-11-19T18:34:00.001-08:00

I have long wanted to write about the mind-blowing presentation "Towards a Whole-Body Neuroprosthetic" from Dr. Miguel Nicolelis I attended back in September (a plenary speak at EMBC2010). Dr Nicolelis is a neuroscientist at Duke University. He has become famous for the brain-computer interface research they are conducting using rhesus monkeys. This is not strictly connected to CIS, but interesting enough to address here at SurgRob.

“Dr. Nicolelis launched a new field of neurophysiological investigation which aims at measuring the concurrent activity and interactions of large populations of single neurons throughout the brain. Thus, for the past 20+ years, Dr. Nicolelis has devoted his career to the search for the physiological principles that govern the operation of key brain circuits in the mammalian brain. For the past decade, Dr. Nicolelis is best known for his pioneering studies of Brain Machine Interfaces (BMI) and neuroprosthetics in human patients and non-human primates.”
His webpage contains a whole lot information about their work, and also, you can learn more through their high-class publications.
Or see these videos: [vid1], [vid2].

In his talk at EMBC, he "reviewed a series of recent experiments demonstrating the possibility of using real-time computational models to investigate how ensembles of neurons encode motor information. These experiments have revealed that brain-machine interfaces can be used not only to study fundamental aspects of neural ensemble physiology, but they can also serve as an experimental paradigm aimed at testing the design of a whole-body neuroprosthetic. I will also describe evidence indicating that continuous operation of a closed-loop brain machine interface, which utilizes a whole-body neuroprosthetic as its main actuator, can induce significant changes in the physiological properties of neurons located in multiple motor and sensory cortical areas. This raises the hypothesis of whether the properties of a whole-body neuroprosthetic, or any other tool, can be assimilated by neuronal representations as if they were simple extensions of the subject's own body."
Recent experiments showed that a monkey had absolutely no problem controlling a third, artificial (and remote) arm with its brain, generating the same brain patterns.

The plasticity of the brain allows for the control of any external device as if it were an extension to the body.
The recorded brain patters (with amazing resolution; 64x64 electrodes) during these experiments seems to underline that we DO NOT HAVE discrete functional areas, the whole cortex is multimodal, taking part in the action generation. What’s more, the brain pattern for the same task is never the same. The brain keeps reinventing the way it directs the body, therefore learning new skills very quickly.
The brain is a simulator that always reaches out through the sensory connections to see what peripheral devices are available. Theoretically, it means that some people can learn to map external objects as a part of their body: “feeling it”. Pelé might had a ball mapped onto his legs, allowing him to control it by instinct.

All this might enable us one day to extend the reach of our brain to control full-body avatars through brain-machine interfaces, while actually living our everyday life. Sounds scary, but also exciting!

Learn more about it at Dr. Nicolelis’ research page.

The other major monkey-computer project is ran at University of Pittsburgh.

SurgRob

The IRCAD-IEEE course rolls on

IARP meeting on Cognitive Surgical Robotics

Call for IEEE RAS student reviewer mentors

The EuroSurge project

Surgenius--another pretender

EAES Winter Symposium

IFAC BMS conference deadline extended!

More videos of ALF-X

CIS news

AVRA Surgical's new robot

RAVEN 2

ALF-X Telelap getting commercial

Intuitive's fairy tale--every story has a beginning

CIS news

Visiting the ALTAR Robotics lab in Verona

Medical Robotics Symposium in Taiwan

Season's Greetings

Updates on the Vesalius/Huatuo robot

CIS news

Humans-robots-humans: Who is operating who?

CIS news

IRCAD France // Taiwan

ARTAS hair transplant robot

IRCAD MIS course #2

CIS news

IRCAD MIS course #1

Into Intuitive financials

CIS news

Eye surgery system from Univ. Eindhoven

B.E.S.T. Innovation in MIS course from IRCAD

Da Vinci for SILS

CIS news

8th IFAC Symposium on Biological and Medical Systems

MICCAI in Toronto

Visiting Intuitive

CIS news

Micro Hand A--China's bet in robotic surgery

Conference proceedings--EMBC

Updates on the Alf-x robot

Amadeus Composer and Maestro

Visit at WPI

AMIGO at Harvard

CIS News

Robotic surgery presented biased

ROBODOC advances--the story of an FDA approval

ROBODOC advances--historical timeline

No-scar surgery with the MASTER robot

CIS news

Origins of surgical robotics

SmartMove: a TMS robot

The new ALF-X robot

SCATh Workshop in Graz

CIS News

CIS Workshop presentations and videos

LEGO in surgical robotics

CIS news

Using Robots to Train the Surgeons of Tomorrow

ROSA--surgical assistance robot

Introduction to Surgical Robotics (HUN)

Updates on the Amadeus surgical robot

The iSYS robot, descendant of the B-ROBs

Another Summer School on Surgical Robotics

CIS Workshop in Budapest

CIS news

ACMIT - the new focus point of CIS research in Austria

Dr. Satava in Budapest

CIS news

Hopkins Updates

BioRobotics at the upcoming EMBC

CIS news

A surgeon's view on CIS, presentation at SPIE

Seminar talk at Hopkins

CIS news

Da Vinci news

IGSTK User Group Meeting

Single-incision robotic surgery is taking off

CIS news

Intuitive's da Vinci simulator

Sofie