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Medical Robots

Dr. Pushparaj Mani Pathak,


Associate Professor
Mechanical & Industrial Engineering Department
IIT, Roorkee
Contents
Introduction
Why medical robots
Current status
In Vivo robots
Introduction
The growth of medical robotics since
the mid-1980s has been enormous.
From a few initial efforts in stereotactic
brain surgery, orthopaedics, endoscopic
surgery, microsurgery, and other areas,
the field has expanded.
Medical robots may be classified in
many ways:
by manipulator design (e.g., kinematics,
actuation);
by level of autonomy (e.g.,
preprogrammed versus teleoperation
versus constrained cooperative control),
by targeted anatomy or technique (e.g.,
cardiac, intravascular, percutaneous,
laparoscopic, microsurgical);
Why medical robots?
A fundamental property of robotic systems is their ability
to couple complex information to physical action in order
to perform a useful task.
The robots may be thought of as information-driven
surgical tools that enable human surgeons to treat
individual patients with greater safety, improved efficacy,
and reduced morbidity than would otherwise be possible.
The consistency and information infrastructure associated
with medical robotic and computer-assisted surgery
systems have the potential to make computer-integrated
surgery as important to health care
Complementary strengths of
human surgeons and robots
Current status
Da Vinci for
heart
surgeries.
Robot is
programmed
to follow the
physician hand
accurately.
The daVinci telesurgical robot extends a surgeons capabilities by providing the
immediacy and dexterity of open surgery in a minimally invasive surgical
environment. (Photos: Intuitive Surgical, Sunnyvale)
In Vivo Robots
In Vivo Robots
Endoscopes have been in use for many procedures
including biopsy.
However present endoscopes have certain limitations
such as restricted degrees of motion of tool.
Thus, has poor manipulation of tissues, limited
visualization of surgical field, heightened sensitivity to
hand movement.
The left/right, up/down position of the end of the
endoscope is controlled by deforming the last 10 cm of
the tube.
Reduced access reduces dexterity, limits perception,
increases strain and likelihood of error, increased
procedural time.
There is also lack of fine motion control in these
systems.
Limitations of the present endoscopy call for an
improved technique with increased dexterity.
This provided the motivation to develop a robotic
system for In Vivo surgery.
Biopsy of an internal organ through natural opening involves two
issues insertion of biopsy tool and manipulation of tissues by tool.
The proposed system will use one of the existing biopsy channels of
the endoscopic tube for insertion of robotic arm.
Endoscopic tube will be stationed at the end of the esophagus and
robot will be anchored in the leading face of the tube.
The robot will be actuated by servomotors kept outside the body
through wires.
The proposed robot shall provide distinctly more DOF, better
maneuverability inside the stomach w.r.t. currently used tool.
This will also enable the surgeon to access much greater area inside
the stomach.
The view of operating zone can also be improved by integrating
vision system to the arms of the manipulator.
Importance of In Vivo Robots
The current biopsy tool used with endoscope has only one
DOF which will be replaced by four DOF system tool as
proposed.
The robot will be inserted through one of the existing ports
of the endoscope through mouth.
This technique will significantly reduce patients pain,
recovery time, and hospitalization charges etc.
At present, stomach surgery is largely done by
conventional key-hole surgical instruments or by open
surgery.
Current status of the knowledge
International status:
Initial work in In vivo surgery is being carried out only at a few places globally.
In MIT, USA and University of Nebraska, researchers have been working
towards developing a mobile in vivo biopsy robot.
Phee et al. have analysed and developed a locomotion devices for
Gastrointestinal Tract.
Breedveld and Hirose have reported development of a 6 DOF steerable
endoscope to improve the visual perception of depth.
A Micro Robotic Arm for a Self Propelling Colonoscope -developed in Belgium.
National status
In India robot assisted heart surgery has been performed since 2001 in Escorts
Heart Institute and Research Center, New Delhi.
In AIIMS, robot assisted surgery by da vincis robotic surgical system was
performed in April 2005 to conduct the procedure for prostate cancer.
In all these surgery procedures the robot system has been out side the body.
1. To do the mathematical modeling and simulation of In- Vivo
robot system based on geometric, kinematic and dynamic
requirement of end- effector.
2. Development of a control strategy for trajectory and force
control of end- effector.
3. To design and develop a miniature robot to implement biopsy
of stomach model made of tissue like material e.g. foam.
4. To create the knowledge in the area of In- Vivo surgery.
Objective
Workspace constraints
Gastrointestinal tract
esophagus
diameter of 17- 26 mm,
length 25-30 cm,
min of 17 mmat esophagus ring
stomach (at its widest point)
length 304.8 mm,
width 152.4 mm,
volume 0.94 liters
Methodology Adopted
Methodologies involved are:
1. Design of a robot based on the constraints such as size of the
stomach and behaviour of stomach tissues as regards their
interaction with the base and tip of the robot.
2. Modeling and simulation of the designed robot for trajectory
and force control for taking biopsy in abdominal cavity
environment.
3. Fabrication of a working model and testing of the same at the
simulated condition
Schematic of the
Proposed Design
CAD Model of the
Design
Minimum Dia. of Esophagus = 12-
15 mm
Length of stomach = 150-200 mm
Width of stomach = 100-150 mm
Material for tissue modeling -
Foam
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Bond graph
model
Tip Trajectory In-Vivo robot by rotating first joint
with all other joints locked at zero degree initial
value.
Tip trajectory by rotating second joint with all other joints
locked at zero degree initial value
Tip Trajectory by actuating wire with tip moving in
upward direction
Tip Trajectory by actuating wire with tip moving in
downward direction
Experimental details
Wire actuation
The Arduino ADKis a microcontroller
board based on the ATmega2560,
was selected owing to excellent
documentation and support for control
of actuators especially DC-motors.
4- scaled fabricated model
4- scaled foam based stomach model
Force Control
A very simple model of interaction between a
manipulator (IN-VIVO Robot) and the
environment is developed, which control force
with the help of force sensor.
The purpose of doing so is to avoid any harm
effect on healthy tissue during movement of robot
body inside the stomach.
Cutting force for tissue is equal to (5N).
Here model is developed for the contact
between the manipulator and the tissues of
stomach which includes spring mass system
with assumption that the manipulator is
rigid and the stomach muscle has
stiffness

.
Reflect based force control
Control law based force
control
Working Video
References
1. Mihir Kumar Sutar, P. M. Pathak, A. K. Sharma, N. K. Mehta, V. K.
Gupta, Forward kinematic analysis of in-vivo robot for stomach
biopsy, J Robotic Surg, Springer, DOI 10.1007/s11701-012-0375-y,
2012
2. Lokesh Sardana, Mihir Sutar, P.M. Pathak, A Geometric Approach
for Inverse Kinematics of a Four Link Redundant In-Vivo Robot for
Biopsy, Robotics and autonomous systems, Communicated
3. Mihir Kumar Sutar, P.M. Pathak, A. K. Sharma, N. K. Mehta, V. K.
Gupta, Bond graph modelling of in vivo robot for biopsy,
MATHMOD 2012 -7th Vienna International Conference on
Mathematical Modelling, February 15 - 17, 2012.
4. Mihir Kumar Sutar, Achin Garg, Chandra Sen Vikram, Saurabh
Gupta, P.M. Pathak, A. K. Sharma, N. K. Mehta, V. K. Gupta,
Design of In-Vivo Robot for Biopsy, International Conference on
Microactuators and Micromechanism, Jan 19-20, 2012, CMERI,
Durgapur,
5. Mihir Kumar Sutar, P.M. Pathak, Kinematic Analysis of In-
Vivo Robot for Stomach Biopsy, International conference on
soft computing for problem solving, IIT Roorkee, December
20-22, 2011
6. OSAMAH FADHIL FAKHRI, Development of control strategy for
force control in in-vivo robot, M. Tech thesis, IIT Roorkee,
2012
7. Bruno Siciliano, Oussama Khatib, Springer Handbook of
Robotics, 2008
8. R. MERZOUKI, A. K. SAMANTARAY, P. M. PATHAK, B. OULD
BOUAMAMA, INTELLIGENT MECHATRONIC SYSTEMS:
MODELING, CONTROL AND DIAGNOSIS, SPRINGER, 2013.
Thank you