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Robots in Medicine: Past, Present and Future

International Journal of Manufacturing, Materials, and Mechanical Engineering

October 2017
7(4):44-64

DOI:10.4018/IJMMME.2017100104

Authors:

M V A Raju Bahubalendruni

National Institute of Technology Puducherry

Robots are wide across used in several industrial applications. Robot applications are more found in medical industry in recent days. In initial days, robots were mostly used for simple surgeries and medical applications such as laparoscopic surgery and minimally invasive surgery in 1980's. At that time robotic surgeries were performed with the presence of surgeons in operation theatre. The present day technology has been so much advanced with more enhanced capabilities to perform several complicated tasks such as remote surgery and micro robotic surgery. The current paper discuss about the history and evolution of robots in medical industry and their latest technological advances, applications in various fields in medicine and limitations of robots in medical industry along with its future scope.

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DOI: 10.4018/IJMMME.2017100104



Volume 7 • Issue 4 • October-December 2017





Hruday Kasina, GMR Institute of Technology, Rajam, India

M. V. A. Raju Bahubalendruni, GMR Institute of Technology, Rajam, India

Rahul Botcha, GMR Institute of Technology, Rajam, India



Robots are wide across used in several industrial applications. Robot applications are more found

in medical industry in recent days. In initial days, robots were mostly used for simple surgeries and

medical applications such as laparoscopic surgery and minimally invasive surgery in 1980’s. At

that time robotic surgeries were performed with the presence of surgeons in operation theatre. The

present day technology has been so much advanced with more enhanced capabilities to perform

several complicated tasks such as remote surgery and micro robotic surgery. The current paper

discuss about the history and evolution of robots in medical industry and their latest technological

advances, applications in various fields in medicine and limitations of robots in medical industry

along with its future scope.



CASPAR, Cyber Knife, General Laparoscopy, Intra Corporal Systems, MINERVA, Minimally Invasive Surgery,

Prosthetic, Radiology, RoboCouch, Synergistic, Transurethral Resection, Unicndylar Knee



In present days, robots have occupied major stake in engineering applications. The first robot

“UNIMATE” was introduced by George Devol in the year 1954. It is used in production and

manufacturing (Camarillo et al., 2004). Robots were first introduced in medical industry in early

1980’s. Based on the role of the robot, they can be classified as active, passive, synergistic, semi-

active and intra corporal systems (Smith-Guerin et al.,2008). The active robots play significant role

in medical industry than other classification due to their flexibility and adaptability.

Robots in medical industry are used for various applications such as diagnosis, support actions

during the surgeries and to perform complicated surgeries (Susilo et al., 2009; Zhao et al., 2015;

Gomes, 2011; Hockstein et al., 2007).

Robots have been introduced in orthopedics to help the patients to recover from physical disorders

(Napper and Seaman, 1989; Xiong et al., 2009). Due to the reason that the medical tasks performed

by robot are high accurate and thus leads to low human error.

The master slave robot configuration enables the surgery, even though the surgeon is far from the

location of the patient (Schmidt et al., 2014; Bloss, 2012; Lee et al., 2015). The application of robots

Volume 7 • Issue 4 • October-December 2017

in treating surgery of tumor offers greater accuracy and flexibility (Bogue, 2011). This enables the

doctors or radio specialists to minimize interaction with radioactive environment.

Even though the robots have reached to the greater heights, there exist certain limitations across

each medical specialization. The next chapters discuss about classification of robots in medicine,

history and evolution of medical robots, capabilities and their enhancement along with limitations.



Robots used in medicine are classified into five types according to their actuation and applications

(Smith-Guerin et al., 2008). Figure 1 shows tree of robot for each category represents the classification

of robots and an example.



These are the robots actuated by human operator (Smith-Guerin et al., 2008). The information about

the position of the tool relative to the pre-planned data is displayed to the surgeon. The execution

of the surgical action is completely performed by the surgeon (Mosges et al., 1989; Lavallee et al.,

1994). Dynamic walking robot and AESOP endoscopic positioner are examples for passive robots

(Smith-Guerin et al., 2008; Collins et al., 2001).

Automated Endoscopic System for Optimal Positioning (AESOP) represented in Figure 2 is a

voice controlled robot which is used to position an endoscope (Stoianovici, 2000). It was developed by

Defense Advanced Research Projects Agency (DARPA), Computer Motion Inc. in 1989 and received

FDA clearance in 1994 (Hockstein et al., 2007; Unger et al., 1994). It consists of motorized joints

where the surgeon controls it with foot and hand (Kavoussi et al., 1994). It also consists of Hermes

Voice-activation to control it with few simple voice commands (Ballantyne, 2002). It does not perform

any invasive manipulation rather it is used only for endoscopy purpose (Camarillo et al., 2004).



These types of robots are completely actuated where interaction between the robot and the surgeon

is very minimal (Smith-Guerin et al., 2008). The main purpose of the robot is to hold a sensor or

a surgical tool or to machine the bone without any involvement of the human operator (Paul et al.,

1992). It can perform tasks without any human interaction. Laparoscopic camera holders, Tele-

manipulators, Da Vinci surgical system, Zeus surgical systems, ROBODOC, CASPAR, cyber knife

are some of the examples of active robots.

CASPAR (Computer Assisted Surgical Planning and Robotic system) is used for complete knee

and hip replacement, the technology followed in this is very much advanced, which reduces the role

of the surgeon, with the help of CASPAR the surgeon performs the operation through 3D visualization

Figure 1. Classification of robots in medicine

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Article

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COMPUT MED IMAG GRAP

We present a general framework for analysis of wireless Capsule Endoscopy (CE) studies. The current available workstations provide a time-consuming and labor-intense work-flow for clinicians which requires the inspection of the full-length video. The development of a Computer-Aided Diagnosis (CAD) CE workstation will have a great potential to reduce the diagnostic time and improve the accuracy of assessment. We propose a general framework based on Hidden Markov Models (HMM) for study synopsis that forms the computational engine of our CAD workstation. Color, edge and texture features are first extracted and analyzed by a Support Vector Machine classifier, and then encoded as the observations for the HMM, uniquely combining the temporal information during the assessment. Experiments were performed on 13 full-length CE studies, instead of selected images previously reported. The results (e.g. 0.933 accuracy with 0.933 recall for detection of polyps) show that our framework achieved promising performance for multiple classification. We also report the patient-level CAD assessment of complete CE studies for multiple abnormalities, and the patient-level validation demonstrates the effectiveness and robustness of our methods.

Robot-assisted gait rehabilitation: From exoskeletons to gait systems

Conference Paper

Aug 2011

K.H. Low

In recent years, robotic technologies have been applied to build assistive robots, such as robotic exoskeletons and rehabilitation robots. Based on the clinical considerations, new trends of rehabilitation, like over-ground rehabilitation robots and home-based mobile rehabilitation robots, have emerged by combining both the knowledge from the exoskeleton and the rehabilitation robots. In this article, we review some of the important assistive and rehabilitation robots, in terms of their hardware, actuation, sensory and controls systems. The paper ends with a discussion on the future trends of the rehabilitation robots, especially on clinical-based considerations.

Robots in Medicine: Past, Present and Future

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