Title: Robotics and telerobotics technologies for medicine and surgery
Author: prof. Alberto Rovetta N. AF-3

Objectives
The first surgical robotic system was constructed in 1992, in approximately 3 years, using with some modifications an industrial robot Scara IBM. Today approximately 60 robots execute this surgery. There are Aesop robots that help the surgeon for the execution of laparoscopic surgery, supporting the television camera. Robots help in the neurosurgical operations, for the execution of biopsies of the prostate, etc. Robots of experimental type are used for several applications, and approximately 20 robots operate on the articulations of the knee.
Moreover some telerobots very expensive are used for surgical operations at distance. We consider a total of 1000 existing and active robots in year 2001. In 8 years the increment is not at all negligible.

Contents
Some positive factors for the adoption of the robots in medicine and surgery are listed.

  1. The robot is a precise machine. Many robots have a repetitive precision of tenth of millimetre, others arrive to the precision of 20 micron. Once defined the point in which the robot must carry the extreme tip of its terminal (end effector), the software imposes to the robot to reach that point.
  2. The robot is a repetitive machine. When it is decided to return in the same position, in order to repeat an action, in order to execute more times an analogous operation, or when it is decided of moving from the initial point of prefixed amounts, then the robot with a simple software instruction executes such functions modifying the previous choices.
  3. The robot can memorise more actions, can simulate the operation and the surgeon may choose the action of the operation and which strategy the robot is better to execute. The robot executes faithfully.
  4. The surgeon may have the design of the trajectories, on the screen of the monitor or on the printer.
  5. The robotic system may memorise the happened sequences, may take photos and videotapes, also from more visual points, for the moments of greater importance in the operation, and may supply one complete and endowed documentation of every data of the surgical action.
  6. The robotic system allows implementing the software. In case the surgeon wants to add performances to the robot, in order to execute new functions, or to propose more sophisticated and complex executive alternatives, the software may contain every new proposed action.
  7. Moreover maps that illustrate the possible executions of the robot.
  8. The calibration of the robot occurs one single time at its installation. Once installed the robot, with the television cameras for the analysis of the scene, with ecograph or radiographic machines for the analysis of the human body, the calibration is maintained for all the duration of the use.
  9. The robots adapted for surgical operating room are certified. Moreover they are sterilised. The technical robotics has produced robots suitable for the surgical operating room.

Results

  1. The robot has insufficient operating flexibility after that is put in motion. In fact the robot executes programmed movements. If it is decided to modify the motion of the robot while it is on motion, it is necessary to stop it and to start it again from the reached position.
  2. The robot is not of easy programming. While it is easy to launch the commands in order to execute the surgical operations, for a new programming of the robot it is necessary the presence of a software expert.
  3. The robot demands television cameras and systems of vision of high quality. The robot moves according to the data that it receives from the television cameras that are assembled on its structure. Therefore its quality of job depends also on the quality of the television cameras.
  4. The robot must be completely safe and reliable. In order to have the perfectly safe and reliable robot in surgery, it is necessary to satisfy some engineering and production rules, and also the norms of the medical applications.
  5. The robot demands a remarkable quality of software and hardware systems for the safety and for emergency. Such systems are necessary and are adopted regularly for all the robots that work in surgical room.
  6. The robot may be cumbersome around the operating table. In such case, it is possible to hang the robot to the ceiling or to put it in a position, which occupies the minimum space.

Future possible developments
The cost of an industrial robot adapted to the surgical room is of approximately $ 100-200.000. The cost of the equipment for the calibration and the vision, is about $ 100.000. The cost of the software is not quantifiable, because it can be software for a robot with an only one surgical function and may be software for multifunctional robots, which may execute more types of operations, with a greater cost. In practical, one surgical robotic system may cost 1 million of $.
It is demanded that the robots for the medicine and the surgery are:

  • multifunctional;
  • with a friendly interface;
  • with a software extremely easy to use;
  • reliable in front of every emergency.