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Project Telesurgery

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Modular robotic system for minimally invasive telesurgery

Funding Organization: Instituto de Salud Carlos III. Ministerio de Sanidad

Reference: PI-021708

Participants: Universidad de Málaga

Period: From 01/01/2003 to 31/12/2005

Main Researcher: Víctor Fernando Muñoz Martínez

System Abilities

Group	Ability	Level	Description
Configurability	Mechatronic Configuration	1	Start-up Configuration. The configuration files, or the mechatronic configuration can be altered by the user prior to each task in order to customise the robot system in advance of each cycle of operation.
Interaction	Human-Robot	3	Position selection. The system is able to execute pre-defined actions autonomously. The user selects the subsequent action at the completion of each action.
	Human-Robot Feedback	3	Simple haptic feedback. The robot system is able to feedback a physical force that represents the forces at the end effector of the robot. The force feedback is delivered to the user via a single point of contact, for example a joystick.
	Human-Robot Safety	1	Basic Safety. The robot operates with a basic level of safety appropriate to the task. Maintaining safe operation may depend on the operator being able to stop operation or continuously enable the operating cycle. The maintenance of this level of safety does not depend on software.
Dependability	Dependability	2	Fails Safe. The robot design is such that there are fail safe mechanisms built into the system that will halt the operation of the robot and place it into a safe mode when failures are detected. This includes any failures caused by in-field updates. Dependability is reduced to the ability to fail safely in a proportion of failure modes. Fail safe dependability relies on being able to detect failure.
Motion	Unconstrained	3	Open path motion. The robot can execute a motion that follows a path with a given path accuracy. This path is described by a specific point on the robot. The robot is able to return to any given point on the path with an accuracy that is appropriate to the task.
Manipulation	Grasping	1	Simple pick and place. The robot is able to grasp any object at a known pre-defined location using a single predefined grasp action. The robot is then able to move or orient the object and finally un-grasp it. The robot may also use its Motion Ability to move the object in a particular pattern or to a particular location. Grasping uses open-loop control.

Abstract

The aim of this project is defined as the continuation of the works carried out by this team of researchers on the framework of the previous financial aid given by the Health Research Fund (Project coordinated with record numbers 00/0050-01 and 00/0050-02).

It details, particularly, the creation of a specific robot arm specialized in handling the camera during laparoscopic surgery operations. The main feature will be the perfect adaptation to the spatial conditions of the operating room and the no need of any kind of running installation. It will be managed under voice control, via a wireless communication network, using an additional system placed at the laparoscopic column. A series of advanced features for the telemedicine will be added: a remote surgeon positioned in a distant site will be able to carry out tasks of telesurgery, telediagnosis or to act as a telementor. Likewise, it expects to continue the research on telemanipulation and apply it to both the laparoscopic surgery and the transurethral resection of the prostate.

Proposed goals and achievements

1. Improvement of the robotic system to allow it to be used in human surgery

This work starts from the experience obtained in the previous FIS project for constructing a more accurate mechanical system for the robotic arm, and a motion control electronic system which is included in the machine. This will be performed in order to fulfil the current regulation for electro-medical machines.

Achievements:

This aim is completely reached. A robotic assistant has been designed and created for laparoscopic surgery. It operates under voice control of the surgeon, and it fulfils the current regulation for electro-medical machines. This prototype is certified for use in the operating room, and it is employed in human surgery. To achieve this, it firstly started from a mechanical structure created in a previous project, it was modified and the motor and control electronic systems were added. This latter was devised to respond to a planned functionality and to fulfil all regulations for electro-medical machines. The resulting robot was subsequently certified, a clinical protocol was elaborated, and after getting the corresponding licences from the Ethics Committee, it was used in human surgery. Sixteen interventions were performed with the robot. Thanks to the obtained experience, a new mechanical structure for the robot better adapted to the surgeons needs and with a better accuracy in the laparoscopic camera position has been designed and constructed.

2. System for telediagnosis and telesurgery.

It is expected to create an autonomous device placed at the laparoscopic column and web connected in order to provide a communication system and to share textual and visual information between a local surgeon present at the operating room and a remote surgeon. It will be able to be used without the robotic arm in routine procedures only for teleconsultation tasks and cooperative diagnosis. The arm will be communicated via radio if it is in the operating room, and the remote surgeon will be able to telecontrol it.

Achievements:

This aim is also completely reached. A teleoperation station has been designed and constructed capable of receiving images via web from the laparoscopic camera, and to send movement orders, in a remote manner, to the robot. Likewise, the remote surgeon can make marks in the received image and send the information to the computer in the operating room, like this, the local surgeon can check them and act accordingly. It consists of a system in which a remote surgeon can supervise and advise the surgeon in the operating room. Besides, the robot has been provided with new peripherals to teleoperate in a local mode. It has been developed a speech recognition system that communicates with the robot by means of Bluetooth wireless technology. Also, due to this wireless technology, a PDA has been used to manage the robot and to read its internal information.

3. Robotic arm for telemanipulation in laparoscopic intervention and for the transurethral resection of the prostate.

It details the design of a specific tool for all the interventions enumerated above: one for carrying laparoscopic forceps and other for activating a resector used in urological techniques. An adapted industrial robotic arm will be able to teleoperate through the same human-machine interface based on a master arm. Particular emphasis will be placed on safety conditions in such a way that the working area will be limited and sudden movements will not be allowed.

Achievements:

A robotic station for surgery has been developed. It is based on the robot designed and constructed for handling the laparoscopic camera defined in the objective No. 1, and on two industrial additional robots. The latter ones have been provided with force sensors and a special grip to carry specific tools for minimally invasive surgery. Firstly, the task begins with a teleoperation by using a passive master arm accordingly designed and constructed to such task. Secondly, two active master arms (haptic devices) have been obtained to perform the teleoperation with the force feedback. New specific motion control algorithms of industrial robots have been developed through the force feedback. They have been tested by means of in-vitro experiments for both the laparoscopic surgery procedures and the transurethral resection of the prostate.