Page 184 - Control Theory in Biomedical Engineering

Medical robotics 169

Stage 1: Industrial robots for surgery applications
1983: Position of a patient’s leg on voice command (Arthrobot)
1984: Orthopedic surgical procedure (Arthrobot)
1985: Neurosurgery (PUMA 260)
1989: Neuro-stereoctatic surgery (PUMA 560)
1991: Transurethral Resection of prostate (ProBot)
1992: Hip replacement surgery (Robodoc)
1996: Knee replacement (Acrobot)
Stage 2: Minimal invasive surgery (MIS)
1994: Automated endoscopic system for optimal positioning (AESOP)
1998-2003: Zeus surgical system
1999: Tele-echography emergence (Hypocrate)
2000: Da Vinci system cleared by Food and Drug Administration (FDA)
Since 2001: Da Vinci system used in many surgical procedures and
most laparoscopic surgical procedures.

Stage 3: Next generation
Intra-body robots: flexible capsules, flexible active catheter
system, robotic endoscopes,...
Patient-Mounted Robots
Transluminal endoscopy and surgery

Fig. 12 Timetable of surgical robotics.

one larger incision (about 20–40mm) at the patient’s navel and introduce
several semi- flexible instruments through the incision. This approach has
the advantage to reduce the number of ports, but it can lead to tool encum-
brance. MIS can also be performed through natural orifices such as the
mouth, vagina, or anus using a flexible endoscope. This procedure is called
natural orifice transluminal endoscopic surgery (NOTES) (Cianchetti et al.,
2018). In MIS, single-port surgery and NOTES, reachability of the target
organ can be a crucial issue. Indeed, the instruments clash during the oper-
ation, which increases the overall complexity of the procedure. Redesigning
the instruments is an imperative measure in order to make this emerging
operative method safe and reproducible. Fig. 13 describes the latest surgical
approaches.
Nowadays robot-assisted surgery is used in many clinical sub-domains of
surgery, for example, neurosurgery, orthopedic surgery, throat surgery,
abdominal surgery/laparoscopy, radio surgery, and so on. Some of these
sub-domains are shown in Fig. 14. The main clinical applications of surgical
robots and related clinical needs, technical requirements, and normativity in