servicerobotics140414 majorfields of service...

SERVICEROBOTICS140414

Major Fields of Service Robotics


Medical Robotics


MAS : Minimal Access Surgery

Less Pain

Fast Postoperative Convalescence

important for elderly patients

Reduction of Insurance Costs

Increasingly employed in more specialized surgery


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.


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


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


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).


hansenmedical.com

Sensei

Manipulation of Catheter Tip

Force Feedback

FDA Cleared in March 2007

Microrobot : Catheter Robot


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


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.


BrainLab ExacTrac X-Ray :Respiration Motion Management


Surgery Robot Simulator

COLON HEART


Walk-assist Robot : SUBAR

• Seogang University


Characteristic of Medical Robot

● Object : Human Body

● Sophisticated Medical Technology

● Robot in Human (Cyborg*)

*Cyborg(Hybrid of Human & Electromechanics) = Bionic system


● Surgery Robot

● Rehabilitation Robot

● Micro/Nano Robot

Forecast


Present Future

Articular

Assistantto surgeon

Robot Initiative : No man Operation

Nightingale

SRIInternational

Abdominal

Surgery Robotics


Present Future

Mechanical Control

BrainGateBrown Univ

Brain(Thought) Control

Surgery Robotics

Articular

Abdominal


Present Future

leg

arm

mechanical Artificial organ(Robot part) + human body = CYBORG

Rehabilitation Robotics


Present Future

capsule

colonoscopic

Organ >1mm Nanobio Robot ~ 10 m

Micro Robotics


Medical Robotics Market BCC Research

WorldwideAnnual growth rate 34.7 %

USAAnnual growth rate 31.4 %


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 %


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.


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


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


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)


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)


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


Robot-assisted Surgery & Therapy : da Vinci

intuitivesurgical.com

Stereoscopic View (Dia 9 mm)

7 DOF Robot Arm (Dia 8 mm)

Major in Market Share


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


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


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


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 :


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)


Rehabilitation systems

GT-1 mobility trainer (Reha-Stim, Germany)

Lokomat (Hocoma, Switzerland)

AutoAmbulator (HealthSouth, USA)

ReWalk (Argo Medical, Israel)

Quanser (Canada)

HAL (Cyberdyne, Japan)


Rehabilitation systems : Lokomat

Hokoma, Switzerland

Walk Rehabilitation Equipment

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