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Robotics in Cardiac Surgery: Basic Principles

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Atlas of Robotic Cardiac Surgery

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Abstract

The recent use of robotic surgical assistance has spawned an entirely new way of operating on many human systems. These devices provide the link to the least invasive cardiac operations, including coronary artery and mitral valve surgery. This chapter describes the evolution of robotic surgery as well as enabling robots in other areas of medicine. Moreover, the ergonomic aspects of complex surgical tele-manipulation systems are described in detail.

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Author information

Authors and Affiliations

  1. Department of Heart and Vascular Surgery, Clinic for Heart and Vascular Surgery, University of Zürich, Ramistrasse 100, Zürich, 8091, Switzerland

    Volkmar Falk MD, PhD

  2. Clinical Development Engineering, Product Development Department, Intuitive Surgical, Inc., 1266 Kifer Rd., Sunnyvale, CA, 94086, USA

    Hubert Stein BSc, MBE

Authors
  1. Volkmar Falk MD, PhD
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  2. Hubert Stein BSc, MBE
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Corresponding author

Correspondence to Volkmar Falk MD, PhD .

Editor information

Editors and Affiliations

  1. East Carolina Heart Institute, Greenville, North Carolina, USA

    W. Randolph Chitwood, Jr.

Appendix

Appendix

Accuracy: Accuracy is the degree of veracity. The closer a system’s measurements to the accepted value, the more accurate the system is considered to be.

Cartesian Coordinates: Cartesian Coordinates are used to define the kinematics of an object. In a Cartesian coordinate system the position of each joint can be mathematically described.

Degree of freedom: Degrees of freedom (DOF) are the set of independent displacements and/or rotations that specify the position and orientation of a body or system. A minimum of 6° of freedom is required for free orientation and position in 3-space.

Force Feed Back: Force Feed Back relates to one quality of haptics. It provides the operator with a sense of the force at the site of remote operation. Remote controlled telemanipulators reproduce some contact forces to the operator.

Haptics: Haptics refers to the sense of touch. Haptic or tactile feedback technology is used to provide an operator with a sense of touch by applying forces or other tactile qualities such as compliance, texture or temperature.

Hand-Eye-Alignment: The human operator usually works in the direction of his sight with good hand-eye alignment. When an endoscope is used and inserted at an angle different from the line of sight, the video-image used for visualization displays the environment from a different angle. Depending on the degree of hand-eye misalignment, operation becomes difficult. Telemanipulation systems can restore hand-eye-alignment by automatically compensating for scope angulation.

Kinematics: Kinematics describes the motion of objects without consideration of the causes leading to the motion. A robotic arm can be considered as a system of rigid bodies linked together by mechanical joints. The position of each point in such a kinematic chain can be described by Cartesian coordinates.

Mechatronics: The term mechatronics is best described as a combination of Computer Science, mechanical control and electrical engineering. A surgical telemanipulator can be seen as a mechatronic device.

Model guided Surgery: For model guided surgery an accurate model of the patient is usually created from different imaging sources. The region of interest is scanned and uploaded into the computer system. Datasets from different sources can be combined through data fusion techniques. The resulting dataset can then be used to render a 3D-model of anatomical structures. If a mechatronic system such as a surgical telemanipulator is to be used, for planning purposes a model of the system is also required. System/Patient interaction, Setup, path-planning can all be simulated in such model.

Navigation: Navigation Systems are used to follow a tool within an image. Reference points are needed to detect orientation and position of the patient and the tool in space. Navigation systems use infrared light sources, electromagnetic waves or other energy sources to detect the reference points in space.

Precision: precision is the degree of reproducibility.

Registration: Registration is a computational process to locate and orient preoperative imaging data with the position of the patient on the operating room table. As image data are usually acquired at different perspectives they relate to different coordinate systems. Image registration is the process of transforming the different sets of data into the same frame of reference (one coordinate system).

Remote center kinematics: Remote center kinematics are applied to limit motion of the tool at the entry point.

Segmentation: Segmentation refers to the process of partitioning a digital image into multiple segments (sets of pixels). Image segmentation is used to locate and visualize objects and boundaries in images. Depending on image source and quality and Segmentation is either performed manually or threshold based at various levels of automation.

Shared control: With shared-control systems, the operator performs the procedure with the use of a robot that offers steady-hand manipulations of the instrument. This is in contrast to supervisory-control systems that act autonomously with the operator observing.

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Falk, V., Stein, H. (2014). Robotics in Cardiac Surgery: Basic Principles. In: Chitwood, Jr., W. (eds) Atlas of Robotic Cardiac Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-6332-9_1

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  • DOI: https://doi.org/10.1007/978-1-4471-6332-9_1

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  • Online ISBN: 978-1-4471-6332-9

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