SERVICEROBOTICS140414 MajorFields of Service...
Transcript of SERVICEROBOTICS140414 MajorFields of Service...
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Major Fields of Service Robotics
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Medical Robotics
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MAS : Minimal Access Surgery
Less Pain
Fast Postoperative Convalescence
important for elderly patients
Reduction of Insurance Costs
Increasingly employed in more specialized surgery
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Category of Surgery Robots (1)
Assistant functions, such as holding instrumentsrobotic arm to hold endoscopic cameravoice controlled or following the surgeon’s head motion
Telesurgical functionsallow the surgeon to use the robot as an extension of his own direct manipulative capabilities
Navigationprovides accurate feedback about location of surgical instruments relative to the patient’s anatomyconsist of 3D localizing device & workstation to displaypositions relative to volumetric medical images.
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Category of Surgery Robots (2)
Positioninginsert and align a tool guide, relative to the targetanatomy.they follow a co-ordinate system, which is registeredto pre-surgical images of the patient.During the insertion of instruments, robots are turnedoff for security reasons.
Surgical activities
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special ergonometric operating chairs are being developed to give visual and tactile feedback and support the surgeon’ concentrated, steady moving hand and optimize the dexterity enhancement effect.
The robots can be used in neurosurgery, microsurgery, orthopaedics, ophthalmology, cardiology, and for further
The novel Vector vision® of BrainLAB enables surgeon to align medical instruments, inc. endoscopes, biopsy needlescatheters and pedicle screw drills to predefined trajectory with millimetre precision. -move in seven degrees of freedom-the joints equipped with integrated sensors for both jointposition and joint torque
SERVICEROBOTICS140414BrainLab Vector Vision :Wireless Image-Guided Surgery System
Neurosurgery Solution
www.brainlab.com
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Classical robot systems are being used for radiotherapy such as the CyberKnifeTM of Accuray (USA). Incorporating a compact linear accelerator mounted on an industrial robotic arm, the system provides the surgeon with unparalleled flexibility in targeting. Advanced image guidance technology tracks patient and target positions during treatment, ensuring accuracy without use of an invasive head frame.
The SenseiTM Robotic Catheter System of HansenMedical assists the surgeon in precision catheter guidance. The system replicates the surgeon’s hand movements which are captured by a 3D motion input device to position the working catheter. The flexible catheter is controlled by external servo drives. Similar functionality is attributed to the ViaCath System of endoVia Medical (USA).
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hansenmedical.com
Sensei
Manipulation of Catheter Tip
Force Feedback
FDA Cleared in March 2007
Microrobot : Catheter Robot
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Level of distribution
With experience and knowledge gained from the systems already in use, acceptance of surgical robots is in general growing. The number of operations requiring technically advanced methods is increasing, and as a result, new methods are being sought.
In addition, many more systems are being developed or are currently in their prototype phase and awaiting approval from medical authorities.
While so far about 3,700 systems are in use, sales of 2,700 units are projected for 2007-2010
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Cost benefit analysis and major restraints on further diffusion
The MAS procedure lets the surgeon lose tactile sense and restricts his manipulative capability. Telesurgical devices are set to remedy this. “Virtual instruments“. Although standing at a distance, where he has more manipulative freedom, the surgeon has the feeling that he is operating directly. Positioning robots allow for faster and more convenient positioning.
Sensor information is used to quickly correct goal coordinates representing the area of intervention. This is important where deformable soft tissue and patient motion (e.g. for respiration) is involved. The system allows the surgeon to go back to a specific place on exactly the same path, so as not to destroy more tissue. ExacTrac X-Ray of BrainLAB which interfaces with most treatment couches, allowing accurate set-up verification & automated patient positioning After precise determination of the required correction shift, ExacTrac X-Ray 6D interfaces with couches for immediate and fully automatic table motion. Patient set-up becomes more efficient, saving time for the therapist and guaranteeing clinical throughput.
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BrainLab ExacTrac X-Ray :Respiration Motion Management
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Surgery Robot Simulator
COLON HEART
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Walk-assist Robot : SUBAR
• Seogang University
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Characteristic of Medical Robot
● Object : Human Body
● Sophisticated Medical Technology
● Robot in Human (Cyborg*)
*Cyborg(Hybrid of Human & Electromechanics) = Bionic system
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● Surgery Robot
● Rehabilitation Robot
● Micro/Nano Robot
Forecast
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Present Future
Articular
Assistantto surgeon
Robot Initiative : No man Operation
Nightingale
SRIInternational
Abdominal
Surgery Robotics
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Present Future
Mechanical Control
BrainGateBrown Univ
Brain(Thought) Control
Surgery Robotics
Articular
Abdominal
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Present Future
leg
arm
mechanical Artificial organ(Robot part) + human body = CYBORG
Rehabilitation Robotics
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Present Future
capsule
colonoscopic
Organ >1mm Nanobio Robot ~ 10 m
Micro Robotics
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Medical Robotics Market BCC Research
WorldwideAnnual growth rate 34.7 %
USAAnnual growth rate 31.4 %
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Medical Robotics Market BCC Research
The biggest US market share :Surgical navigation systems 53 %
The fastest growing segment :Surgical robot 43 %
The biggest surgical application :Neurosurgery 40 %
The fastest-growing application :Endoscopy (later) 45 %
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Potential of Medical Robots
Facilitating medical processes by precisely guidinginstruments, diagnostic equipment and tools for diagnosis and therapy.
Improving safety and overall quality of medical surgery
Enhancing the cost-effectiveness of patient care.
Improving the training and education of medical personnel through the use of simulators.
Promoting the use of information in diagnosis and therapy.
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Diagnostic System• to guide diagnostic equipment outside the human body• to guide the body relative to a diagnostic instrument • to carry diagnostic instruments inside the body
Estele(Robosoft)Tele-echographic Robot
MiroCam(Intromedic),PillCam(GivenImaging)
Capsule EndoscopeRP-7(IntouchHealth)
Tele-diagnosis
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Diagnostic System : Tele-diagnosis
Intromedic.com
“The technology is not new, but it's the first time it's been used”
“You can immediately put the physician by the patients bedside wherever they’re at.”
The physician “can be at the golf course and instantly be at their patients bedside.”
www.intouchhealth.com
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Diagnostic System : Benefit & Constraint
Improvement of surgeon’s technical ability by exploiting
the complementary strengths of robots.
More precise and geometrically accurate than an human.
Available in hostile radiological environments.
Minimally invasive inside body & reducing infection risk
Consistent patient info. for further human/computer
Navigation/registration of robot motion to body parts is less accurate than positioning accuracies of robots.
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Diagnostic System : Major producers
Hansen Medical (USA)
Medtronic (Germany)
Robosoft (France)
Siemens (Germany)
Givenimaging (Israel)
Intromedic (Korea)
Olympus (Japan)
IntouchHealth (USA)
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Robot-assisted Surgery & Therapy
MIS : Less Pain, Faster Convalescence, Low Insurance Cost
CyberKnife (Accuray, USA)Robodoc (CTC, USA/Korea)daVinci (Intuitive Surgical Solutions, USA)MAKO TGS (MAKOplasty, USA)cardioARM(Cardiorobotics,)SpineAssist (Mazor Surgical Technologies)Sensei Robotic Catheter (Hansen Medical, USA)ViKY (endocontrol, France)Arthroscopic (ACROBOT, UK)FreeHand-System (FreeHand Surgical, UK)Niobe System (Stereotaxis, USA)
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Robot-assisted Surgery & Therapy : MAKO TGS
Surgeon Support using CT-Scan Data
HGS S/W : Op Planning
Currently for Uni-Knee
Cleared from FDA
Established in 2004 makosurgical.com
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Robot-assisted Surgery & Therapy : da Vinci
intuitivesurgical.com
Stereoscopic View (Dia 9 mm)
7 DOF Robot Arm (Dia 8 mm)
Major in Market Share
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Robot-assisted Surgery & Therapy : Major Application
Orthopedicsurgery
Neurosurgery
Gynecologicsurgery
Cardiothoracicsurgery
Urology Generalsurgery
Total hipArthroplasty:
femur preparation
Complementimage
guided-surgery
TubalReanasto
mosis
Mammaryarteryharvest
RadicalProsta
tectomyCholecystectomy
Total hiparthroplasty:acetabular
cupplacement
Radiosurgery
Hysterectomies CABG Ureter
repairNissenFundo
plication
Kneesurgery
Ovaryresection
Mitral valverepair
Nephrectomy
Heller myotomy
Spinesurgery
Gastric bypassBowel
resectionEsopha
gectomyAdrenalec
tomy
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Robot-assisted Surgery & Therapy : da Vinci
Prostatecomy (54 %), Hysterectomy (29 %) in 2008Average selling price : 2.3 M USDMarket growth rate : 39 % in 2008Standard care : Prostatectomy (now),
Myomectomy/Hysterectomy (later)Three major markets :
Length of Hospital Stay :
Urology Gynecology Cardiothoracic
1 Prostatectomy Hysterectomy Mitral valve repair & replacement
2 Nephrectomy Myomectomy Single vessel beating heart bypass
Open Laparoscopic da Vinci
Cancer 7.75 2.67 1.45
Benign 6.04 2.45 1.19
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Robot-assisted Surgery & Therapy : MAKO TGS
Leading manufacturer for orthopedic medical devicesSelling price : 0.65 ~ 0.75 M USDSelling Units :
Application : (now) uni-condylar(later) patellofemoral replacement,
bi-condylar knee replacementtotal knee replacement
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Robot-assisted Surgery & Therapy : Cyberknife
Approval for full-body radiation tumor treatment
Market growth rate : over 30 %
Market volume : Lung > Liver > Prostate > Brain > Spine
World Market for Full Body Radiosurgery :
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Robot-assisted Surgery & Therapy : Sensei & Niobe
Sensei :
Average selling price : 658 T USD (Sensei system)1.7 T USD (Artisan catheter)
Niobe :
Heart & blood vessel [cardiac, peripheral vascular, neurovascular]
Unit price : 1.2 M USD (Installation 2 M USD)
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Rehabilitation systems
GT-1 mobility trainer (Reha-Stim, Germany)
Lokomat (Hocoma, Switzerland)
AutoAmbulator (HealthSouth, USA)
ReWalk (Argo Medical, Israel)
Quanser (Canada)
HAL (Cyberdyne, Japan)
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Rehabilitation systems : Lokomat
Hokoma, Switzerland
Walk Rehabilitation Equipment