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Title: http://biomed.brown.edu/Courses/BI108/BI108_2005_Groups/04/timeline.html


1
??????? ?????? ????? ??????? ????? ????????
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2
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3
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1985 Kwoh et al used Puma 560a standard industrial robotto hold a fixture next to the patients head to locate a biopsy tool for neurosurgery
1985 Taylor at IBM was developing an industrial robot system (based on an IBM Scara style of robot) for hip surgery. Following laboratory studies, the robot became a veterinarian robot replacing hips of pet dogs under direction of vet Dr. Hap Pal. The IBM robot was replaced by a Scara industrial robot from the Japanese company, whose Sanko-Seiki control system incorporated additional safety structures for surgery.
1988 First attempt at active motion robot in surgery. The Mechatronics in Medicine Group at Imperial College built onto Puma 560 to perform soft-tissue surgery in transurethral resection of prostate (TURP).
4
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April 1991 First time an active robot was used to automatically remove tissue from patients. This resulted from developments based on the PUMA studies for TURP. Since that time a 2nd-generation prostate robot (called Probot) has been developed at Imperial College.
Late 1991 The modified Sanko Seiki robot system, now called Robodoc was tried clinically on human patients.
Dec 1993 The AESOP 1000, used for holding an endoscopic camera in minimal invasive laparoscopic surgery, developed by Computer Motion was approved by the FDA.
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1997 The da Vinci Surgical System manufactured by Intuitive Surgical Inc., became the first assisting surgical robot to receive FDA approval to help surgeons more easily perform laparoscopic surgery. Jacques Himpens and Guy Cardier in Brussels, Belgium used the da Vinci by Intuitive Surgical Inc. system to perform the first telesurgery gall bladder operation.
Oct 2001 ZEUS Robotic Surgical System from Computer Motion receives FDA regulatory clearance. (ZEUSs 3rd arm is an AESOP voice-controlled robotic endoscope for visualization Lanfranco et al, 2004.)
Sept 2001 ZEUS robotic system developed by Computer Motion was used in the trans-Atlantic operation. A doctor in New York removed the diseased gallbladder of a 68-year-old patient in Strasbourg, France. See Marescaux, 2002 for details.
??? ??????? ????? http//biomed.brown.edu/Course
s/BI108/BI108_2005_Groups/04/timeline.html
6
Medical Robotics
  • Biorobotics
  • Rehabilitation Robotics
  • Robotics for Surgery

7
BioRobotics
  • ??? ?? ??????
  • ????? ???????? ??? ?? ?? ???
  • ????? ?????????? ???? ?? ??? ??? ????? ???
  • ???? ? ????? ?????????? ??? ?????? ??? ??? ??????
  • ????? ??? ?? ???? ??? ????? ??? ? ?? ?????
    ???????? ??? ????

8
????? BioRobotics
  • Biorobotic System DDX
  • Disease Detector 3 (DD3)

9
????? BioRobotics
  • ?????
  • intestinal bug
  • ????? ??? ?????
  • inch-worm
  • http//www.post-gazette.com

10
????? BioRobotics
  • ?????
  • Cmos
  • ???? ?????
  • ??? ??? ??????
  • ????? ???? ?????????
  • http//biorobotics.harvard.edu/research/heather.h
    tml

11
???????? ????????
  • 1- ???????? ??????? ????? ???????????
  • MELKONG
  • 2- ????? ????? ?? ????????
  • ??????? ?????
  • MovAR
  • URMAD
  • 3- ???????? ??????

12
???????? ????????
  • 4- ?? ????? ???????? ????? ??????
  • MOVAID
  • 5- Functional Electric Simulation (FES)
  • ???? ??? ???????? ?????
  • 6- ???? ??? ????? ??? ????? ? ????? ????????

13
MoVAR (1983-1988)
  • ???? 3 ??? ?? ????? ?????? ?? ??????? ????? ??
    ??? ?????
  • ????? ????? puma-250
  • ?????? ??? ??? ?? ????? ????? ???????? ? ???? ???
    ????? ?? ???? ?????
  • ?? ?????? ???? ?? ????? ???? ?? ??? ???? ?
    ?????? ????? ???????? ???
  • ?? ???????? wireless digital link ?? ?????
    ?????? ??????? ? ????? ??????? ????? ? ???????
    ???????? ???
  • ????? ????? ???? ????? ?????
  • ????? ????? ???? 3 ??????? ???? ????? ???? ??
    ???? ??????? ? ????? ????? ? ? ?????? ????? ????
    . ??? ????? ?????? ???? ?????? ?voice? ??????
    ???? ? ????? ??? ?? ????

14
Gravity Balancing Leg Orthosis (GBO)
  • ??? ????? ??? ?????? ?? ??????
  • 1 - ?? ????? ???? ? ?? ?? ??? ????? ?????? ???
    ????? ?? ?? ???? ?? ????? ??? ???
  • 2- ???? ????? ???? ????? ???? ????? ???

15
  • Active Leg Exoskeleton
  • (ALEX)
  • Swing Assist Unmotorized Exoskeleton
  • (SUE)

16
???????? ????
  • ?????
  • ???????? ???????? ???? ????? ???????? ?? ?????
    ??????? ?????? ?? ???? ?? ??? ???? ???? ???????
    ????? ????? ?? ??? ??????? ????? ?? ????? ??????
    ???? ?? ???
  • B Davies (2000)

17
(No Transcript)
18
????? ????? ?? ????? ???? ?? ????? Davies,
1999
Pre-operative ????? ?????????? ?????? ?????? ? ????? ?? ??? 3 ???? ?? ?? ????? ?? ??? 3 ???? ????? ?????? ???? ???? ????? ?????? ?? ??? ??? 3 ???? ?? ????? ? ????? ???? ??? ?????? ???? ???? ???
Intraoperative ???? ???? ? ???? ???? ????? ??? ??? ???? ???? ? ???? ???? ????? ??? ???? ?? ??? ???? ???? ??????? ?? ??? 3 ???? ?? ?????? ????? ????? ????? ?? ????? ????? ????? ???? ????? (????? ???? ???? ??? ????? ?????)
Post-operative ????? ???? ????? ?? ?????? ???? ???? ????? ?? ???? ????? ???? ???
If further cuts are necessary ?????? ????? ????? ???? ???? ???? ????? ? ????? ????? ?? ????? ????? ??? ???????
19
??????? ????
  • - ???? ??? ????? ??????
  • - ?????? ????? ?? ??? ???
  • - ???? ????? ???????

20
??????? ????
  • ?? ?? ??? ?? ????????? ? ????? ??? ???? ? ????
    ????? ? ??????? ? ????? ?????? ??????? ???
  • ??? ????? ??????? ?? ????? ??? ????? ? ???? ????

21
???????? ????? ??????? ?? ?????
  • da Vinci Surgical System a master-slave system
  • Institute of Robotics and Mechatronics
  • UCB/UCSF laparoscopic telesurgical workstation
  • Zeus a master-slave system

22
???? ????? ???????
  • ????? ????? ???????
  • (DaVinci Surgical System)

23
????? ?? ?? ???????
  • ?? 11 ????? ??? 2000 ????? ??
  • Intuitive Surgical

24
?????? ???? ???????1-????? ?????
25
?????? ???? ???????2- Patient-side Cart
26
?????? ???? ???????3- ????? ???? ?????
27
?????? ???? ???????4- ????? ?????? ?? ????
28
?????? ???? ???????
29
??????? ?????? ?? ???? ????? ????? ??? ?????
?????
Equipment Costs Company Equipment Descriptions
da Vinci Surgical System 1 million Intuitive Surgical Robot-assistant, with arms to connect surgical instruments
Zeus Robot Surgical System 975,000 Computer Motion Robot-assistant, with arms to connect surgical instruments
Aesop 3000 80,000 Computer Motion Voice-controlled endoscope-positioning robot
Hermes Control Center Request price quota Computer Motion Centralized system used to network an intelligent OR
Socrates Robotic Telecollaboration System Request price quota Computer Motion Allows shared control of Aesop 3000 from different locations
30
????? ????? ??? ??????
  • ???? ????? ????? ?? ???? ???
  • ????? ?? ????? ???
  • ????? ??? ? ??????? ???? ?????
  • ???? ???? ????? ??? ? ?? ??? ???? ???
  • ???? ????? ?? ????? ?? ?? ???
  • ????? ????? ???? ???? ????

31
????? ??????? ???? ?????
  • ??????? ?? ?????
  • ???? ???????
  • ???? ????
  • ??????? ?? ???? ??????

32
?????? ?????? ????? ? ????? ????? ?? ??? ?????
??? ???? ??????? ?? ?????
Maintenance/year Physician Training 1 million 100,000 250,000
Cost of one inpatient hospital day 2,000
Reduced inpatient hospital days for heart procedures 4.5 days
Cost saving per heart procedure due to reduced hospital stay 9,000 per heart valve
Extra procedure cost 2000 more per operation
Surgical assistance 175,000 for fourth arm (Compared to 80,610 per year for extra OR nurse)
33
(No Transcript)
34
??????? ???????
  • ??????? ?? 15 ?????? 2003 ?? ???? ???????
  • 30 ?????? 2003 ???? ????? ???? ????
  • 23?? ?? ?????? ??????? ??? ???? ???? ????? ????
    ????
  • ?? 24 ????? 2003 ???? ?? ???? 2/19 ?????? ????
    ?? ????? 4/1 ?? 33 ???? ????? ??? ?? ????

35
??????? ???????
  • ?? ????? ??? 2004 ?? ??? ???? ?? ???? ?? ?? 8/138
    ?????? ???? ????( 51 ???? ??? ?? ??? ?????) ?? ??
    ??? ???? ????? ???? ? ??????? ? ????? ??? ????
    ??? ??? ???? ???
  • ?? ??? 2004 ?? ?????? 76 ??????? ?? ???? ?? ????
    1.5 ?????? ???? ?? ???? ????

36
FDA Approval http//www.intuitivesurgical.com/ne
ws_room/fda_clear.html
Date Procedure
April 26, 2005 Gynecological Laparoscopic Procedures
January 30, 2003 Totally Endoscopic Atrial Septal Defect (ASD)
November 13, 2002 Mitral valve repair surgery
November 12, 2002 Thoracoscopically-Assisted Cardiotomy Procedures, K022574
July 11, 2000 General Laparoscopic Surgery (gallbladder, gastroesophageal reflux and gynecologic surgery), K990144
March 5, 2001 Thoracoscopic Surgery (IMA Harvesting for Coronary Artery Bypass and Lung surgery), K002489
May 30, 2001 Laparoscopic Radical Prostatectomy, K011002
July 31, 1997 Surgical Assistance, K965001

37
2- Institute of Robotics and Mechatronics
38
3- UCB/UCSF laparoscopic telesurgical
workstation
39
3- UCB/UCSF laparoscopic telesurgical
workstation
40
ZEUS
41
  • ?????
  • www.bme.uconn.edu/bme/davinci/
  • www.biomed.brown.edu/Course/b1108/b1108 2005
    Groups/04/davinci.html
  • www.electronics.howstuffworks.com/robotic-surgery.
    html/printable
  • www.stronghealth.com/services/surgical/aboutdavinc
    i.cfm
  • www.stjosephsatlanta.org/center-for-robotic-surger
    y/how-robotic- surgery-works.html
  • http//biorobotics.harvard.edu/research/heather.h
    tml http//www.benaxelrod.com/robotvideo/index.htm
    l

42
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