INDUS COLLEGE OF ENGINEERING

KALIMANGALAM, ALANDURAI COIMBATORE

DEPARTMENT OF ELECTRICAL & ELECTRONICS ENGINEERING

ROBOTIC SURGICAL SYSTEMS USING VR-GUIDED NEUROARM WITH PRE-TOUCH TECHNOLOGY:

CREATED BY,

M.MOHAN RAJ. EMAIL:[email protected] Contact number:9629158849

V.SHIVA PRAKASH. EMAIL:[email protected] Contact number:9600573872

ABSTRACT:
Advances in MIS(Minimally Invasive Surgery),particularly in neurosurgery have paralleled technological developmentparticularly in terms of lesion localization and microsurgical techniquefor many years. Incorporating robotic technology into the surgical imaging environment couples the human ability to predict based on past experience with the increased precision and accuracy of machines.It takes surgery beyond the limits of the human hand, to quote Intuitive Surgical, maker of the endoscopic da Vinci instrument, the most widely used surgical robotic system.But while da Vinci has had tremendous success in urologic surgery (particularly for prostate cancer removal) among other areas, such existing systems are not ideal for neurosurgery. Ideally, a neurosurgical robotic system would integrate with installed imaging systems, including the ubiquitous magneticresonance (MR) imaging machines that have already been successfully integrated into the operating room.A different approach to robotic surgery, Neuroarm is not an endoscopic system, but rather an image-guided robotic system capable of both stereotaxy (biopsy) and microsurgery. In this paper,we detail the use of MRIaided Neuroarm enabled with electric field(EF) sensing for safer surgical procedures and avoiding fatal errors due to erroneous diagnostics by an ordinary neuro arm. When a conductive object comes near the sensors, the hand detects it, and an algorithm estimates the objects shape and position. This technology, called pretouch, incorporates the sensors into a robotic hand as well, allowing the end effectors to adjust to the size and shape of an object that they encounter. At present,this pre-touch technology finds its application in industrial field.In this paper we suggest the use of this technology in highly precise and delicate medical applications where even a slightly erroneous movement can prove fatal. KEYWORDS: MIS,Neurosurgery,Neuroarm,Electric Field Sensing Element.

INTRODUCTION:
NeuroArm is a surgical robot. It was specifically designed for neurosurgery and can perform both microsurgery and stereotaxy. It was designed to be image-guided and can perform procedures inside an MRI. NeuroArm includes two remote detachable manipulators on a mobile base, a workstation and a system control cabinet. For biopsy-stereotaxy, either the left or right arm is transferred to an extension board that attaches to the OR table. The procedure is performed with imageguidance, as MR images are acquired in near real-time. The end-effectors interface with surgical tools which are based on standard neurosurgical instruments. End-effectors are equipped with threedimensional force-sensors, providing the sense of touch. The surgeon seated at the workstation controls the robot using force feedback hand controllers. The workstation recreates the sight and sensation of microsurgery by displaying the surgical site and 3D MRI displays, with superimposed tools. NeuroArm enables remote manipulation of the surgical tools from a control room adjacent to the surgical suite. It was designed to function within the environment of a 1.5 tesla intraoperative MRI system. As

neuroArm is MR-compatible, stereotaxy can be performed inside the bore of the magnet with near real-time image guidance. NeuroArm possesses the dexterity to perform microsurgery, outside of the MRI system.Even though this system is far safer than all other MIS systems,the use of the EF enabled end effectors can avoid the fatalities that might occur due to the mere touch of the robotic arm in the case of very complex and delicate tissues.

NEUROARM:
NeuroArm was designed to take full advantage of the imaging environment provided by intraoperative MRI. The ability to couple near real-time, high resolution images to robotic technologies will provide the surgeon unprecedented image guidance, precision, accuracy and dexterity. MDA Engineers were immersed in the operating room to study typical tool and surgeon motions in order to use biomimicry for effective design of the computer-assisted surgical device. NeuroArm has been designed to replace the main neurosurgeon and can easily be moved. The OR environment, personnel, surgical rhythm and instrumentation remains unchanged. The surgeon, sitting at the workstation, is provided a rich visual, virtual environment

that recreates the sight, sound and touch of surgery. All components of the device and workstation are of the highest quality and were chosen to reproduce and enhance the surgical environment. Functions like tremor filtering and motion scaling were applied to increase precision and accuracy while functions like no-go zones and linear lock were applied to enhance safety. The system is incapable of fully independent movement and is at all times slaved to the surgeons movement. An automove from point A to point B (specified by the surgeon) can however be pre-recorded in advance but has to be activated by the operator. The neuroArm system is the first of its kind.

touch to a robot, it can sense the shape and size of unfamiliar objects at close range and react accordingly. By improving this close-range interaction, robots will be more useful in homes, able to bring an elderly person a glass of water. Each sensor consists of simple electrodes that can be made of copper and aluminum foil; in the case of a robotic hand, an electrode is at the tip of the thumb and each finger. When the researchers apply an oscillating voltage to the electrode in, say, the thumb, it creates an electric field that in turn induces a current in the electrodes of the fingers. When a conducting object--metal, or anything with water in it, such as an apple or a person--comes close to the sensors, it reduces the induced current in

PRE-TOUCH TECHNOLOGY IN ROBOTIC ARMS:

The pre-touch technology is the idea of using Electric Field sensors to sense the objects and sizing them up without even touching them.Incorporating this technology into robots or robotic arms help them to size up objects and people they encounter. This type of EF sensing robotic arm is currently proposed to be used in industrial and domestic scenario.Currently, robotic arms and hands routinely grab and hold objects on factory floors, where the uncertainty has been engineered away. By adding pre-

the fingers' electrodes. This change in the electric field is detected by the sensors. Specialized algorithms process the data and instruct the robotic fingers to move around the object appropriately.

Augmented reality
Augmented reality (AR) is a term for a live direct or indirect view of a physical real-world environment whose elements are merged with (or augmented by) virtual computer-generated imagery - creating a mixed reality. The augmentation is

conventionally in real-time and in semantic context with environmental elements, such as sports scores on TV during a match. With the help of advanced AR technology (e.g. adding computer vision and object recognition) the information about the surrounding real world of the user becomes interactive and digitally usable. Artificial information about the environment and the objects in it can be stored and retrieved as an information layer on top of the real world view. The term augmented reality is believed to have been coined in 1990 by Thomas Caudell, an employee of Boeing at the time. Augmented reality research explores the application of computer-generated imagery in live-video streams as a way to expand the real-world. Advanced research includes use of head-mounted displays and virtual retinal displays for visualization purposes, and construction of controlled environments containing any number of sensors and actuators. There are two commonly accepted definitions of Augmented Reality today. One was given by Ronald Azuma in 1997 . Azuma's definition says that Augmented Reality combines real and virtual

is interactive in real time is registered in 3D

Additionally Paul Milgram and Fumio Kishino defined Milgram's RealityVirtuality Continuum in 1994 . They describe a continuum that spans from the real environment to a pure virtual environment. In between there are Augmented Reality (closer to the real environment) and Augmented Virtuality (is closer to the virtual environment).

CONVENTIONAL MIS or ROBOTIC SURGERY:

Robotic surgery is a technique in which a surgeon performs surgery using a computer that remotely controls very small instruments attached to a robot. The

surgeon sits at a computer station nearby and directs the movements of a robot. Small instruments are attached to the robot's arms.The surgeon first inserts these instruments into your body through small surgical cuts. Under the surgeons direction, the robot matches the doctors hand movements to perform the procedure using the tiny instruments.A thin tube with a camera attached to the end of it (endoscope) allows the surgeon to view highly magnified three-dimensional images of your body on a monitor in real time. Robotic surgery is a type of procedure that is similar to laparoscopic surgery. It also can be performed through smaller surgical cuts than traditional open surgery. The small, precise movements that are possible with this type of surgery give it some advantages over standard endoscopic techniques. Sometimes robotic-assisted laparoscopy can allow a surgeon to perform a less-invasive procedure that was once only possible with more invasive open surgery. Once it is placed in the abdomen, a robotic arm is easier for the surgeon to use than the instruments in endoscopic surgery.The robot reduces the surgeons movements (for example, moving 1/2 inch for every 1 inch the surgeon moves), which reduces some of the hand tremors and movements that

might otherwise make the surgery less precise. Also, robotic instruments can access hard-to-reach areas of your body more easily through smaller incisions compared to traditional open and laparoscopic surgery. During robotic surgery, the surgeon can more easily see the area being operated on. The surgeon is also in a much more comfortable position and can move in a more natural way than during endoscopy. However, robotic surgery can take longer to perform, due to the amount of time required to set up the robot. In addition, the robot is expensive to use and may not be available in many hospitals.Robotic surgery may be used for a number of different procedures, including:

Coronary artery bypass Cutting away cancer tissue from sensitive parts of the body such as blood vessels, nerves, or important body organs

Gallbladder removal Hip replacement Hysterectomy Kidney removal Kidney transplant Mitral valve repair Pyeloplasty (surgery to correct ureteropelvic junction obstruction)

Pyloroplasty Radical prostatectomy Tubal ligation Robotic surgery cannot be

The existing Neuroarm can perform a number of complex neurosurgeries with higher degree of correctness.But in case of highly complex surgeries like those related to brain or the central nervous system,we need a much more efficient surgical system which can give more safety during surgery.Thus it can be achieved by replacing the 3 dimensional force sensors at the end effectors of the conventional Neuroarm with the Electric Field sensors which gives a pre-touch of the area where the surgery is to be performed.The EF sensors can sense the area ,here, the tissues or the tumourous growths and sizing them up without even touching them.This is highly beneficial in cases where the tissues or nerves needs to be cured by surgery are highly minute and are extremely delicate which may be damaged by the mere touch of the sensing element of the robotic arm. When a conducting object--metal, or anything with water (here the tissues or nerves)--comes close to the sensors, it reduces the induced current in the Neuroarm's electrodes. This change in the electric field is detected by the sensors. Specialized algorithms process the data and instruct the robotic fingers to move around the object appropriately. The

used for some complex procedures. For example, it is not appropriate for certain types of heart surgery that require greater ability to manipulate instruments in the patients chest.Thus for much complex neurosurgeries pertaining to the chest,brain or nervous system of the patient the highly efficient Neuroarm can be used.In this paper we detail the use of an advanced Neuroarm for neurosurgeries,which is modified to have a pre-touch of the area where the surgery needs to be performed.This is brought to reality using the Electric Field sensing elements attached to the Neuroarms end effectors or the surgical instruments attached to it.

ADVANCED NEUROARM WITH PRETOUCH:

surgeon who controls the arm through a computer interface can easily detect the malfunctioning nerves and can control the

arm to perform the necessary surgical actions through its small instruments.This technique reduces the risk in neurosurgeries to a great extent.

where the information regarding the further progress of the surgery will be displayed on the doctors computer. This provides the doctor with additional tips which increases the accuracy and safety to higher levels.

The following figure shows how the mixed reality is developed:

AUGMENTED REALITY IN SURGERY:

The doctor uses a computer which has all the pre defined medical terms and procedures regarding a surgery. The PRE TOUCH concept provides the necessary information regarding the cells to the doctor through the computer. These data are compared with the existing data in the data base and provides a mixed reality

CONCLUSION:
All advances in science and technology are mainly directed towards the betterment of man kind.Every advances in the medical field in the past has contributed to mans welfare and has helped to increase his lifespan. Even though human beings cannot be entirely excluded from performing a complex surgery as of now the effective use of man-machine interface can do wonders and save many a life.

REFERENCES:

Eichel L, McDougall EM, Clayman RV. Basics of laparoscopic urologic surgery. In: Wein AJ. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 7. Gomez G. Emerging technology in surgery: Informatics, electronics, robotics. In: Townsend CM, Beauchamp RD, Evers BM. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa:Saunders Elsevier;2007:chap 19. Lanfranco AR, Castellanos AE, Desai JP, Meyeres WC. Robotic surgery: A current perspective. Ann Surg. 2004;239:14-21. Oleynikov D. Robotic surgery. Surg Clin N Am. 2008;88:1121-1130