Purpose of Review Robotic assistance systems for diagnosis and therapy have become technically mature and widely available. Thus, they play an increasingly important role in patient care. This paper provides an overview of the general concepts of robotically assisted surgical systems, briefly revisiting historical and current developments in the surgical robotics market and discussing current focus areas of research. Comprehensiveness cannot be achieved in this format, but besides the general overview, references to further readings and more comprehensive reviews with regard to particular aspects are given. Therefore, the work at hand is considered as an introductory paper into the topic and especially addresses investigators, researchers, medical device manufacturers, and clinicians, who are new to this field. Recent Findings The current research in Robotically Assisted Surgical Systems (RASS) increasingly uses established robotic platforms. To minimize the patient trauma while optimizing the dexterity of the surgeon, miniaturized instruments and semi-autonomous assistance functions are developed. To provide the surgeon with all necessary information in an adequate manner, novel imaging sensors as well as techniques for multimodal sensory feedback and augmented reality are investigated. The Surgical Data Science applies data management and processing approaches including machine learning on medical data to provide optimal, individualized and contextual support to the surgeon. Summary Robotic systems will significantly influence future patient care. Since they must fulfill manifold medical, technical, regulatory and economic requirements, their development calls for a close, active and interdisciplinary cooperation between stakeholders from hospitals, industry and science.
Abstract-Safety is one of the key issues in the use of robots, especially when human-robot interaction is targeted. Although unforeseen environment situations, such as collisions or unexpected user interaction, can be handled with specially tailored control algorithms, hard-or software failures typically lead to situations where too large torques are controlled, which cause an emergency state: hitting an end stop, exceeding a torque, and so on-which often halts the robot when it is too late. No sufficiently fast and reliable methods exist which can early detect faults in the abundance of sensor and controller data.
Minimally invasive robotic surgery copes with some disadvantages for the surgeon of minimally invasive surgery while preserving the advantages for the patient. Most commercially available robotic systems are telemanipulated with haptic input devices. The exploitation of the haptics channel, e.g., by means of Virtual Fixtures, would allow for an individualized enhancement of surgical performance with contextual assistance. However, it remains an open field of research as it is non-trivial to estimate the task context itself during a surgery. In contrast, surgical training allows to abstract away from a real operation and thus makes it possible to model the task accurately. The presented approach exploits this fact to parameterize Virtual Fixtures during surgical training, proposing a Shared Control Parametrization Engine that retrieves procedural context information from a Digital Twin. This approach accelerates a proficient use of the robotic system for novice surgeons by augmenting the surgeon’s performance through haptic assistance. With this our aim is to reduce the required skill level and cognitive load of a surgeon performing minimally invasive robotic surgery. A pilot study is performed on the DLR MiroSurge system to evaluate the presented approach. The participants are tasked with two benchmark scenarios of surgical training. The execution of the benchmark scenarios requires basic skills as pick, place and path following. The evaluation of the pilot study shows the promising trend that novel users profit from the haptic augmentation during training of certain tasks.
Urolithiasis is a common disease with increasing prevalence across all ages. A common treatment option for smaller kidney stones is flexible ureterorenoscopy (fURS), where a flexible ureteroscope (FU) is used for stone removal and to inspect the renal collecting system. The handling of the flexible ureteroscope and end effectors (EEs), however, is challenging and requires two surgeons. In this paper, we introduce a modular robotic system for endoscope manipulation, which enables solo surgery (SSU) and is adaptable to various hand-held FUs. Both the developed hardware components and the proposed workflow and its representation in software are described. We then present and discuss the results of an initial user study. Finally, we describe subsequent developmental steps towards more extensive testing by clinical staff.
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