Reducing rotator cuff stiffness may be beneficial in improving the ROM deficits associated with injury risk in overhead athletes.

The use of robotics in medicine has been growing in recent years. The introduction of specialized robots for surgery such as the daVinci (Intuitive Surgical, Sunnyvale, CA, USA) has largely motivated this growth. The currently available robotic-assisted surgery systems rely only on direct vision through the use of a laparoscopic camera for surgical guidance. While these cameras provide a stereoscopic view of the surface, they are incapable of showing beneath the surgical surface. In other surgical developments, image guidance has become an integral part of navigation and planning, allowing understanding of the locations beneath the surgical plane. As an early step in the development of a robotic image-guided surgical (RIGS) system, the physical limitations of a surgical robot must be assessed. In this paper the accuracy and the precision of the daVinci surgical system are quantified. It is shown that the daVinci system can successfully localize a point with an approximate fiducial localization error (FLE) of 1 mm. This FLE value demonstrates that the daVinci is within the accuracy limits of the other commonly used surgical localizers.

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It was demonstrated that there is a benefit from the augmentation of laparoscopic video with updated preoperative images. Incorporating our image guided system into the da Vinci robotic system improved overall tissue resection, as measured by our metric. Adding image guidance to the da Vinci robotic surgery system may result in the potential for improvements such as the decreased removal of benign tissue while maintaining an appropriate surgical margin.

The hybrid localization method improved the localization accuracy of the setup joints. The inter-arm accuracy in hybrid localization was improved to 3.02 mm. This inter-arm error value was shown to be further reduced when the arms are co-registered, thus reducing common error.