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Robotics in Surgery - a virtual mini-symposium
31 July 2020
In the first of a series of virtual mini-symposia hosted by WEISS, researchers from across the world came together on 14 July to discuss novel research on robotics for surgery. The session was a great success, bringing together 165 attendees from 6 continents!
Prof. Ka-Wai Kwok (University of Hong Kong) began the session by discussing challenges in robotics for MRI-guided interventions. The benefits of MRI guided interventions include fast imaging with no radiation, high contrast images of soft tissue and detailed visualisation of physiological and pathological changes. However the MR environment can pose challenging for the surgeon, as not only do many screens have to be monitored, it is also extremely loud. Ka-Wai described how these challenges inspired the design of the first MR-compatible catheter robot for cardiovascular electrophysiology which is able to be teleoperated. He also discussed the development of a semi-automated robotic system for MRI-guided percutaneous needle procedures.
Dr Justin Collins (CMR Surgical) discussed the development of the Versius surgical robot. This robot is designed to be portable and transportable. Furthermore, as it is modular, the arms can be moved around individually for precise control. Because it mimics the dexterity and range of movement in the surgeon’s own hand and wrist, it’s flexible enough to handle a vast range of laparoscopic procedures.
Next, Prof Ferdinando Rodriguez y Baena (Imperial College London) delivered his talk on needle steering for precision neurosurgery. Recent trends in surgery have been leaning towards an increase in minimally invasive procedures rather than open surgery. One of the challenges associated with minimally invasive surgery in the brain relates to the fact that most instruments are straight, constraining surgery to a straight path from the entry point to the target tissue. Using a biologically inspired reciprocating mechanism approach (from the wood burrowing wasp) Ferdinando and colleagues developed a concept design with 4-stroke cyclic actuation which allowed for carriable steering and a curved trajectory. Furthermore, using reciprocal motion upon insertion results in reduced axial displacement. This exciting development could have important applications for localised drug delivery, in situ diagnostics and tumour laser ablation.
Dr Christos Bergeles (KCL) discussed the development of the first robotic prototype designed for optic nerve sheath fenestration. Optic nerve sheath fenestration is an invasive procedure which is done to reduce intercranial pressure in the brain (which can lead to brain damage and optic nerve damage). However, getting access to the optic nerve can be very difficult. Using concentric tube robots, Christos and colleagues were able to design a minimally invasive robot prototype to perform optic nerve sheath fenestration which was tested using an eye phantom designed from MRI scans in collaboration with the Royal College of Art.
Prof Jessica Burgner-Kahrs (University of Toronto) discussed her latest research into continuum robots for surgery. Continuum robot designs can traverse confined spaces, manipulate objects in complex environments, and therefore have potential applications for minimally invasive surgical interventions such as transnasal surgery. However, before translation into clinic, further questions need to be addressed related to tube design and control. Jessica discussed her latest research associated with these problems, including enforcing shape constraints, visual-servoing for tissue targeting, and her work into tendon-driven continuum robots.
Finally, Dr David Noonan (Auris Health) discussed the development of the Monarch Platform, a robotic assistant bronchoscope, all the way from concept to 510K submission. The three pillars of the system are reach (direct bronchoscopic access to peripheral nodules), vision (maintaining direct vision throughout the intervention) and control (micromovements for precise large targeting).
Keep your eye out for future WEISS mini-symposia!