Surgical Robot - Virginia Tech

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Surgical Robot“Will AI driven robot replace a surgeon?”In K. Mun, PhDMedical Robotic Research, LLCc: 1 (305) 582-7221, e: ikm1@aol.com

Surgical Robots

Surgical Robot Functional Type Passive:ooo Active:ooo Robot / navigational tool to support a manual surgical approachSurgical approach based on 2D images and/or video imagesDecision making: Surgeon CentricRobot to support a pre-defined surgical planSurgical plan based on 2D/3D imagesDecision making: Surgical plan centric under surgeon’s supervisionIntelligent:oooRobot to support an AI-driven surgical planSurgical plan based on AI processed 2D/3D images and sensorsDecision making: AI-driven process with quality control

Surgical Robot Clinical Applications Radio-SurgeryoUnity (Elekta) Semi-Active Robotics (Radio-surgery Planning)MR-Linac, targeting based on 1.5T MR imagesImprove outcome without breaking skin Soft TissueoDa Vinci (Intuitive Surgical) Passive Robotics (Tele-presence)Surgical Planning with endoscope & video imagingImprove outcome Hard TissueoMako (Stryker) Passive / Semi-Active Robot (Surgical guidance)Surgeon centric decision making based on the surgical planImprove outcome

Radio-Surgery Robot Radiation Treatment SystemsoSeveral products from Varian, Elekta, Treatment planning system based on CT & MRI imagesMultiple treatmentsRadio-SurgeryooooGammaKnife (Elekta) Single treatment for cranial tumors Few treatments Few treatmentSelf-shielded Few treatmentMR-Linac, targeting based on real time MR imagesCyberKnife (Accuray)Zap-X (Zap Surgical)Unity (Elekta)CBCT1.5T MRQuantitative 1.5T MR

Soft Tissue RobotDa VinciMonarch“flexible robotics”

Hard Tissue Robot: Before Surgery Patient Selection Selecting robotic surgery candidate 60 – 80% of cases Imaging CT / X-ray / US / MRI DICOM image Selecting imaging quality and coverage Surgical Planning Planning quickly & reproducibly Placing implant accurately Tool path avoiding critical structures

Hard Tissue Robot: During Surgery Registration of robot coordinate system with patient’s Matching surgical plan with patient anatomical structure Movement control (Navigation) Reducing relative motion Protecting critical structure Cut path avoiding critical structures Monitoring quality of incision / cutting Accuracy and reproducibility

Hard Tissue Robot: Validation Range of motion Managing quality of life Implant placement and alignment Placing implant accurately & reproducibly Infection management Preventing infection

Wish List Real-Time Visualization / Surgical Planning:oo Reproducibility & Precision:oo Reproducible surgical planDependable outcome: no surprisesNew Information:oo DICOM image to surgical plan: 45 min to under 2 minUpdating surgical plan: few secondsImproving knowledge base with new information.Real-time sensor inputManagement of Error:ooHow to identify singularity before it happens.How to learn from error

Thank you.In K. Mun, PhDe: imun@mroboticresearch.com,ikm1@aol.comc: 1 305-582-7221

o Robot / navigational tool to support a manual surgical approach o Surgical approach based on 2D images and/or video images o Decision making: Surgeon Centric Active: o Robot to support a pre -defined surgical plan o Surgical plan based on 2D/3D images o Decision making: Surgical plan centric under surgeon's supervision Intelligent:

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