Robotic technology in surgery: Past, present, and future

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Presentation transcript:

Robotic technology in surgery: Past, present, and future David B. Camarillo, M.S., Thomas M. Krummel, M.D., J.Kenneth Salisbury, Ph.D. The American Journal of Surgery Volume 188, Issue 4, Pages 2-15 (October 2004) DOI: 10.1016/j.amjsurg.2004.08.025 Copyright © 2004 Excerpta Medica Inc. Terms and Conditions

Fig. 1 Subspaces of computer-aided surgery relevant to robotics and depiction of subfields relevant to robotics. Some technologies are overlapping between subfields. Categorization as robot-assisted computer-aided surgery requires processing capabilities with sensors and actuators for controlled motion. CT = computed tomography; MRI = magnetic resonance imaging. The American Journal of Surgery 2004 188, 2-15DOI: (10.1016/j.amjsurg.2004.08.025) Copyright © 2004 Excerpta Medica Inc. Terms and Conditions

Fig. 2 Tradeoff between procedural role and autonomy. Procedural role indicates the level of responsibility and involvement the robot has with the patient during a procedure. Robot role in a procedure scales up with greater duration, scope, invasiveness, and risk, which decreases the level of autonomy in current systems, including Acrobot (Acrobot Company Limited, London, England), Automated Endoscopic System for Optimal Positioning (AESOP; formerly Computer Motions, Inc., Goleta, CA; now operated by Intuitive Surgical, Inc., Sunnyvale, CA), computed tomography (CT), CyberKnife (Accuray Inc., Sunnyvale, CA), da Vinci (Intuitive Surgical), and NeuroMate (Integrated Surgical Systems, Davis, CA). The American Journal of Surgery 2004 188, 2-15DOI: (10.1016/j.amjsurg.2004.08.025) Copyright © 2004 Excerpta Medica Inc. Terms and Conditions

Fig. 3 CyberKnife Stereotactic Radiosurgery System. (Courtesy of Accuray Inc., Sunnyvale, CA.) The American Journal of Surgery 2004 188, 2-15DOI: (10.1016/j.amjsurg.2004.08.025) Copyright © 2004 Excerpta Medica Inc. Terms and Conditions

Fig. 4 Acrobot Active Constraint Knee Arthroplasty System. (Courtesy of the Acrobot Company Limited, London, England.) The American Journal of Surgery 2004 188, 2-15DOI: (10.1016/j.amjsurg.2004.08.025) Copyright © 2004 Excerpta Medica Inc. Terms and Conditions

Fig. 5 The telerobotic da Vinci Surgical System. (Courtesy of Intuitive Surgical, Inc., Sunnyvale, CA.) The American Journal of Surgery 2004 188, 2-15DOI: (10.1016/j.amjsurg.2004.08.025) Copyright © 2004 Excerpta Medica Inc. Terms and Conditions

Fig. 6 Degrees of freedom. A robotic instrument with 6 degrees of freedom is shown. The first 2 degrees of freedom are the ability to pivot about the entry port in 2 planes (hatched arrows). The next 2 degrees are the ability to move in and out as well as the ability to roll the instrument (light arrows). The final 2 degrees of freedom are the ability to pitch and yaw the wrist (dark arrows). These 6 degrees of freedom allow for an arbitrary choice of position and orientation of the jaws, which is not possible with conventional endoscopic instruments. Final small bidirectional arrow is for grasp, which is sometimes called the seventh degree of freedom. (Courtesy of Intuitive Surgical, Inc., Sunnyvale, CA.) The American Journal of Surgery 2004 188, 2-15DOI: (10.1016/j.amjsurg.2004.08.025) Copyright © 2004 Excerpta Medica Inc. Terms and Conditions

Fig. 7 The da Vinci EndoWrist (top) and console masters (bottom). The wristed slave instruments exactly track the surgeon's master controllers. (Courtesy of Intuitive Surgical, Inc., Sunnyvale, CA.) The American Journal of Surgery 2004 188, 2-15DOI: (10.1016/j.amjsurg.2004.08.025) Copyright © 2004 Excerpta Medica Inc. Terms and Conditions