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Robot Assisted Cardiac Surgery Course: Cardiovascular Imaging Submitted by: Alper Yaman Instructor: Assoc. Prof. Dr. Cengizhan Öztürk
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What is robot assisted surgery? Application of computer assisted robotics to enhance surgeon’s capability to carry out various “minimally invasive” surgical procedures.
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The advantages of robotic surgery Faster, easier and steadier surgery More accuracy Enhanced visualisation, zooming Minimally invasive [1].
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The advantages of robotic surgery 2 Less pain to patient Shorter recovery time Shorter hospital stays [1]
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Robot Assisted Surgery Approach Perception & imaging by sensors and cameras to monitor the heart
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Robot Assisted Surgery Approach 2 Arms and wrists for clamping, suturing, and severing. Control Panel
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Technical Information Registration Preoperative images (CT or MRI) are registered both to stabilize target point images on the monitor and to guide the manipulators [2]. Imaging Fast video cameras are used to obtain operative images.
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Technical Information 2 Robot Positioning Optimal position of the robot should be provided concerning with degrees of freedom of the manipulator [2].
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Technical Information 3 Port Placement: Entry points are selected by images on the port. Robot is registered to the patient. Ports are expressed in the robot coordinate frame and used to guide the surgeon [2].
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Heart Beat Synchronization “Motion Cancelling Robot System” Visual Synchronization: Provides stabilized target point images on the monitor. Motion Synchronization: The slave robot is synchronized with the heart beat. Master – Slave Control: Transfers the master motion to control the slave robot [3].
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Heart Beat Synchronization “Motion Cancelling Robot System” [3]
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Haptics and Augmented Reality Haptics Applying tactile sensation and control to interaction with computer applications. Augmented Reality Computer graphics are superimposed or composited with real images.
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Haptic Virtual Fixtures Software-generated force and position signals applied to human operators. To improve the safety, accuracy, and speed of manipulation tasks. Integrates robots accuracy and precision with human intelligence [4].
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Haptic Virtual Fixtures 2 Guidance Virtual Fixtures: guides the robot along desired paths (a). Forbidden-Region Virtual Fixtures: Keep the robot out of forbidden regions (b). [4] [4]
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An example to robots “Da Vinci Surgical System” Intuitive nature of the surgeon’s hand movements Components: A surgeon console Patient-side cart Instruments Image processing equipment
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An example to robots “Da Vinci Surgical System” 2 Benefits For The Surgeon: Improved dexterity Enhanced 3D visualisation and magnification Greater surgical precision Increased range of motion Better ergonomics
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An example to robots “Da Vinci Surgical System” 3 Robotic articulated instrumentation daVinci prototype 1997 [5]
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An example to robots Leipzig 1998 [5]
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Current Operations with daVinci Atrial septal defect closure Internal thoracic artery take-down Endoscopic coronary bypass LV bipolar pacing lead placement Mitral valve repairment and replacement Ablation of atrial fibrillation [5]
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Current Operations with daVinci 2 [5]
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Current Operations with daVinci 3 [5]
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Transmyocardial Revascularization Laser is used to open tiny holes (transmyocardial channels) on myocardium. Angiogenesis: Laser stimulates new blood vessels to grow. Channels heal on the outside but remain open on the inside. [6]
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Transmyocardial Revascularization 2 [6]
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Results and Discussion Robot assisted cardiac surgery is combining various disciplines: robotics, computer vision and biomedical engineering. It’s advantages are: Faster, easier and steadier surgery More accuracy Enhanced visualisation, zooming Minimally invasive Less pain to patient Shorter recovery time Shorter hospital stays
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References 1. E. Adams, Bibliography: Robotic Surgery, Technology Assessment Program, Office of Patient Care Services, Boston, March 2004. 2. `E. Coste-Mani`ere and L. Adhami. Optimal Planning of Robotically Assisted Heart Surgery: Transfer Precision in the Operating Room. The International Journal of Robotics Research, Vol. 23, No. 4-5, 539-548 (2004). 3. Y. Nakamura, K. Kishi, and H. Kawakami. Heartbeat Synchronization for Robotic Cardiac Surgery. Proc. of the IEEE. International Conf. On Robotics&Automation, pp. 2014-2019, 2001. 4. J. J. Abbott, P. Marayong, and A. M. Okamura, "Haptic Virtual Fixtures for Robot-Assisted Manipulation," 12th International Symposium of Robotics Research, 2005. (accepted).Haptic Virtual Fixtures for Robot-Assisted Manipulation 5. W. R. Chitwood. Robotic Cardiac Surgery. 90th Annual Clinical Congress, American College of Surgeons, New Orleans, 2004. 6. Cleveland Clinic Heart Center web page, http://www.clevelandclinic.org/heartcenter/pub/guide/disease/cad/TM R.htm
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Thank you for your attention!
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