Surgical and interventional robotics - Core concepts, technology, and design

This article presents the first of a three-part tutorial on surgical and interventional robotics. The core concept is that a surgical robot couples information to action in the operating room or interventional suite. This leads to several potential benefits, including increased accuracy and the ability to intervene in areas that are not accessible with conventional instrumentation. We defined the categories of surgical CAD/CAM and surgical assistance. The former is intended to accurately execute a defined plan. The latter is focused on providing augmented capabilities to the physician, such as superhuman or auxiliary (additional) eyes and hands. These categories will be the focus of the final two parts of this tutorial. There are numerous challenges in surgical manipulation, sensing, registration, user interfaces, and system design. Many of these challenges result from the requirements for safety, sterility, small size, and adaptation to a relatively unstructured (and changing) environment. Some software toolkits are available to facilitate the design of surgical robotics systems. The design of a surgical robot should include a risk analysis. Established methodologies such as FMEA/FMECA can be used to identify potential hazards. Safety design should consider and eliminate single points of failure whenever possible. Validation of system performance is critical but is complicated by the difficulty of simulating realistic clinical conditions. Surgical robotics is a challenging field, but it is rewarding because the ultimate goal is to improve the health and quality of human life.