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Development of a Robotic Surgery System for Beating Heart Surgery

Final Report Summary - HEARTSURGERYROBOT (Development of a Robotic Surgery System for Beating Heart Surgery)

Coronary artery bypass graft (CABG) surgery requires surgeons to operate on blood vessels that move rapidly. This high-bandwidth motion of the heart makes it impossible to track these arteries by hand effectively. Present-day methods either stop the heart and use a heart-lung machine, or passively restrain the beating heart with stabilizers to cancel the biological motion of heart during surgery. However, using on-pump (with lung-heart machine) CABG surgery might cause the patient to suffer from long term cognitive loss due to possible complications due to side effects of stopping the heart. On the other hand, off-pump CABG surgery is limited to only the front surface of the heart, and also significant residual motion still remains even after stabilization. Robotic-assisted beating heart surgery replaces the conventional surgical tools with robotic instruments, which are directly controlled by the surgeon through teleoperation.

The surgery robot actively tracks and cancels the relative motion between the heart surface and the surgical tools that are attached to the robotic manipulators, dynamically stabilizing the heart for the operation. The surgeon views a stabilized view of the heart on a video display with images provided by a camera mounted on the robotic arm, allowing CABG surgeries to be performed on a beating heart with technical perfection equal to traditional on-pump surgeries. This approach is called “Active Relative Motion Canceling (ARMC)”. This would eliminate the use of heart-lung machine (the pump) and prevent shortcomings of the on-pump CABG surgery. It differs from the traditional off-pump CABG surgery since in the proposed robotic-assisted surgical system, heart motion is canceled with motion compensation (See Fig. 1).

This project aims to develop a robotic surgery system for beating heart surgery. Specifically, the developed surgery robot will be used for off-pump Coronary Artery Bypass Graft (CABG) surgery. The proposed surgical system, unlike the ones available, is a small, lightweight, high bandwidth, 6-DOF system that is capable of tracking the highly dynamic heart motion, and dexterous enough to perform surgical manipulations. For this, we first focused on developing surgical robots that are capable of active relative motion cancellation. Initial efforts were focused on the development of a 5-DOF robot for percutaneous operations. This system enabled us to study motion-tracking algorithms and investigate sensing systems that could be used to improve the heart motion tracking. Also, a 6-DOF robot for minimally invasive surgery (MIS) was developed. The robot has two parallel mechanisms for high position resolution, and has a surgical tool holder as an end-effector. The robot design is lightweight, and has high motion bandwidth. We also focused on the development of an immersive telepresence interface for the robotic system to control the robotic arm during motion cancellation.

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