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Authors, filmmakers, and television programs have given us visions of robots serving humanity for most of the past 100 years. Some of the most iconic fictional ones include the benevolent Robby in the 1956 movie “Forbidden Planet,” the chatty C-3PO from all six of the “Star Wars” films, and the humanoid Commander Data from “Star Trek: The Next Generation” – sentient beings that can freely move, converse, and even reason. Actual robot technology has not reached that level yet, but continues to make rapid advances in the military, security, manufacturing, and healthcare fields. This year alone has seen many new medical applications. This overview article will examine some of the newest uses of medical robotics alongside some now-standard uses.

A Little History

Fig. 1 – Paro, the robotic seal, is marketed as a therapeutic companion robot for those with cognitive disorders.
As the world’s population ages, medical and home health groups seek new ways to address the issue. A new sciencefiction film opened in late August called “Robot & Frank,” introducing a household healthcare robot to help keep tabs on, and to improve the physical and mental health of an elderly man.

A similar, although far more primitive, mobile robotic assistant for the elderly was created in 1999 by a multi-disciplinary, multi-university project with researchers from the University of Pittsburgh, the University of Michigan, Ann Arbor, and Carnegie Mellon University, Pittsburgh, PA, who call their mobile robot a “Nursebot.” The in-homeuse Nursebot had two primary functions: reminding people about such daily activities as eating, drinking, taking medicine, and using the bathroom; and guiding them through their environments.

A different non-mobile elderly companion robot was developed by researchers at The National Institute of Advanced Industrial Science and Technology (AIST), Kimura Clinic, and Brain Functions Laboratory in Japan. Called Paro, it’s a cute and cuddly therapeutic baby harp seal-shaped companion for those with cognitive disorders, such as Alzheimer’s. (See Figure 1) The current Paro, which responds with movement and sound to human interaction, is the eighth generation of a design that has been in use in Japan since 2003. By reacting to voice, it motivates people to remain communicative. Paro is marketed within Japan and the US.

Robot-Assisted Surgery Continues to Expand

Fig. 2 – The da Vinci Si surgical system with Single-Site™ instrumentation in docked position. © 2012 Intuitive Surgical, Inc.
In the surgical arena, the da Vinci® surgical system has been assisting surgeons since 1999, when it was introduced by Intuitive Surgical, Inc., Sunnyvale, CA. The system enables surgeons to create minimally invasive incisions allowing for shorter surgeries, especially coronary, urological, colorectal, and gynecological surgeries. (See Figure 2)

The system consists of a cart with four interactive robotic arms controlled by a surgeon seated at a console. Three arms hold tools and act as electrocautery instruments as well as scalpel and scissors. The fourth arm is equipped with an endoscopic camera, which give the surgeon a full vision of what he or she is operating on from the console. The latest system, the Si, released in 2009, has dual console controls, allowing two surgeons to work collaboratively or for train ing new surgeons.

The original prototype for the da Vinci System was developed in the late 1980s at the former Stanford Research Institute with grant support from the U.S. Army and NASA. Today, more than 1,840 da Vinci systems are installed in more than 1,450 hospitals worldwide. See a video of the system in use at http://www.techbriefs.com/tv/davincigrape.

Fig. 3 – The CorPath 200 System is operated by a surgeon from a control console in a radiationshielded cockpit.
A new surgical robot-assisted system was approved in July 2012. The CorPath 200 System, developed by Corindus Vascular Robots, Natick, MA, received FDA 510(k) clearance to be used to assist interventional cardiologists in performing percutaneous coronary interventions, a procedure to restore blood flow to blocked arteries in patients with coronary artery disease.

In a traditional operation, the surgeon would need to wear a heavy lead apron for protection from the high radiation present in the cath lab, which could lead to back strain and potential radiation exposure. The CorPath 200 System, shown in Figure 3, consists of a robotic drive and single-use cassette mounted on an articulating arm attached to the cath lab patient table. The physician control console is located in a separate radiation-shielded cockpit and allows the physician to precisely control the coronary guidewires and stent/balloon catheters using simple touch-screen and joystick controls. Since the cockpit is shielded, the cardiologist sits in comfort. A video of the CorPath system can be seen at http://www.techbriefs.com/tv/corpathsystem. In August, Royal Philips Electronics, Amsterdam, the Netherlands, signed an agreement to be the exclusive distributor of the CorPath 200.

In the past few years, robotic systems for orthopedic surgeries have sprung up as well. In 2009, Mako Surgical Corp., Ft. Lauderdale, FL, introduced its RIO™ Robotic Arm Interactive Orthopedic System to make bone and tissue sparing partial knee resurfacing available to a growing population of patients with early to mid-stage osteoarthritis of the knee — a less invasive treatment option than total knee replacement. MAKO’s robotic arm system is the first FDAcleared robotic arm system for orthopedic surgery.

The following year, Omnilife science Inc., East Taunton, MA, acquired Praxim’s APEX surgical robot for total knee replacement. This robotic system allows intra-operative customization to accurately place the knee implant. It uses patented technology that creates a precise virtual 3D model of the patient’s anatomy, and provides ideal positioning of an automated bone-cutting guide for leg alignment.

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