Robotic assistance is technically superior to conventional laparoscopy in hemicolectomies

Abstract Endoscopy and robotics represent two emerging technologies within the field of spine surgery, the former an ultra-MIS approach minimizing the perioperative footprint and the latter leveraging accuracy and precision. Herein, we present the novel incorporation of robotic assistance into endoscopic laminotomy, applied to a 27-yr-old female with a large caudally migrated L4-5 disc herniation. Patient consent was obtained. Robotic guidance was deployed in (1) planning of a focussed laminotomy map, pivoting on a single skin entry point; (2) percutaneous targeting of the interlaminar window; and (3) execution of precision drilling, controlled for depth. Through this case, we illustrated the potential synergy between these 2 technologies in achieving precise bony removal tailored to the patient's unique pathoanatomy while simultaneously introducing safety mechanisms against human error and improving surgical ergonomics.1,2 The physicians consented to the publication of their images.

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Development of an autonomous robotic system for beard shaving assistance of disabled people based on an adaptive force tracking impedance control

Proceedings of the Institution of Mechanical Engineers Part C Journal of Mechanical Engineering Science ◽

10.1177/0954406220984821 ◽

2021 ◽

pp. 095440622098482

Author(s):

Oladayo S Ajani ◽

Samy FM Assal

Keyword(s):

Impedance Control ◽

Environmental Parameters ◽

Robotic System ◽

Robotic Systems ◽

Full Potential ◽

Robotic Assistance ◽

Head Pose ◽

Detection And Tracking ◽

Control Scheme ◽

Force Tracking

Recently, people with upper arm disabilities due to neurological disorders, stroke or old age are receiving robotic assistance to perform several activities such as shaving, eating, brushing and drinking. Although the full potential of robotic assistance lies in the use of fully autonomous robotic systems, these systems are limited in design due to the complexities and the associated risks. Hence, rather than the shared controlled or active robotic systems used for such tasks around the head, an adaptive compliance control scheme-based autonomous robotic system for beard shaving assistance is proposed. The system includes an autonomous online face detection and tracking as well as selected geometrical features-based beard region estimation using the Kinect RGB-D camera. Online trajectory planning for achieving the shaving task is enabled; with the capability of online re-planning trajectories in case of unintended head pose movement and occlusion. Based on the dynamics of the UR-10 6-DOF manipulator using ADAMS and MATLAB, an adaptive force tracking impedance controller whose parameters are tuned using Genetic Algorithm (GA) with force/torque constraints is developed. This controller can regulate the contact force under head pose changing and varying shaving region stiffness by adjusting the target stiffness of the controller. Simulation results demonstrate the system capability to achieve beard shaving autonomously with varying environmental parameters that can be extended for achieving other tasks around the head such as feeding, drinking and brushing.

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True Kinematic Alignment Is Applicable in 44% of Patients Applying Restrictive Indication Criteria—A Retrospective Analysis of 111 TKA Using Robotic Assistance

Journal of Personalized Medicine ◽

10.3390/jpm11070662 ◽

2021 ◽

Vol 11 (7) ◽

pp. 662

Author(s):

Kim Huber ◽

Bernhard Christen ◽

Sarah Calliess ◽

Tilman Calliess

Keyword(s):

Soft Tissue ◽

Retrospective Analysis ◽

Patient Specific ◽

Kinematic Alignment ◽

Postoperative Phase ◽

Robotic Assistance ◽

Component Position ◽

Joint Stability ◽

Robotic Assisted ◽

Primary Tkas

Introduction: Image-based robotic assistance appears to be a promising tool for individualizing alignment in total knee arthroplasty (TKA). The patient-specific model of the knee enables a preoperative 3D planning of component position. Adjustments to the individual soft-tissue situation can be done intraoperatively. Based on this, we have established a standardized workflow to implement the idea of kinematic alignment (KA) for robotic-assisted TKA. In addition, we have defined limits for its use. If these limits are reached, we switch to a restricted KA (rKA). The aim of the study was to evaluate (1) in what percentage of patients a true KA or an rKA is applicable, (2) whether there were differences regarding knee phenotypes, and (3) what the differences of philosophies in terms of component position, joint stability, and early patient outcome were. Methods: The study included a retrospective analysis of 111 robotic-assisted primary TKAs. Based on preoperative long leg standing radiographs, the patients were categorized into a varus, valgus, or neutral subgroup. Initially, all patients were planned for KA TKA. When the defined safe zone had been exceeded, adjustments to an rKA were made. Intraoperatively, the alignment of the components and joint gaps were recorded by robotic software. Results and conclusion: With our indication for TKA and the defined boundaries, “only” 44% of the patients were suitable for a true KA with no adjustments or soft tissue releases. In the varus group, it was about 70%, whereas it was 0% in the valgus group and 25% in the neutral alignment group. Thus, significant differences with regard to knee morphotypes were evident. In the KA group, a more physiological knee balance reconstructing the trapezoidal flexion gap (+2 mm on average laterally) was seen as well as a closer reconstruction of the surface anatomy and joint line in all dimensions compared to rKA. This resulted in a higher improvement in the collected outcome scores in favor of KA in the very early postoperative phase.

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Robotic Assistance System for Cone-Beam Computed Tomography-Guided Percutaneous Needle Placement

CardioVascular and Interventional Radiology ◽

10.1007/s00270-021-02938-7 ◽

2021 ◽

Author(s):

Michael Kostrzewa ◽

Andreas Rothfuss ◽

Torben Pätz ◽

Markus Kühne ◽

Stefan O. Schoenberg ◽

...

Keyword(s):

Computed Tomography ◽

Target Lesion ◽

Robotic Arm ◽

Cone Beam ◽

Mean Deviation ◽

Robotic Assistance ◽

Needle Placement ◽

Image Guided ◽

Out Of Plane ◽

Tip Position

Abstract Purpose The study aimed to evaluate a new robotic assistance system (RAS) for needle placement in combination with a multi-axis C-arm angiography system for cone-beam computed tomography (CBCT) in a phantom setting. Materials and Methods The RAS consisted of a tool holder, dedicated planning software, and a mobile platform with a lightweight robotic arm to enable image-guided needle placement in conjunction with CBCT imaging. A CBCT scan of the phantom was performed to calibrate the robotic arm in the scan volume and to plan the different needle trajectories. The trajectory data were sent to the robot, which then positioned the tool holder along the trajectory. A 19G needle was then manually inserted into the phantom. During the control CBCT scan, the exact needle position was evaluated and any possible deviation from the target lesion measured. Results In total, 16 needle insertions targeting eight in- and out-of-plane sites were performed. Mean angular deviation from planned trajectory to actual needle trajectory was 1.12°. Mean deviation from target point and actual needle tip position was 2.74 mm, and mean deviation depth from the target lesion to the actual needle tip position was 2.14 mm. Mean time for needle placement was 361 s. Only differences in time required for needle placement between in- and out-of-plane trajectories (337 s vs. 380 s) were statistically significant (p = 0.0214). Conclusion Using this RAS for image-guided percutaneous needle placement with CBCT was precise and efficient in the phantom setting.

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