Doctor Robot - the beginning of medical robotics
It doesn't have to be the specialist robot controlling Luke Skywalker's arm that we saw in Star Wars (1). It is enough for the car to keep company and perhaps entertain sick children in the hospital (2) - as in the ALIZ-E project funded by the European Union.
As part of this project, XNUMX Nao robotswho were hospitalized with children with diabetes. They are programmed for purely social functions, equipped with speech and facial recognition skills, as well as various didactic tasks related to information about diabetes, its course, symptoms and treatment methods.
Empathizing as fellow sufferers is a great idea, but reports are coming in from everywhere that robots are taking up real medical work in earnest. Among them, for example, Veebot, created by a California startup. His task is to take blood for analysis (3).
The device is equipped with an infrared "vision" system and aiming the camera at the corresponding vein. Once he finds it, he further examines it with an ultrasound to see if it fits in the needle cavity. If everything is in order, he sticks a needle and takes blood.
The whole procedure takes about a minute. Veebot's blood vessel selection accuracy is 83 percent. Little? A nurse doing this by hand has a similar result. In addition, Veebot is expected to exceed 90% by the time of clinical trials.
1. Robot Doctor from Star Wars
2. A robot that accompanies children in the hospital
They had to work in space.
building idea surgical robots etc. In the 80s and 90s, US NASA built intelligent operating rooms that were to be used as equipment for spacecraft and orbital bases participating in space exploration programs.
3. Veebot - a robot for collecting and analyzing blood
Although the programs closed, researchers at Intuitive Surgical continued to work on robotic surgery, with private companies funding their efforts. The result was da Vinci, first introduced in California in the late 90s.
But first the world's first surgical robot approved and approved for use in 1994 by the US Food and Drug Administration was the AESOP robotic system.
His job was to hold and stabilize cameras during minimally invasive surgeries. Next up was ZEUS, a three-armed, steerable robot used in laparoscopic surgery (4), very similar to the da Vinci robot that would come later.
In September 2001, while in New York, Jacques Maresco removed the gallbladder of a 68-year-old patient in a Strasbourg clinic using the ZEUS robotic surgical system.
Probably the most important advantage of ZEUS, like everyone else surgical robot, was the complete elimination of the effect of hand trembling, which even the most experienced and best surgeons in the world suffer from.
4. ZEUS robot and control station
The robot is accurate thanks to the use of an appropriate filter that eliminates vibrations at a frequency of about 6 Hz, which are typical for a human handshake. The aforementioned da Vinci (5) became famous in early 1998 when a French team performed the world's first single coronary bypass operation.
A few months later, mitral valve surgery was successfully performed, i.e. surgery inside the heart. For medicine at that time, this was an event comparable to the landing of the Pathfinder probe on the surface of Mars in 1997.
Da Vinci's four arms, ending in instruments, enter the patient's body through small incisions in the skin. The device is controlled by a surgeon sitting at the console, equipped with a technical vision system, thanks to which he views the operated site in three dimensions, in HD resolution, in natural colors and with a 10x magnification.
This advanced technique allows the complete removal of diseased tissue, especially those affected by cancer cells, as well as inspecting hard-to-reach places, such as the pelvis or base of the skull.
Other physicians can observe da Vinci's operations even in places thousands of miles away. This allows complex surgical procedures to be carried out using the knowledge of the most reputable specialists, without bringing them into the operating room.
Types of medical robots Surgical robots - their most important feature is increased accuracy and the associated reduced risk of error. Rehabilitation works - facilitate and support the life of people with permanent or temporary functional impairments (during the recovery period), as well as the disabled and the elderly.
The largest group is used for: diagnosis and rehabilitation (usually under the supervision of a therapist, and independently by the patient, mainly in telerehabilitation), changing positions and exercises in bed (robotic beds), improving mobility (robotic wheelchairs for the disabled and exoskeletons) care (robots), academic and work assistance (robot workspaces or robotic rooms), and therapy for certain cognitive disorders (therapeutic robots for children and the elderly).
Biorobots are a group of robots designed to mimic humans and animals that we use for cognitive purposes. An example is a Japanese educational robot used by future doctors to train in surgery. Robots that replace an assistant during an operation - their main application concerns the ability of the surgeon to control the position of the robotic camera, which provides a good "view" of the operated sites.
There is also a Polish robot
History medical robotics in Poland was started in 2000 by scientists from the Zabrze Cardiac Surgery Development Foundation, who were developing a prototype of the RobinHeart family of robots (6). They have a segmented structure that allows you to choose the right equipment for various operations.
The following models were created: RobinHeart 0, RobinHeart 1 - with an independent base and controlled by an industrial computer; RobinHeart 2 - attached to the operating table, with two brackets on which you can install surgical instruments or a viewing path with an endoscopic camera; RobinHeart mc2 and RobinHeart Vision are used to control the endoscope.
Initiator, coordinator, creator of assumptions, operations planning and many mechatronic project solutions. Polish surgical robot Robinhart was a doctor. Zbigniew Nawrat. Together with the late Prof. Zbigniew Religa was the godfather of all works carried out by specialists from Zabrze in consultation with academic centers and research institutes.
The group of designers, electronics, IT and mechanics who worked on RobinHeart were in constant consultation with the medical team to determine what fixes needed to be made to it.
“In January 2009, at the Center for Experimental Medicine of the Medical University of Silesia in Katowice, when treating animals, the robot easily performed all the tasks assigned to it. Currently, certificates are being issued for it.
6. Polish medical robot RobinHeart
When we find sponsors, it will go into series production,” said Zbigniew Nawrat from the Foundation for the Development of Cardiac Surgery in Zabrze. The Polish design has much in common with the American da Vinci - it allows you to create a 3D image in HD quality, eliminates hand trembling, and the instruments telescopically penetrate the patient.
RobinHeart is not controlled by special joysticks, like da Vinci's, but by buttons. One hand polish robot surgeon able to wield up to two tools, which, moreover, can be removed at any time, for example, to use them manually.
Unfortunately, the future of the first Polish surgical robot remains very uncertain. So far, there is only one mc2 that has not yet operated on a live patient. Cause? There are not enough investors.
Dr. Navrat has been looking for them for many years, but the introduction of RobinHeart robots in Polish hospitals requires about 40 million zł. Last December, a prototype of a lightweight, portable video-tracking robot for a wide range of clinical applications was unveiled: RobinHeart PortVisionAble.
Its construction was financed by the National Center for Research and Development, funds from the Fund for the Development of Cardiac Surgery and many sponsors. This year it is planned to release three models of the device. If the Ethics Committee agrees to use them in a clinical experiment, they will be tested in a hospital environment.
Not only surgery
In the beginning, we mentioned robots working with children in the hospital and collecting blood. Medicine could find more "social" uses for these machines.
An example is robot speech therapist Bandit, created at the University of Southern California, is designed to support therapy for children with autism. It looks like a toy that is designed to facilitate contact with the sick.
7. Robot Clara dressed as a nurse
There are two cameras in its “eyes”, and thanks to the installed infrared sensors, the robot, moving on two wheels, is able to determine the position of the child and take appropriate actions.
By default, he tries to approach the little patient first, but when he runs away, he stops and gestures him to the approach.
Typically, children will approach the robot and form a bond with it due to its ability to express emotions with “facial expressions”.
This allows children to get involved in the game, and the presence of the robot also facilitates social interactions such as conversation. The robot's cameras also allow recording of the child's behavior, supporting the therapy provided by the doctor.
Rehabilitation work providing accuracy and repeatability, they allow exercises to be performed on patients with less involvement of therapists, which can reduce costs and increase the number of people undergoing treatment (the supported exoskeleton is considered one of the most advanced forms of rehabilitation robot).
In addition, accuracy, unattainable for a person, makes it possible to reduce the rehabilitation period due to greater efficiency. usage rehabilitation robots however, supervision by therapists is required to ensure safety. Patients often do not notice too much pain during exercise, mistakenly believing that, for example, a higher dose of exercise leads to faster results.
Excessive sensation of pain is likely to be quickly noticed by the traditional therapy provider, as is exercise that is too light. It is also necessary to provide the possibility of an emergency interruption of rehabilitation using a robot, for example, if the control algorithm fails.
Robot Clara (7), created by USC Interaction Lab. robot nurse. It moves along predetermined routes, detecting obstacles. Patients are recognized by scanning codes placed next to the beds. The robot displays pre-recorded instructions for rehabilitation exercises.
Communication for diagnostic purposes with the patient occurs through the answers "yes" or "no". The robot is intended for people after cardiac procedures who need to perform spirometry exercises up to 10 times per hour for several days. It was also created in Poland. rehabilitation robot.
It was developed by Michal Mikulski, an employee of the Department of Control and Robotics of the Silesian University of Technology in Gliwice. The prototype was an exoskeleton - a device worn on the patient's hand, capable of analyzing and improving muscle function. However, it could only serve one patient and would be very expensive.
Scientists decided to create a cheaper stationary robot that could help in the rehabilitation of any part of the body. However, with all the enthusiasm for robotics, it is worth remembering that the use of robots in medicine it is strewn not only with roses. In surgery, for example, this is associated with significant costs.
The procedure using the da Vinci system, located in Poland, costs about 15-30 thousand. PLN, and after ten procedures you need to buy a new set of tools. NHF does not reimburse the costs of operations performed on this equipment in the amount of approximately PLN 9 million.
It also has the disadvantage of increasing the time required for the procedure, which means that the patient must remain under anesthesia for longer and be connected to artificial circulation (in the case of heart surgery).
