Robots

1
Robots

• In medicine

Sijun Yang Francis Eusebio Pavel
Romanovski Bhavini Prajapati
2
What are robots?

• Commonly, when we think of robots, we think of

• Essentially artificially intelligent beings
  created from someone's imagination for a movie or
  book

3
Actually

• A robot is any mechanical device for performing a
  task which might otherwise be done by a human
• That means that the robots in our every day lives
  really dont look like we imagine them to be and
  actually little resemble humans.
• This holds especially true in the medical field.

4
Functions of Robots in Medicine

• When picturing a hospital, you think doctors,
  nurses, medicine, right?
• There is actually a whole lot more behind the
  story. The team of doctors and nurses are
  supported by the pharmacy, chemistry labs,
  surgeons, and even people responsible for
  rehabilitation.
• While the doctors you see make the diagnosis,
  they are given the information to make the
  decision whether a tumor is benign or malignant,
  or whether it is MRSA or not based on laboratory
  results.
• And while doctors order the medicine, these
  pharmaceuticals take a long journey in order to
  get to the patients bedside. Even more
  importantly, there are patients that must undergo
  rehabilitation after treatment.

5
Functions of Robots in Medicine (II)?

• So, what does this all mean?
• Well, previously, all of these support roles
  are fulfilled by humans. However, in recent
  years, automated machines are taking over the
  task.
• There are several major areas of medicine a robot
  fulfills.
• However, because robots have strengths as well as
  limitations, there are always positions in the
  medical field that a robot cannot fulfill.

6
General Strengths and Weaknesses

• Human Strengths
• Strong hand-eye coordination
• Dexterous (at human scale)
• Flexible and adaptable
• Can integrate extensive and diverse information
• Able to use qualitative information
• Human Limitations
• Limited dexterity outside natural scale
• Prone to tremor and fatigue
• Limited ability to use quantitative information
• Limited sterility
• Susceptible to radiation and infection

• Robot Strengths
• Dexterous
• Flexible and adaptable
• Robot Limitations
• Limited to relatively simple procedures
• Expensive
• Technology in flux
• Difficult to construct and debug
• Requires extensive human supervision

7
Contents

• We will take a look at the different aspects of
  medicine.
• Diagnosis
• Surgery
• Pharmacy
• Rehabilitation
• Prosthetics

8
Diagnosis
9
Diagnosis

• Robots are also capable of performing multiple
  tests. These machines range from sophisticated
  blood and urine testing machines to computerized
  scans like the CAT scan.
• In recent years, a single robot-equip lab can cut
  the needed number of human laboratory staff down
  by half.
• They lessen the chances of human error and
  increase test accuracy. They also cut down on the
  time required for testing. For example, one gram
  staining machine can take ten blood samples,
  smear samples on the slides, stain it, and dry it
  in less the time required for a lab tech to stain
  one slide.
• This efficiency speeds up the time required to
  diagnose and treat a patient, making it much
  easier to save a life.

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Meet Engen

• Southern Arizonas veterans hospital recently
  installed Engen. Pronounced engine, it is a
  robot that handles blood samples.
• Once a sample is put into the robot, the entire
  process is automated.
• The robot pulls off the caps of the sample, scans
  the bar code, spins the samples, and efficiently
  performs the tests offered.
• No patient sample mix-ups
• It is even smart enough to recognize test results
  that seem suspect and set them aside to be
  rechecked
• The robot allows the hospital to handle a large
  workload with a smaller staff
• It also decreases the instances of broken tubes
  and splashes and decrease human contact with
  biohazardous materials.
• St. Josephs hospital in Paterson has similar
  technology. The entire chemistry lab is connected
  to a conveyor-belt like system that connects
  different machines and a refrigerator that stores
  the samples
• With the click of a mouse, someone can order a
  specific sample to be retrieved from storage and
  have tests performed on it.
• Because the entire systems operates based on
  barcodes with patient information attached,
  sample mix-up and paperwork are kept to a minimum.

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Helper from Korea

• Korea's Pohang University of Science and
  Technology researchers have developed a robot
  that performs about 70 different blood tests so
  far, with the ability of 100 by next year.
• The 1.6 meter tall bot has a built-in reagent
  dispenser, protein detector, and software to do
  its thing.
• While this is only a prototype at this stage, the
  scientists are hoping to release it to the
  general public by 2012.

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And Japan

• Matsushita Electric Works, came up with a
  blood-loving robot for medical use.
• The Hospi droid is currently being deployed in
  facilities across Japan, starting with a medical
  analysis firm known as BML.
• Hospi grabs blood from patients whether it
  leeches it directly from a vein with some sort of
  probe or if it is handed the claret in a jug
  isnt clear and uses laser guidance to find its
  way to wherever the blood is to be delivered.
• Such bots usually require special markers on the
  floor but Hospi is bright enough to just download
  a map from a PC and get cracking on his own.

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Surgery
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Surgery

• Surgery is perhaps the most glamorous job of a
  robot. They are able to replace human hands in
  intricate procedures, supervised by an
  experienced surgeon.
• The robots are often able to make smaller
  incisions and perform tasks that are too big for
  human hands.
• To date, there are a number of robots that
  specialize in commons surgeries

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Benefits of Using Robotic Surgery

• Small incisions, which means less chances of
  infection
• Smaller average blood loss, without robotic
  surgery, average blood loss was around 300 cc,
  but with it, average is less than 60 cc
• shortened hospital stays
• lower cost
• less pain
• less psychological distress
• quicker resumption of functioning at home, on the
  job and in the patients social life

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Cardiothoracic Surgery
Cardiothoracic Surgery
Cardiothoracic surgery is the field of medicine
involved in surgical treatment of diseases
affecting organs inside the thorax (the chest).
Generally treatment of conditions of the heart
(heart disease) and lungs (lung
disease)? Robot-assisted MIDCAB ( Minimally
Invasive Direct Coronary Artery Bypass) and
Endoscopic coronary artery bypass (TECAB) surgery
are being performed with the da Vinci system.
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Cardiothoracic Surgery (cont.)?
Since the first robotic cardiac procedure
performed in the USA in 1999, The Ohio State
University has performed esophagectomy, lung
resection, tumor resections, among other robotic
assisted procedures and serves as a training site
for other surgeons.
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Cardiology and Electrophysiology
The Stereotaxis Magnetic Navigation System (MNS)
has been developed to increase precision and safe
in ablation procedures for arrhythmias and atrial
fibrillation while reducing radiation exposure
for the patient and physician, and the system
utilizes two magnets to remotely steer
catheters. The system allows for automated 3-D
mapping of the heart, and MNS has also been used
in interventional cardiology for guiding
stents(mesh tubes).
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Gastrointestinal Surgery
Multiple types of procedures have been performed
with either the Zeus or da Vinci robot systems,
including bariatric surgery. Bariatric surgery,
also known as weight loss surgery, refers to the
various surgical procedures performed to treat
obesity by modification of the gastrointestinal
tract to reduce nutrient intake and/or
absorption. The term does not include procedures
for surgical removal of body fat such as
liposuction. For individuals who have been
unable to achieve significant weight loss through
diet modifications and exercise programs alone,
bariatric surgery may help to attain a more
healthy body weight. There are a number of
surgical options available to treat obesity, each
with its advantages and pitfalls.
20
General Surgery

• Many general surgical procedures can now be
  performed using the state of the art robotic
  surgical system.
• In 2007, the University of Illinois at Chicago
  medical team performed the world's first ever
  robotic pancreatectomy and also the Midwests
  fully robotic Whipple surgery, which is the most
  complicated and demanding procedure of the
  abdomen.
• In April 2008, the same team of surgeons
  performed the world's first fully minimally
  invasive liver resection for living donor
  transplantation, removing 60 of the patient's
  liver, yet allowing him to leave the hospital
  just a couple of days after the procedure, in
  very good condition.
• Furthermore the patient can also leave with less
  pain than a usual surgery due to the four
  puncture holes and not a scar by a surgeon.

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Gynecology
Gynecology refers to the surgical specialty
dealing with health of the female reproductive
system (uterus, vagina and ovaries). Robotic
surgery in gynecology is one of the fastest
growing fields of robotic surgery. This
includes the use of the da Vinci surgical system
in benign gynecology and gynecologic oncology.
Robotic surgery can be used to treat fibroids,
abnormal periods, ovarian tumors, pelvic
prolapse, and female cancers. Using the robotic
system, gynecologists can perform hysterectomies,
myomectomies, and lymph node biopsies. The need
for large abdominal incisions is virtually
eliminated.
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Robotic Operation
The surgeon's computer console is positioned
remotely from the patient FDA requires that in
the US, all operations using the da Vinci
surgical system are performed in the same room as
the patient, although the potential exists for
remote surgery Console houses a stereoviewer
which has an infrared beam to deactivate the
robotic arms whenever the surgeon moves his head
out of the console Surgeon's hands are inserted
into free-moving masters or finger controls,
which convert the movements of the surgeon's
wrist and fingertips into electric signals These
are then translated to computer commands to
direct the robotic instruments to perform the
same movements in the operative field
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Robotic Surgery(Continued)?

• Gynecologic Oncology
• Neurosurgery
• Orthopedics
• Pediatrics
• Radiosurgery
• Urology

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Gynecologic Oncology
Da-Vinci Surgical System

• Gynecologic oncology is a field of medicine that
  deals with cancers in the reproductive system,
  which include cervical, ovarian, uterine,
  vaginal, and vulvar
• The da-Vinci robotic system is used to assist in
  hysterectomies and cancer staging
• Da-Vinci Surgical System consists of three
  components
• A surgeons console
• A patient-side robotic cart with 4 arms
  manipulated by the surgeon
• High-definition 3D vision system
• Surgeons hand movements are scaled and filtered
  to eliminate hand tremor that would translate
  into micro-movements of the proprietary
  instruments
• Camera used in the system provides a true
  stereoscopic picture transmitted to a surgeons
  console
• Da Vinci System is FDA cleared for a variety of
  surgical procedures
• Studies done by the following institutions The
  University of Tennessee (Memphis Chattanoga),
  Northwestern University, Aurora Health Center,
  and West Virginia University have shown
  improvement in morbidity and mortality of
  patients with gynecologic cancers.

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Neurosurgery

• Field of medicine dealing with the brain
• MD Robotics NeuroArm, worlds first
  MRI-compatible surgical robot
• NeuroArm was developed over the past six years by
  Garnette Sutherland, Professor of Neurosurgery,
  University of Calgary and Calgary Health Region,
  and his group, in collaboration with MacDonald
  Dettwiler and Associates (MDA)?
• neuroArm is capable of both microsurgery and
  image guided biopsy. The surgical robotic system
  is controlled by a surgeon from a computer
  workstation, working in conjunction with
  intra-operative MR (magnetic resonance) imaging
• The system includes a workstation, a system
  control cabinet, and two remote manipulators
  mounted on a mobile base.
• The anthropomorphic arms have 7 degrees of
  freedom, are MR compatible and designed to hold a
  variety of surgical tools.
• workstation recreates the sight and sensation of
  microsurgery by displaying the surgical site and
  3D MRI displays, with superimposed tools

NeuroArm
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Orthopedics

• is the branch of surgery concerned with
  conditions involving the musculoskeletal system
• ROBODOC and ORTHODOC system is used
• ROBODOC system includes two components
• ORTHODOC, a computer workstation equipped with
  proprietary software for preoperative surgical
  planning
• ORTHODOC takes a CT scan and converts it into a
  3-dimensional bone image
• ROBODOC, a computer-controlled surgical robotic
  assistant for use in hip and knee replacement as
  well as other orthopedic procedures
• ROBODOC made medical history in 1992 by assisting
  in a Total Hip Arthroplasty (THA) procedure
• The action of the robotic arm, equipped with the
  high-speed drill has been shown in thousands of
  operations to be less traumatic for the patient
  and more precise than manual preparation
  techniques
• The robot mills cavities for hip implants,
  removes bone cement for revision surgeries, and
  planes the femoral and tibia surfaces for knee
  implants
• new applications such as resurfacing, long bone
  Osteotomies, Uni-condylar knee, and spine
  applications are being developed
• reduce surgical complications and eliminate human
  error

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Pediatrics

• is a branch of medicine that deals with the
  medical care of infants, children and adolescents
  
• Surgical robotics has been used in many types of
  pediatric surgical procedures
• tracheoesophageal fistula repair
• Cholecystectomy
• Nissen fundoplication
• Morgagni hernia repair
• Kasiai portenterostomy
• Congenital diaphragmatic hernia repair
• On January 17, 2002 surgeons at Childrens
  Hospital of Michigan in Detroit performed the
  nations first advanced computer assisted
  robot-assisted surgical procedure
• In 2001, The Center for Robotic Surgery at
  Childrens Hospital Boston was the first to
  acquire a surgical robot today surgeons use the
  technology for many procedures and perform more
  pediatric robotic surgeries than any other
  hospital in the world

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Radiosurgery

• is a medical procedure which allows non-invasive t
  reatment of benign and malignant conditions
• by means of directed beams of ionizing radiation
• The CyberKnife Robotic Radiosurgery System uses
  image-guidance and computer controlled robotics
  to treat tumors throughout the body by delivering
  multiple beams of high-energy radiation to the
  tumor from virtually any direction
• frameless robotic radiosurgery system invented
  by John R. Adler, a Stanford University Professor
  of Neurosurgery and Radiation Oncology
• two main elements of the CyberKnife are (1) the
  radiation produced from a small linear particle
  accelerator and (2) a robotic arm which allows
  the energy to be directed at any part of the body
  from any direction
• 6D or skull based tracking is the method used
• Additional image guidance methods are available
  for spinal tumors and for tumors located in the
  lung. For a tumor located in the spine, a variant
  of the image guidance called Xsight-Spine is used
• images of the spinal processes are used
• spinal vertebrae can move relative to each other,
  this means that image warping algorithms must be
  used to correct for the distortion of the X-ray
  camera images

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Urology

• is the surgical specialty that focuses on
  the urinary tracts of males and females, and on
  the reproductive system of males
• Uses da-Vinci robot to remove the prostate gland
  for cancer, repair obstructed kidneys, repair
  bladder abnormalities and remove diseased kidneys
• New minimally invasive robotic devices that use
  steerable flexible needles are currently being
  developed for use in prostate brachytherapy
• A novel robotic transrectal ultrasound probe
  manipulator (TRUS Robot) is used concurrently
  with the daVinci in a tandem robot approach
  (T-RALP) to intraoperatively image the prostate
  and NVB. The TRUS Robot was developed to provide
  a steady holding of the TRUS probe and allow
  remote manipulation using a joystick located next
  to the daVinci console
• The objective of the T-RALP approach is to use
  TRUS images for guiding the surgeon. A clinical
  study is currently in progress for the validation
  of the concept

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Pharmacy
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Robotics in Pharmacy

• Two types of pharmaceutical robots
• Drug manufacturing/packaging/testing robots
• Dispensing/filling robots

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Goals Achievements

• Prescriptions are filled with less error,
  potentially saving lives
• Drugs are dispensed more quickly and efficiently
• Compounds used for drug production could be
  tested in hours as opposed to weeks when humans
  are doing the same job
• Robots can perform work in hostile and dangerous
  environments, such as laboratories, with less
  risk

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More Goals and Achievements

• Money is saved
• Pharmaceutical robots can accomplish more tasks
  more accurately than a human can in a similar
  time period
• A robot is a one-time investment, and is
  near-infallible
• Pharmacists have more time with patients, instead
  of doing repetitive tasks that a robot is capable
  of doing
• Bulk dispensing of loose tablets is eliminated
• The robot can control stock on a pack-by-pack
  basis or dose-by-dose basis

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History of Automated Dispension

• In the 1970s, electronic tablet counters based on
  optical light-beam technology were introduced to
  the market
• By 1980, their use became
• widespread in the US
• UK usage of robots followed with the European
  Community Directive 92/97, which became law in
  1999
• This brought about a
• move towards automated
• dispensing systems

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Popular Dispensing Robots

• Optifill II
• Labeling
• Counting
• Filling
• Capping

• Pillpick
• Used for single doses
• Robot dispenses into bar code- marked bag
• Bar code is matched with patient's code on
  wristband

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Popular Dispensing Robots

• Fastpak 330
• Individually packages and separates day-to-day
  dosage packets

• Each system can fill 500 doses per hour
• Each system is virtually error-free

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Watch a Pharmaceutical Robot in Action
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Rehabilitation
41
Rehabilitation

• Robots are highly useful in rehabilitation
• They can provided exercise platforms to restore
  limb function and monitor patients
• Helps victims of injuries, stroke, or nerve damage

42
Introducing Lenny

• Walk into the intensive care unit at St. Joseph
  Mercy Oakland hospital in Pontiac, Mich., and
  your eye might be drawn to Lenny. He is 5 feet 4
  inches tall, 225 pounds and shuttles among the
  patients, greeting and chatting with them by
  name, checking their vital signs, issuing
  instructions to nurses and other clinicians.
• His face is a TV screen. When hes at work, his
  screen is filled by the face of the physician
  Lenny is assisting, who sits far away at an
  office desktop console or even at a laptop at
  home.
• Lennys eyes are a quick-focusing pan-tilt-zoom
  camera mounted atop the screen.
• He has no arms or legsmaneuvers smoothly among
  the beds on three ball-bearing feet, and he
  dodges collisions through an array of sensors
  positioned around his waist.
• He hears and speaks through audio receivers and
  microphones, and has a built-in printer so he can
  spit out hardcopy orders or prescriptions on the
  spot. His handwriting is legible.
• Lenny is an RP-7 (RP stands for remote presence)
  manufactured by InTouch Health of Santa Barbara,
  Calif. He is one of over 100 currently stationed
  in some 40 hospital systems in the United States
  and internationally.
• Like Lenny, most of these clever machines have
  been given human names. Some robots even visit
  patient bedsides with a white lab coat draped
  around their shoulders.

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The RP-7

• The RP-7, enables physicians to provide timely
  patient care from a remote location.
• How do doctors feel about delegating some
  previously hands-on patient contact to
  intermediation by a versatile droid?
• Almost three-quarters of the physicians who had
  recorded some 850 robot-assisted interactions
  reported the remote visits had sped up patient
  discharges. (Reducing unnecessary lengths of stay
  translates to money in the bank for the hospital.
  One physician calculated that the use of a robot
  at his institution shaved an average of 0.17 days
  from his patients LOS, adding up to savings of
  750,000 over the course of a year.)
• Moreover, the physicians saved their own
  timerobotic visits proved eight times more
  efficient than personal rounds during off
  hours. The doctors had learned more about the
  patient through use of a robot, and remote
  interaction had advanced care.
• How patients feel when a Lenny shuttles into the
  room in place of a living, breathing doctor?
• According to the first multisite patient
  satisfaction study of remote presence rounds,
  only 10 of 135 patients whod been attended by a
  robot at Johns Hopkins, UC Davis Medical Center
  and Eastern Virginia University suggested their
  care had been inferior.
• Two-thirds thought telerounding should become a
  regular feature of hospitalization.
• 90 agreed that communicating with their doctor
  through a robot had been easy (and 75 percent
  said theyd rather talk with their own doctor
  that way than have an unfamiliar doctor drop by).
  Overall, no difference in satisfaction with their
  physicians concern and care, skill,
  communication, awareness, personal attention or
  availability was reported between patients whod
  experienced robot rounding and a control group
  whod received conventional in-person oversight.

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RP-7 in Stroke Units

• First, its important to note that stroke is the
  third leading cause of death in the United States
  after heart disease and cancer, and the leading
  cause of long-term disability. Strokes may be
  caused either by a clot that suddenly cuts off
  blood to the brain (ischemic stroke) or by
  bleeding into the brain from a ruptured vessel
  (hemorrhagic stroke). Prompt administration of
  the clot-dissolving drug tPA can prevent many
  deaths from the formerbut its blood-thinning
  properties can worsen or even kill a victim of
  the latter. Rapid and accurate diagnosis of the
  cause of a stroke, and administration of tPA if
  appropriate within no more than three hours, can
  make the difference between life and death. But
  few hospitals, especially in rural areas, have
  the neurovascular expertise in-house to make and
  expedite the critical judgments.
• Thats where Lenny and his robotic cousins come
  in. When a stroke victim is brought into the
  emergency department, the local robot speeds to
  the patients bedside. Using the robots eyes and
  ears and working with on-site ED personnel who
  have received advanced stroke care training
  neuroendovascular specialists determines what
  treatment the patient needs and where.
• If the local hospital can handle the case, the
  patient is spared an expensive and needless
  precautionary transfer to a hospital far from
  home. Ninety-five percent of stroke victims can
  be treated in their own communities.
• Small hospitals love the idea. They struggle to
  access consultive services, and with robots those
  are very easy to structure in everything from
  infectious diseases to psychiatric services. They
  can be used in the ICU as well as for stroke
  care, and for computer training. Stroke patients
  benefit from state-of-the-art because people walk
  home from the hospital after a stroke rather than
  being wheeled out for year-long rehabilitation.

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Motor Recovery

• Current therapeutic interventions for patients
  with severe brain injury such as stroke are based
  on neurofacilitatory techniques, muscle tonus
  controlling therapies, progressive strengthening,
  biofeedback or electrical stimulation
• Task-oriented therapies are important to improve
  the function of the affected arm. There is
  evidence that machine delivered therapies can be
  effective in progressing the treatment because
  robotic devices are capable of reaction times far
  in advance of any human
• For people with upper limb paralysis it is
  possible to consider therapies where intelligent
  assistance from a robot is able to provide
  varying degrees of compensatory movements for the
  affected limb.
• Furthermore sensing that already exists within
  the robot can be used to provide a wealth of
  information about the underlying pathology.

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Neurorehabilitation

• Robot-aided neurorehabilitation is a
  sensory-motor rehabilitation technique based on
  the use of robots and mechatronic devices.
• The purpose is to aid and augment the traditional
  therapy intended for patients with motor
  disabilities to improve motor performance,
  shorten the rehabilitation time, and provide
  objective parameters for patient evaluation.
• Measurements of forces and positions acquired
  during the tasks allow quantitative assessment of
  neuro-motor state of the patients and their
  progress.

The virtual environment and haptic device for
assessing arm movement abilities.
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Prosthetics
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Prosthetics

• Prosthetics are mechanical replacements for
  missing limbs and organs. They can interact with
  the organic human systems to improve the quality
  of life for the patient.
• Things like replacement hearts and limbs are
  often necessary in medicine.
• Robotic devices can also aid people with severe
  restrictions on movement by allowing them some
  ability to move.
• The biggest problem of developing robotics for
  implantation is making a nonorganic material.

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Goals

• Prosthetics today allow for not just walking, but
  running, skiing, swimming, and other active
  pursuits.  Prosthetics in the coming decades will
  allow for complete control of the missing parts
  of the human anatomy. In medicine, a prosthesis
  is an artificial extension that replaces a
  missing body part. Prostheses are typically used
  to replace parts lost by injury or missing from
  birth, or to supplement defective body parts. 
• Robotics is the development of machines to do
  things which had traditionally been done by
  humans. With the fast pace of developmental
  robotics, the field of prosthetics is
  benefiting. 
• Little by little, limbs are becoming more natural
  looking and much more functional. 
• An Exoskeleton - a unique application for
  Prosthetic Robotics

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Honda's computerized "walking assist devices"

• Honda's latest prototype-- a pair of wearable
  robotic "Walking Assist Devices."
• The two prototypes, exhibited at Detroit's
  Society of Automotive Engineers World Congress,
  are designed to provide walking assistance for
  people with weakened legs or those who need to
  perform a lot of fatiguing leg work.
• Stride Management Assist looks a bit like a
  garter belt. It secures around the user's waist
  and grips each thigh. Then, by monitoring the
  angle of the hips, it calculates the wearer's
  stride and provides helpful force, lengthening
  the stride and regulating the pace of walking.
• The second device, Bodyweight Support Assist,
  consists of a motorized, articulated frame, with
  a pair of shoes at one end and a bicycle-style
  saddle at the other. You switch on the device and
  then lift the padded saddle up into place between
  your thighs, where it exerts an upward force of 3
  kilograms to help support the wearer's body
  weight. The devise has a program that adjusts for
  the force and balance..
• When you bend your knees to crouch down, the
  force is increased up to 17 kilograms, making it
  very easy to hold a crouching posture for long
  periods of time. Proposed users of the device
  include factory workers who crouch to lift.

Stride Management Assist
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Merging Science and Science Fiction

• Dean Kamen invented the mind-controlled
  prosthetic robot arm.
• Kamens arm, dubbed "Luke" (after Skywalker), is
  incredibly sophisticated, far ahead of the
  clamping "claws" that many amputees are forced to
  use today.
• The arm is fully articulated, giving the user the
  same degrees of movement as a natural arm, and is
  sensitive enough to pick up a piece of paper, a
  wineglass or a grape.
• The invention is truly impressive in its advances
  in technology.

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Sources

• http//www.moah.org/exhibits/archives/robotman/med
  icine/medicine/html
• http//klangundkleid.ch/img/starwars/c3po.jpg
• http//www.kvoa.com/global/story.asp?s5759267
• http//www.robotsnob.com/archives/2008_07.php
• http//www.digitalworldtokyo.com/index.php/digital
  _tokyo/articles/japanese_blood_sucking_robots_on_t
  he_loose/
• http//www.google.com/search?hlenqrobotatthe
  bedsideaqfoq
• http//en.wikipedia.org/wiki/Rehabilitation_roboti
  cs
• http//www.popsci.com/gear-amp-gadgets/article/200
  9-04/future-legs
• http//www.wired.com/gadgetlab/2008/05/dean-kamens
  -rob/
• http//www.biomed.brown.edu
• http//www.wikipedia.org
• http//www.howstuffworks.com
• Fertility and Sterility Vol. 84, No.1, July 2005
• news.bbc.co.uk
• http//www.med.unc.edu/obgyn/news/BoggessAJOBGYN-s
  taging.pdf
• http//www.med.unc.edu/obgyn/news/BogessAJOBGYN-hy
  sterectomy.pdf
• medgadget.com