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Next-Generation Surgical Robotics

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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Mechanical Engineering".

Deadline for manuscript submissions: closed (31 August 2019) | Viewed by 52933

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Special Issue Editors

Prof. Dr. Byung-Ju Yi

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Guest Editor

Department of Electronic System Engineering, Hanyang University, Seoul, Korea
Interests: surgical robot design; flexible end-effector design; registration algorithm
Special Issues, Collections and Topics in MDPI journals

Prof. Jaesung Hong

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Guest Editor

Department of Robotics Engineering, DGIST, Daegu, Korea
Interests: medical imaging; surgical robotics; augmented reality

Prof. Arianna Menciassi

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Guest Editor

The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
Interests: surgical robotics; targeted therapy; mechatronic surgical devices and artificial organs; robotic endoscopes and capsules; microrobotics

Dr. Jumpei Arata

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Guest Editor

Department of Mechanical Engineering, Faculty of Engineering, Kyushu University, Fukuoka 819-0395, Japan
Interests: parallel mechanisms; surgical robots; haptic device
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

As the daVinci Surgical System developed by Intuitive Surgical Inc. was successfully launched and spread around the world, more active challenges in surgical robotics have been attempted, and specialized robotic systems are being made available in the medical markets as new players. The trend is becoming more apparent, boosted by emerging techniques that include artificial intelligence, deep learning, 3D printing, and VR/AR imaging, as well as high-precision sensor and device elements. One approach is to improve or exceed the existing system performance and the other direction is in frontier clinical fields that traditional systems may not cover. In this Special Issue, emerging techniques that can realize next generation surgical robotics are featured and studies on how unmet clinical needs are handled with novel techniques are introduced.

We welcome research papers from both the engineering and clinical sides that will eventually contribute to better outcomes in surgery using advanced methodologies.

Prof. Byung-Ju Yi
Prof. Jaesung Hong
Prof. Arianna Menciassi
Assoc. Prof. Jumpei Arata
Guest Editors

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Keywords

advanced surgical robotics
novel sensors and devices
intelligent deep learning algorithm for surgery
personalized medicince and patient-specific design
VR and AR imaging for navigation surgery
advanced haptic devices and algorithms

Published Papers (11 papers)

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Research

23 pages, 13670 KiB

Open AccessArticle

Surgical Navigation System for Transsphenoidal Pituitary Surgery Applying U-Net-Based Automatic Segmentation and Bendable Devices

by Hwa-Seob Song, Hyun-Soo Yoon, Seongpung Lee, Chang-Ki Hong and Byung-Ju Yi

Appl. Sci. 2019, 9(24), 5540; https://doi.org/10.3390/app9245540 - 16 Dec 2019

Cited by 1 | Viewed by 9080

Abstract

Conventional navigation systems used in transsphenoidal pituitary surgery have limitations that may lead to organ damage, including long image registration time, absence of alarms when approaching vital organs and lack of 3-D model information. To resolve the problems of conventional navigation systems, this study proposes a U-Net-based, automatic segmentation algorithm for optical nerves and internal carotid arteries, by training patient computed tomography angiography images. The authors have also developed a bendable endoscope and surgical tool to eliminate blind regions that occur when using straight, rigid, conventional endoscopes and surgical tools during transsphenoidal pituitary surgery. In this study, the effectiveness of a U-Net-based navigation system integrated with bendable surgical tools and a bendable endoscope has been demonstrated through phantom-based experiments. In order to measure the U-net performance, the Jaccard similarity, recall and precision were calculated. In addition, the fiducial and target registration errors of the navigation system and the accuracy of the alarm warning functions were measured in the phantom-based environment. Full article

(This article belongs to the Special Issue Next-Generation Surgical Robotics)

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17 pages, 5956 KiB

Open AccessArticle

Development of a Spherical Positioning Robot and Neuro-Navigation System for Precise and Repetitive Non-Invasive Brain Stimulation

by Hyunsoo Shin, Wooseok Ryu, Sungtaek Cho, Woosung Yang and Sungon Lee

Appl. Sci. 2019, 9(21), 4561; https://doi.org/10.3390/app9214561 - 27 Oct 2019

Cited by 2 | Viewed by 3056

Abstract

Although non-invasive brain stimulation techniques do not involve surgical procedures, the challenge remains in correctly locating the stimulator from outside the head. There is a limit to which one can manually and precisely position and orient the stimulator or repeatedly move the stimulator around the same position. Therefore, in this study, we developed a serial robot with 6 degrees-of-freedom to move the stimulator and a neuro-navigation system to determine the stimulus point from looking at the shape of the subject’s brain. The proposed robot applied a spherical mechanism while considering the safety of the subject, and the workspace of the robot was designed considering the shape of the human head. Position-based visual servoing was applied to compensate for unexpected movements during subject stimulation. We also developed a neuro-navigation system that allows us visually to check the focus of the stimulator and the human brain at the same time and command the robot to the desired point. To verify the system performance, we first performed repeatability and motion compensation experiments of the robot and then evaluated the repeated biosignal response experiments through transcranial magnetic stimulation, a representative technique of non-invasive brain stimulation. Full article

(This article belongs to the Special Issue Next-Generation Surgical Robotics)

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14 pages, 10386 KiB

Open AccessArticle

Advantage of Steerable Catheter and Haptic Feedback for a 5-DOF Vascular Intervention Robot System

by Jaehong Woo, Hwa-Seob Song, Hyo-Jeong Cha and Byung-Ju Yi

Appl. Sci. 2019, 9(20), 4305; https://doi.org/10.3390/app9204305 - 14 Oct 2019

Cited by 34 | Viewed by 6773

Abstract

Vascular intervention involves inserting a catheter and guidewire into blood vessels to diagnose and treat a disease in an X-ray environment. In this conventional vascular intervention procedure, the doctor is exposed to considerable radiation. To reduce the exposure, we developed a master–slave robot system. A steerable catheter is employed to shorten the task-time and reduce the contact force applied to the vessel walls during catheter insertion. The steerable catheter helps to select a vascular branch; thus, the radiation exposure time for patients is reduced, and perforation in the patient’s vessel is prevented. Additionally, the robot system employs a haptic function to replicate the physician’s tactile sensing in vascular intervention. In this study, the effectiveness of the steering catheter and haptic function was demonstrated experimentally in comparison with a conventional catheter. Full article

(This article belongs to the Special Issue Next-Generation Surgical Robotics)

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14 pages, 3568 KiB

Open AccessArticle

Effectiveness of Mechanical Design Optimization Using a Human-in-the-Loop Simulator for the Development of a Pediatric Surgical Robot

by Kazuya Kawamura, Hiroto Seno, Yo Kobayashi, Satoshi Ieiri, Makoto Hashizume and Masakatsu G. Fujie

Appl. Sci. 2019, 9(19), 4136; https://doi.org/10.3390/app9194136 - 2 Oct 2019

Cited by 1 | Viewed by 2458

Abstract

In pediatric surgery, robotic technology is useful. However, it is difficult to apply this technology due to size-related problems. In our study, we proposed a mechanical design method using a human-in-the-loop type simulator, and the moving volume and invisible area were optimized. We also verified the effectiveness of the optimization of the mechanical parameters by applying the simulator to pediatric surgery. In this experiment, a needle-hooking task was carried out by four subjects with five types of mechanisms using the results of the Pareto optimal solution obtained in the previous research. Moreover, the accuracy of the needle tip manipulation was verified. It was confirmed that the accuracy was higher under the operation of the mechanism that satisfied the Pareto optimal solution in comparison with the other mechanism. As the operation was carried out based on movement in the direction of the arm, the moving volume decreased. Therefore, the accuracy of the hooking was found to improve. It would be useful to optimize the mechanism by verifying the moving volume and invisible area rate for the needle-hooking task. In future work, the optimization of the mechanism for procedures that require both hands will be carried out. Full article

(This article belongs to the Special Issue Next-Generation Surgical Robotics)

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21 pages, 8307 KiB

Open AccessArticle

Kinematic Model and Real-Time Path Generator for a Wire-Driven Surgical Robot Arm with Articulated Joint Structure

by Sangrok Jin, Seoung Kyou Lee, Jaeyeon Lee and Seokyoung Han

Appl. Sci. 2019, 9(19), 4114; https://doi.org/10.3390/app9194114 - 1 Oct 2019

Cited by 22 | Viewed by 6609

Abstract

This paper presents a forward kinematic model of a wire-driven surgical robot arm with an articulated joint structure and path generation algorithms with solutions of inverse kinematics. The proposed methods were applied to a wire-driven surgical robot for single-port surgery. This robot has a snake-like robotic arm with double segments to fit the working space in a single port and a joint structure to secure stiffness. The accuracy of the model is highly important because small surgical robot arms are usually controlled by open-loop control. A curvature model is widely used to describe and control a continuum robotic body. However, the model is quite different from a continuum robotic arm with a joint structure and can lead to slack of the driving wires or decreased stiffness of the joints. An accurate forward kinematic model was derived to fit the actual hardware structure via the frame transformation method. An inverse kinematic model from the joint space to the wire-length space was determined from an asymmetric model for the joint structure as opposed to a symmetric curvature model. The path generation algorithm has to generate a command to send to each actuator in open-loop control. Two real-time path generation algorithms that solve for inverse kinematics from the task space to the joint space were designed and compared using simulations and experiments. One of the algorithms is an optimization method with sequential quadratic programming (SQP), and the other uses differential kinematics with a PID (Proportional-Integral-Derivative) control algorithm. The strengths and weaknesses of each algorithm are discussed. Full article

(This article belongs to the Special Issue Next-Generation Surgical Robotics)

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21 pages, 10635 KiB

Open AccessArticle

A Static Balancing Method for Variable Payloads by Combination of a Counterweight and Spring and Its Application as a Surgical Platform

by Jaehong Woo, Jong-Tae Seo and Byung-Ju Yi

Appl. Sci. 2019, 9(19), 3955; https://doi.org/10.3390/app9193955 - 20 Sep 2019

Cited by 15 | Viewed by 7742

Abstract

Stackable mechanism architecture has demonstrated effective gravity-balancing over entire workspaces. Adjustable balancing is required when balancing is broken due to changing the payload at the distal end of a mechanism. In this paper, adjustable balancing of the stackable mechanism for a variable payload is investigated. For this, balancing conditions for three adjustable balancing methods are suggested, and a new balancing method combining a spring and counterweight is considered as an effective means of adjustable balancing for variable payloads. The excellent performance of the system is proven through experiments. Electromyography (EMG) sensors are employed to measure the amount of energy expenditure during the drilling task. It was verified through several tests that an operator holding a drill mounted at the distal end of a stackable arm felt less energy compared to an operator holding the drill directly in free space. The developed balancing arm was successfully applied during a mastoidectomy. A 3-step warning algorithm along with a braking function was found to be effective for safe surgery. Full article

(This article belongs to the Special Issue Next-Generation Surgical Robotics)

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6 pages, 2640 KiB

Open AccessArticle

Feasibility of Transcervical Robotic-Assisted Esophagectomy (TC-RAMIE) in a Cadaver Study—A Future Outlook for an Extrapleural Approach

by Peter Philipp Grimminger, Pieter Christiaan van der Sluis, Hubert Stein, Hauke Lang, Richard van Hillegersberg and Jan-Hendrik Egberts

Appl. Sci. 2019, 9(17), 3572; https://doi.org/10.3390/app9173572 - 1 Sep 2019

Cited by 9 | Viewed by 3564

Abstract

In recent years, the evolution of advanced robotic medical systems has increased rapidly. These technical developments have led to advanced robotic systems, such as the da Vinci Xi, which allows superior controlled complex procedures and innovative surgical strategies. In esophageal surgery, the robotic-assisted minimally invasive esophagectomy (RAMIE) procedure is being developed and carried out with increasing frequency at centers worldwide. Recently, a new single port robotic system was introduced (da Vinci Single Port (SP)), which may allow for the exploration of new routes, such as transcervical robotic assisted minimally invasive esophagectomy (TC-RAMIE). This approach avoids opening the pleura by entering the mediastinum through the jugular window. In this report, we describe the technical steps of the TC-RAMIE using the new da Vinci SP system and compare it to the da Vinci Xi system. Full article

(This article belongs to the Special Issue Next-Generation Surgical Robotics)

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11 pages, 1791 KiB

Open AccessArticle

Modular Optic Force Sensor for a Surgical Device Using a Fabry–Perot Interferometer

by Jumpei Arata, Tatsuya Nitta, Toshiki Nakatsuka, Tomonori Kawabata, Tadao Matsunaga, Yoichi Haga, Kanako Harada and Mamoru Mitsuishi

Appl. Sci. 2019, 9(17), 3454; https://doi.org/10.3390/app9173454 - 21 Aug 2019

Cited by 6 | Viewed by 2742

Abstract

The ability to sense force in surgery is in high demand in many applications such as force feedback in surgical robots and remote palpation (e.g., tumor detection in endoscopic surgery). In addition, recording and analyzing surgical data is of substantial value in terms of evidence-based medicine. However, force sensing in surgery remains challenging because of the specific requirements of surgical instruments, namely, they must be small, bio-compatible, sterilizable, and tolerant to noise. In this study, we propose a modular optic force sensor using a Fabry–Perot interferometer that can be used on surgical devices. The the proposed sensor can be implemented like a strain gauge, which is widely used in industrial applications but not compatible with surgery. The proposed sensor includes two key elements, a fiber-optic pressure sensor using a Fabry–Perot interferometer that was previously developed by one of the authors and a structure that includes a carbide pin that contacts the pressure sensor along the long axis. These two elements are fixed in a guide channel fabricated in a 3 × 2 × 0.5 mm sensor housing. The experimental results are promising, revealing a linear relationship between the output and the applied load while showing a linear temperature characteristic that suggests temperature compensation will be needed in use. Full article

(This article belongs to the Special Issue Next-Generation Surgical Robotics)

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11 pages, 737 KiB

Open AccessArticle

The Learning Curve of Robotic Thyroid Surgery and the Avoidance of Temporary Hypoparathyroidism after Total Thyroidectomy and Concomitant Central Compartment Node Dissection: A Single Surgeon’s Experience

by Jae Hyun Park, Jun Hyeok Lee, Jae Won Cho and Jong Ho Yoon

Appl. Sci. 2019, 9(13), 2594; https://doi.org/10.3390/app9132594 - 26 Jun 2019

Viewed by 2622

Abstract

The aim of this study was to evaluate the learning curve of robotic thyroid surgery with regard to both operation time and temporary hypoparathyroidism using quantitative statistical analysis. A total of 194 patients who underwent total thyroidectomy and concomitant central compartment node dissection for papillary thyroid carcinoma by a single surgeon between December 2008 and September 2017 were enrolled. The learning curve for operation time was assessed using the cumulative sum (CUSUM) technique, and the number of procedures required to reduce the incidence of temporary hypoparathyroidism to less than 30% was determined using the CUSUM and risk-adjusted CUSUM (RA-CUSUM) techniques. The learning curve for operation time was divided into three phases: phase 1 (the initial learning period, 1st–19th cases), phase 2 (the challenging period, 20th–121st cases), and phase 3 (the competent phase, 122nd–194th cases). To reduce the incidence of temporary hypoparathyroidism to <30% required 119 cases, and after adjustment for potential risk factors by RA-CUSUM analysis this extended to 173 cases. Technical proficiency for robotic thyroid surgery with respect to the avoidance of surgical complications probably requires a longer learning period than that required for operation time. Full article

(This article belongs to the Special Issue Next-Generation Surgical Robotics)

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19 pages, 6598 KiB

Open AccessArticle

Design of a Laparoscopic Robot System Based on Spherical Magnetic Field

by Hongxing Wei, Kaichao Li, Dong Xu and Wenshuai Tan

Appl. Sci. 2019, 9(10), 2070; https://doi.org/10.3390/app9102070 - 20 May 2019

Cited by 4 | Viewed by 2881

Abstract

In single incision laparoscopic surgery (SILS), because the laparoscope and other surgical instruments share the same incision, the interferences between them constrain the dexterity of surgical instruments and affect the field of views of the laparoscope. Inspired by the structure of the spherical motor and the driving method of an intraocular micro robot, a fully inserted laparoscopic robot system is proposed, which consists of an inner laparoscopic robot and external driving device. The position and orientation control of the inner laparoscopic robot are controlled by a magnetic field generated by the driving device outside the abdominal wall. The instrumental interferences can be alleviated and better visual feedback can be obtained by keeping the laparoscopic robot away from the surgical incision. To verify the feasibility of the proposed structure and explore its control method, a prototype system is designed and fabricated. The electromagnetism model and the mechanical model of the laparoscopic robot system are established. Finally, the translational, rotational, and deflection motion of the laparoscopic robot are demonstrated in practical experiment, and the accuracy of deflection motion of the laparoscopic robot is verified in open-loop condition. Full article

(This article belongs to the Special Issue Next-Generation Surgical Robotics)

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21 pages, 8328 KiB

Open AccessArticle

Human–Robot Cooperative Control Based on Virtual Fixture in Robot-Assisted Endoscopic Sinus Surgery

by Yucheng He, Ying Hu, Peng Zhang, Baoliang Zhao, Xiaozhi Qi and Jianwei Zhang

Appl. Sci. 2019, 9(8), 1659; https://doi.org/10.3390/app9081659 - 22 Apr 2019

Cited by 12 | Viewed by 4585

Abstract

In endoscopic sinus surgery, the robot assists the surgeon in holding the endoscope and acts as the surgeon’s third hand, which helps to reduce the surgeon’s operating burden and improve the quality of the operation. This paper proposes a human–robot cooperative control method based on virtual fixture to realize accurate and safe human–robot interaction in endoscopic sinus surgery. Firstly, through endoscopic trajectory analysis, the endoscopic motion constraint requirements of different surgical stages are obtained, and three typical virtual fixtures suitable for endoscopic sinus surgery are designed and implemented. Based on the typical virtual fixtures, a composite virtual fixture is constructed, and then the overall robot motion constraint model is obtained. Secondly, based on the obtained robot motion constraint model, a human–robot cooperative control method based on virtual fixture is proposed. The method adopts admittance control to realize efficient human–robot interaction between the surgeon and robot during the surgery; the virtual fixture is used to restrain and guide the motion of the robot, thereby ensuring motion safety of the robot. Finally, the proposed method is evaluated through a robot-assisted nasal endoscopy experiment, and the result shows that the proposed method can improve the accuracy and safety of operation during endoscopic sinus surgery. Full article

(This article belongs to the Special Issue Next-Generation Surgical Robotics)

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