Innovative Robotic-Assisted Surgical Systems

More compact, more flexibility, and more precision - these are the main characteristics developers strive for as they advance robotic-assisted surgical systems for the operating room. Several technology providers have already shown how it’s done, including the makers of the popular daVinci Surgical System. Yet for robotic-assisted systems, the sky is the limit.

Besides the well-known daVinci Surgical System, the market offers an increasing number of alternatives, designed to perform robotic surgery. Intuitive Surgical is the maker of the daVinci Surgical System, a robotic-assisted technology that is primarily used for minimally invasive surgical procedures in urology and gynecology. For quite some time, the daVinci Surgical System has had the business to itself and was able to see an increasing number of users and continued technological advancement as a result. Yet at this point, the system’s long-held monopoly is about to end as other systems are making their way into the surgical realm, including the Senhance Surgical Robotic System. The Senhance System by TransEnterix is a robotic system that functions with standard reusable instruments. It is primarily being used in oncology and cancer surgery.

Robotic systems are frequently used in endoscopy or to assist interventions that use miniaturized cutting and gripping tools. Robots filter and suppress the surgeon's tremors during surgery, a key advantage of robotic technology.

For most applications, robots must be able to perceive their environment at a certain level. Apart from sensors, the technology also hinges on complex algorithms. Artificial intelligence also plays a key role in creating the conditions necessary for the use of robotic-assisted surgical systems. Advancements in surgical robotics are only possible when technology, machine learning, and the human aspect (the surgeon) interact perfectly together.

The rise of scenarios in which robotics can assist in the operating room also prompted an increase in technology development. Next to the widely used sensors that help increase precision thanks to acoustics or infrared cameras, there are new transmission systems. "Force Feedback" makes tactile feedback in robotic surgery possible. The German Research Foundation (DFG) -funded project "Tactile Displays for Virtual Reality Applications" already uses a prototype for its research. It has an electronically controllable tactile display and a custom-built mouse. The system allows users to virtually touch various surfaces. The technology opens up new research possibilities for robotics, remote surgery (telesurgery), and virtual reality (VR) applications.

The project titled "Fully actuated electromagnetic bending actuator for endoscopic applications" studies how different aspects from nature can be integrated into endoscopy to improve robotic-assisted surgeries. Endoscopes that resemble a snake in appearance can be used both in medicine and in industry, enabling improved applications thanks to controllable electromagnets.

Added to this are robotic systems composed of soft materials, such as silicones that promise increased flexibility. This setting includes soft (- material) robotics, which, thanks to their softness and moldability, facilitate increased flexibility in surgical interventions and are less damaging to tissue.

Tubular continuum robots offer innovative solutions for minimally invasive surgery. In the future, they could help remove tumors in hard-to-reach regions like the pituitary gland. Medical experts at the Hannover Medical School and the International Neuroscience Institute have already started to develop solutions in this area. Tubular continuum robots can also be beneficial for other types of minimally invasive surgery.

Surgeons are limited in the ways they can insert cochlear implants. It’s not always possible to achieve the exact placement and ensure the best hearing result. Inserting the implant into the cochlea without lateral wall contact is a very complex surgical procedure. Robotic-assisted technology might support the surgeon in this difficult task in the future. The Continuum Robots for Surgical Systems (CROSS) Faculty of Mechanical Engineering at Leibniz University Hannover tested the procedure and filed a patent application.

The Institute of Mechatronic Systems at the Leibniz University Hannover promotes the research branch of transluminal endoscopic surgery with its work in vocal cord surgery and diagnosis. The EU project μRALP, which was completed in 2015, continued research in this area and aimed to improve this surgical process by creating a mechatronic assistance system.

There is an ongoing trend toward even smaller diameters and increased flexibility, while combining the different tools for gripping and cutting in one system at the same time. Find out what it takes to use robotic systems successfully in the operating room and learn about the remaining stumbling blocks in our Topic of the Month.