Hands-On Robotic Surgery: Is This the Future?
An introduction to robotic surgery is given, together with a classification of the range of systems available with their problems and benefits. The potential for a new class of robot system, called a hands-on robot is then discussed. The hands-on robotic system, which is called Acrobot®, is then presented for total knee replacement (TKR) surgery and for uni-condylar knee replacement (UKR) surgery. CT-based software is used to accurately plan the procedure pre-operatively. Intra-operatively, the surgeon guides a small, special-purpose robot, which is mounted on a gross positioning device. The Acrobot® uses active constraint control, which constrains the motion to a predefined region, and thus allows the surgeon to safely cut the knee bones to fit a TKR or a UKR prosthesis with high precision. A non-invasive anatomical registration method is used. The system has undergone early clinical trials of a TKR surgery and, more recently a blind randomised clinical trial of UKR surgery. Preliminary results of the UKR study are presented in which the pre-operative CT based plan is contrasted with a post operative CT scan of the result, in an attempt to gain an objective assessment of the efficacy of the procedure. Finally, proposals for future requirements of robotic surgery systems are given.
KeywordsRobotic surgery Medical robotics Active constraint control
Unable to display preview. Download preview PDF.
- 1.Davies, B.L., Harris, S.J., Hibberd, R.D.: The Probot- an active robot for prostate resection. In: Proc. I Mech E, Part H, vol. 211(H4), pp. 317–326 (1997)Google Scholar
- 3.Tew, M., Waugh, W.: Tibiofemoral Alignment and the Results of Knee Replacement. Journal of Bone and Joint Surgery 67-B(4), 551–556 (1985)Google Scholar
- 4.Jakopec, M., Harris, S.J., Rodriguez y Baena, F., Gomes, P., Cobb, J., Davies, B.L.: The First Clinical Application of a ”Hands-on” Robotic Knee Surgery System. Computer Aided Surgery 6(6), 329–339 (2001)Google Scholar
- 5.Cobb, J., Henckel, J., Richards, R., Harris, S., Jakopec, M., Rodriguez, F., Gomes, P.: Robot assisted minimally invasive uni-compartmental arthroplasty: results of first clinical trials. In: Proc. CAOS Int. Conf. 2004, Chicago, pp. 4–6 (2004) ISBN 0-9754971-0-3Google Scholar
- 6.Mittelstadt, B.D., Kazanzides, P., Zuhars, J.F., Williamson, B., Cain, P., Smith, F., Bargar, W.L.: The Evolution of a Surgical Robot from Prototype to Human Clinical Use. In: Taylor, R.H., Lavallee, S., Burdea, G.C., Mösges, R. (eds.) Computer-Integrated Surgery: Technology and Clinical Applications, pp. 397–407. The MIT Press, Cambridge (1996)Google Scholar
- 9.Harris, S.J., Jakopec, M., Cobb, J., Hibberd, R.D., Davies, B.L.: Interactive Preoperative Selection of Cutting Constraints, and Interactive Force Controlled Knee Surgery by a Surgical Robot. In: Wells, W.M., Colchester, A.C.F., Delp, S.L. (eds.) MICCAI 1998. LNCS, vol. 1496, pp. 996–1006. Springer, Heidelberg (1998)Google Scholar