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Biomedical Devices: Overview
Published in Jack Wong, Raymond K. Y. Tong, Handbook of Medical Device Regulatory Affairs in Asia, 2018
It is estimated that approximately 50,000 people died because of the human error [3]. From 2000 onward, robotics became a reality and began to be used in clinical procedures where extreme precision is critical. For example, a minor error in neurosurgery will lead to paralysis. NeuroArm combines MRI and a surgical robot to perform microsurgery and biopsy-stereotaxy with high precision [4].
Intervention: Nanotechnology in Reconstructive Intervention and Surgery
Published in Harry F. Tibbals, Medical Nanotechnology and Nanomedicine, 2017
Examples of robotic surgery systems include, among others, the following: The da Vinci, a widely used robotic surgical system, produced by Intuitive Surgical Incorporated with three or four arms for laparo-scopic surgery [132,133].The ZEUS system, integrated with the AESOP voice-controlled endoscopic camera and the HERMES platform for manipulating multiple instruments under voice control (Its developer, Computer Motion, merged with Intuitive in 2003, and the ZEUS is superseded by the da Vinci system) [134-136].The NeuroArm system developed at the University of Calgary (Advances include usability in MRI environments) [137].The Laprotek system produced by endoVia Medical, Inc. of Norwood, Massachusetts [138].The TraumaPOD, an advanced medical telerobot developed for military medicine sponsored by the United States Defense Department [139].The PathFinder (Prosurgics, United Kingdom), a robotic arm with six degrees of freedom designed to assist stereotaxic surgery [140].The Stereotaxis, Inc. Niobe electrophysiology magnetic guidance catheter system, integrated with the Webster Biosense and the Siemens AXIOM Artis navigation systems (which, unlike the previous examples, guides catheter tips rather than laparoscopic instruments) [141-143].Catheter Robotics for remote guidance of conventional catheters (tested at the University of chicago and used for atrial surgery at Leicester University and Glenfield Hospital Leicester, U.K.) [144].The Hansen Sensei system, which enables surgeons to guide special catheter tips (Artisan Extend catheters) mechanically from an ergonomic console, out of the x-ray imaging field, with navigation visualization [145].The VikY system, a small and easily deployable robotic holder for endoscopic surgery developed at CHU de Grenoble [146].The ARTEMIS system developed by the Eberhard Karls University, Tübingen [147].The TransPort endoscopic platform with ShapeLock locking overtube, with grasping tools for endoscopic surgery, developed by USGI Medical, San Capistrano, California [148].
Cerebral gliomas: Treatment, prognosis and palliative alternatives
Published in Progress in Palliative Care, 2018
Dharam Persaud-Sharma, Joseph Burns, Marien Govea, Sanaz Kashan
Surgical resection of gliomas has various advantages. Not only can an accurate diagnosis be made by direct biopsy of the tumor, but it also facilitates the use of adjuvant treatment options to prevent recurrence and prolong survival. Surgery usually begins with a craniotomy to access the brain. Patients are anaesthetized, intubated, and markers are placed before the head is shaved. Modern neurosurgical procedures are now implementing intraoperative imaging to more accurately resect tumors. Neuronavigation uses CT and/or MRI throughout surgery to assess any shifts in the position of the tumor. Neurosurgeons are able to see a three dimensional (3D) model of the tumor and change their surgical approach accordingly for the patient’s safety.11 5-Aminolevulinic acid is another method used by neurosurgeons to guide surgeries utilizing its fluorescence as a marker. Using violet-blue excitation light, neurosurgeons are able to detect the fluorescent margins of the tumor to assure safe resection.12 Moreover, new and improved robotics such as the NeuroArm© can be even more precise than a human hand when incising the margins of a tumor, further decreasing the possibility of damage to the surrounding tissues, thus protecting against neurological deficits.13
Cranial neurosurgical robotics
Published in British Journal of Neurosurgery, 2021
Rami Elsabeh, Sukhbir Singh, Jeff Shasho, Yoni Saltzman, John M. Abrahams
In developing a robot, if similar to the NeuRobot or Da Vinci, the size of the arm and accompanying camera pose a key problem in fitting the necessary robot into a small enough opening. The success of the da Vinci system is partly because there is enough volume to manipulate instruments within an insufflated abdomen. Visualization is a requirement in that the Neurosurgeon operator needs proper viewing at all times; current endoscopes would not suffice to satisfy said specifications. Furthermore, in the example of the NeuroArm, the requirement of having an intraoperative MRI (iMRI) has potentially slowed the incorporation of this robotic system. The slow adoption of the Neuroarm could be directly related to a slow adoption of the iMRI.
Data analytics interrogates robotic surgical performance using a microsurgery-specific haptic device
Published in Expert Review of Medical Devices, 2020
Amir Baghdadi, Hamidreza Hoshyarmanesh, Madeleine P. de Lotbiniere-Bassett, Seok Keon Choi, Sanju Lama, Garnette R. Sutherland
A number of commercially available haptic hand-controllers are available [16–19], however these were not developed specifically for microsurgery and therefore do not address microsurgery-specific requirements of force feedback, handpiece properties, workspace, dexterity, or manipulability [10]. One major branch of haptic devices is PHANToM family by 3D Systems (Rock Hill, South Carolina). The Premium™ models of this hand-controller have a serial kinematic design with a range of motion equivalent to human wrist, providing a large workspace, but lower forces compared to a parallel kinematic design [17]. Another family of haptic devices are available through Force Dimension (Nyon, Switzerland) including three classes of Omega, Delta, and Sigma. Sigma 7 as their most advanced product offers a high force feedback capability and relatively larger workspace among the parallel linkage designs [20]. Other commercially available haptic hand-controllers include HD2 High Definition by Quanser Inc. (Markham, Canada) with a dual phantom kinematic design, as the economic version of Omega with less positional resolution and force capacity, and Virtuose™ 6D by Haption, GmbH (Aachen, Germany) [19,21,22]. These devices can provide up to 6 degrees-of-freedom (DOF) with a variable workspace and force feedback capabilities. However, their general-purpose design makes them inefficient for a delicate medical application. HapticMaster by MOOG Inc. (New York, USA) has design specifications exclusive for rehabilitation applications due to high impedance characteristics and larger workspace, however with a lower DOF [18,19]. Freedom 7 is another medical-specific device by MPB Technologies Inc. (Pointe Claire, Canada) with low inertia, low friction, high position resolution, and wide dynamic range, however a very low maximum continuous force application [16,19]. In order to overcome the limitations of existing systems and determine the features of a hand-controller that optimize user performance in surgical applications, our research group compared the Sigma 7 (hereafter called Sigma7), HD2 High Definition and PHANToM Premium™ 3.0 (hereafter called Premium) haptic devices in micromanipulation surgical tasks on a common test rig [19]. Based on the quantifiable performance measures obtained in this study, and with the inclusion of additional microsurgery-specific design requirements, a unique haptic hand-controller, neuroArmPLUSHD, was designed and developed at Project neuroArm, University of Calgary[23–25].