Autonomous Surgical Robotics Nicols Prez de Olaguer Santamara - PowerPoint PPT Presentation

MIN Faculty Department of Informatics Autonomous Surgical Robotics Nicolás Pérez de Olaguer Santamaría University of Hamburg Faculty of Mathematics, Informatics and Natural Sciences Department of Informatics Technical Aspects of Multimodal Systems 04. December 2017 Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 1 / 29

Outline Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions 1. Motivation 2. Non-Autonomous Surgical Robots 3. Supervised Autonomous Robots 4. STAR surgical Robot 5. Discussion 6. Conclusions Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 2 / 29

Motivation Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions Would you trust on a robot to perform you a surgical intervention? https://youtu.be/hulnz902gWo Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 3 / 29

Why use surgical Robots? Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions They provide: ◮ Enhanced effectiveness ◮ Safety ◮ Optimal techniques ◮ Minimally invasive surgery Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 4 / 29

Why use surgical Robots? Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions They provide: ◮ Enhanced effectiveness ◮ Safety ◮ Optimal techniques ◮ Minimally invasive surgery Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 4 / 29

Why use surgical Robots? Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions They provide: ◮ Enhanced effectiveness ◮ Safety ◮ Optimal techniques ◮ Minimally invasive surgery Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 4 / 29

Brief history Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions ◮ First surgical robot: Arthrobot , Vancouver 1983. ◮ PUMA 560 ◮ 1985 1 st neurosurgical biopsy. ◮ ROBODOC , 1992, used to crave a cavity in the femur to perfectly fit a hip prosthesis in the patient. Arthrobot [1] Puma 560 [2] ROBODOC [3] Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 5 / 29

Brief history (cont.) Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions Da Vinci Surgical System , 2000 ◮ Minimally invasive surgery. ◮ Teleoperated system. ◮ Four interactive robot arms. ◮ To replace laparoscopic tools. ◮ US 2 million. Laparoscopic Tools [4] Da Vinci surgical system[5] Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 6 / 29

Brief history (cont.) Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions No. of operations worldwide by the Da Vinci Surgical System [5]. Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 7 / 29

Brief history (cont.) Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions Concentric Tube Robots (2005) youtu.be/IUg4Jco-Apc [6] Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 8 / 29

Autonomy of surgical robots Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions Level of Autonomy Da Vinci surgical system[5] STAR Robot[7] Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 9 / 29

Non-Autonomous Surgical Robots Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions ◮ The action is completely performed by the surgeon. Hand-eye coordination. ◮ We do not have an ’intelligent’ system. ◮ Benefits: ◮ Reduce human fatigue. ◮ Allow high precision. ◮ Minimal Invasive Surgery ◮ Drawbacks: ◮ Relies on the dexterity of the surgeon. ◮ Slow learning curve. Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 10 / 29

Autonomy Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions “an ability to perform intended tasks based on current state and sensing without human intervention” (ISO 8373:2012) Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 11 / 29

State of the art Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions ◮ The robot perform a certain task with the supervision of the doctor. ◮ Surgeon asses the automated planning of the robot before implementation. ◮ Discrete control of the system. ◮ Used in rigid tissues surgeries i.e. bone interventions. ◮ Never tested in human soft tissue. ◮ Increased complexity by tissue deformation . Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 12 / 29

Features Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions ◮ Reduce human errors. ◮ Deal with different sensory data. ◮ Execute predefined motions. ◮ Improve safety, consistency and quality of intervention. Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 13 / 29

Paper Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions Supervised autonomous robotic soft tissue surgery A. Shademan, R. S. Decker, J. D. Opfermann, S. Leonard, A. Krieger, and P. C. Kim Published 4 May 2016, Sci Transl Med 8 (337), 337ra64337ra64 DOI : 10.1126/scitranslmed.aad9398 Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Health System, 111 Michigan Avenue Northwest, Washington, DC 20010, USA. Department of Computer Science, Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218, USA. Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 14 / 29

Hypothesis Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions ◮ Smart Tissue Autonomous Robot (STAR). Defined in [7] ◮ Designed to perform anastomosis of soft tissue (suture). ◮ Hypothesis posed: Can this complex intervention be done autonomously and perform better than other surgical techniques? [7] Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 15 / 29

Tests Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions Tested in: ◮ In-vivo and ex-vivo pig intestine. ◮ Against: manual surgery (OPEN), laparoscopy (LAP) and robot-assisted surgery (RAS). [7] Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 16 / 29

Technologies Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions ◮ Actuated suturing tools. ◮ Fluorescent and 3D imaging. ◮ Force sensing. ◮ Submilimiter positioning. [7] Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 17 / 29

Technologies Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions ◮ Actuated suturing tools. ◮ Fluorescent and 3D imaging. ◮ Force sensing. ◮ Submilimiter positioning. [7] Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 17 / 29

Technologies Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions ◮ Actuated suturing tools. ◮ Fluorescent and 3D imaging. ◮ Force sensing. ◮ Submilimiter positioning. [7] Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 17 / 29

Technologies Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions ◮ Actuated suturing tools. ◮ Fluorescent and 3D imaging. ◮ Force sensing. ◮ Submilimiter positioning. [7] Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 17 / 29

Robot Arm, Suturing Tool and Force Sensor Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions ◮ Seven-DOF KUKA LBR4 robotic arm + one-DOF suturing tool. ◮ Suturing tool designed for manual actuation. ◮ Repeatable 0.05 mm positioning. ◮ Force sensor placed in between the last link of the robot arm and the suturing tool → ideally should be on the end of the suturing tool. ◮ Threshold of 1N. Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 18 / 29

Imaging and 3D tracking Motivation Non-Autonomous Surgical Robots Supervised Autonomous Robots STAR surgical Robot Discussion Conclusions ◮ Near-Infrared fluorescent (NIRF) Imaging. ◮ Chemical solution. ◮ NIRF markers manually placed by the surgeons. ◮ Real-time positioning information. Nicolás Pérez de Olaguer Santamaría – Autonomous Surgical Robotics 19 / 29