Robots lend a helping hand to surgeons

Robot-assisted surgery is the latest development in the larger movement of endoscopy, a type of minimally invasive surgery--the idea being that less invasive procedures translate into less trauma and pain for patients. Surgery through smaller incisions typically results in less scarring and faster recovery. It's not that robots are changing the basics of surgery. Surgeons are still cutting and sewing like they have been for decades. Robots represent a new computer-assisted tool that provides another way for surgeons to work.

Rather than cutting patients open, endoscopy allows surgeons to operate through small incisions by using an endoscope. This fiber optic instrument has a small video camera that gives doctors' a magnified internal. view of a surgical site on a television screen.

In abdominal endoscopy, known as laparoscopy, surgeons thread the fiber optic instrument into the abdomen. First performed in the late 1980s, laparoscopy is now routine for many procedures, such as surgery on the gallbladder and on female organs.

With robotic surgical systems, surgeons don't move endoscopic instruments directly with their hands. Instead, surgeons sit at a console several feet from the operating table and use joysticks similar to those used in video games. They perform surgical tasks by guiding the movement of the robotic arms in a process known as tele-manipulation.

The Food and Drug Administration reviews data on the safety and effectiveness of robotic software and hardware and requires manufacturers to implement training programs for surgeons. The FDA also monitors experimental uses for robotic applications, including clinical trials for robotic heart surgery. It's too soon to say for sure how far and how fast robotic surgery will grow, but experts say the future looks promising.

Two robotic surgical systems have received FDA clearance to be marketed in the United States: The da Vinci Surgical System,ZEUS robotic surgical system made by Intuitive Surgical, Inc. of Sunnyvale, Calif., is cleared to perform surgery under the direction of a surgeon. The , made by Computer Motion, Inc. of Goleta, Calif., has been cleared by the FDA to assist surgeons.

"[The] da Vinci is cleared to assist in advanced surgical techniques such as cutting and suturing [sewing]," says Neil Ogden, chief of the FDA's General Surgery Devices Branch in the Center for Devices and Radiologicai Health. "ZEUS is cleared to assist in grasping, holding, and moving things out of the way, but isn't cleared for cutting or suturing." Clinical trials on ZEUS are underway with the goal of obtaining FDA clearance to assist in the performance of advanced surgical tasks in the United States, according to Paul Nolan, senior director of customer training and education at Computer Motion.

The da Vinci Surgical System

In July 2000, the FDA cleared da Vinci as an endoscopic instrument control system for use in laparoscopic (abdominal) surgical procedures such as removal of the gallbladder and surgery for severe heartburn. In March 2001, the FDA cleared da Vinci for use in general non-cardiac thoracoscopic (inside the chest) surgical procedures--surgeries involving the lungs, esophagus, and the internal thoracic artery. This is also known as the internal mammary artery, a blood vessel inside the chest cavity. In coronary bypass surgery, surgeons detach the internal mammary artery and reroute it to a coronary artery. In June 2001, the FDA cleared da Vinci for use during laparascopic removal of the prostate (radical prostatectomy).

The da Vinci is intended to assist in the control of several endoscopic instruments, including rigid endoscopes, blunt and sharp dissectors, scissors, scalpels, and forceps. The system is cleared by the FDA to manipulate tissue by grasping, cutting, dissecting and suturing.

In use, a surgeon sits at a console several feet away from the operating table and manipulates the robot's surgical instruments. The robot has three hands attached to a free-standing cart. One arm holds a camera (endoscope) that has been passed into the patient through small openings. The surgeon operates the other two hands by inserting fingers into rings.

The arms use a technology called EndoWrist--flexible wrists that surgeons can bend and twist like human wrists. The surgeon uses hand movements and foot pedals to control the camera, adjust focus, and reposition the robotic arms. The da Vinci has a three-dimensional lens system, which magnifies the surgical field up to 15 times. Another surgeon stays beside the patient, adjusting the camera and instruments if needed.

There are 50 da Vinci systems placed in U.S. medical centers, 34 placed in Europe and five placed in Asia.

ZEUS Robotic Surgical System

The FDA cleared ZEUS in October 2001 to assist in the control of blunt dissectors, retractors, graspers, and stabilizers during laparoscopic and thoracoscopic surgeries.

ZEHS has three robotic arms that are mounted on the operating table. One robotic arm is called the Automated Endoscopic System for Optimal Positioning Robotic System (AESOP). AESOP is a voice-activated robot used to hold the endoscope. The FDA cleared AESOP to hold and position endoscopes in 1994, and voice activation was added later. ZEUS differs from the da Vinci system in that the AESOP part of ZEUS responds to voice commands. For example, a surgeon might say: "AESOP move right." The positioning arm then would move right until the "stop" command was given.

Social Impact
Given that in the next two decades robots will be capable of replacing humans in most manufacturing and service jobs, economic development will be primarily determined by the advancement of robotics. Given Japan's current strength in this field, it may well become the economic leader in the next 20 years. Marshall Brain also discusses the emergence of robotic economy.

Unfortunatly, due to Japan's shrinking population and poor government intervention plans, they will be completly unable to capitalize on their (shrinking) advantage in technology. India's vast advantage in the fields of technology, and Germany's massive amounts of capital will make them far larger powers then Japan.

Microsoft Robotics Studio

Microsoft is currently working to stabilize the fragmented robotics market with its new software Microsoft Robotics Studio.

Humanoid robots

Lara is the first humanoid robot with artificial muscles (metal alloy strands that instantly contract when heated by electric current) instead of electric motors (2006).

Asimo is one of the most advanced projects as of 2006.

Modular robots

• Utility fog.
• Scenario:Modular Robots. Modular robots can be built from standard building blocks that can be combined in different ways.
• M-Tran- a snake-like modular robot that uses genetic algorithms to evolve walking programs
• Self replicating robots - modular robots that can produce copies of themselves using existing blocks.
• Swarmanoid is a project that uses 3 specialized classes of robots (footbots, handbots and eyebots) to create an effective swarm. Such swarm should be able, for example, to tidy a bedroom with each robot doing what it is best at.

Police Robots

Being a police officer or a fireman is a dangerous job. They will be replaced by robots. Robot police officers will be sent to the scene of the crime to stop it. The police robots will know automatically who is committing the crime (city awareness grid electronic C.A.G.E). People are afraid of robots with guns. Guns will be illegal in the future. Police robots will only have non-lethal weapons.

Applications

• Caterpillar plans to develop remote controlled machines and expects to develop fully autonomous heavy robots by 2021. Some cranes already are remote controlled.
• It was demonstrated that a robot can perform a herding task.
• Robots are increasingly used in manufacturing (since 1960s). In auto industry they can amount for more than half of the "labor". There are even "lights off" factories such as an IBM keyboard manufacturing factory in Texas that are 100% automated.
• Robots such as HOSPI are used as couriers in hospitals, etc. Other hospital tasks performed by robots are receptionists, guides and porters (not to mention surgical robots such as Da Vinci)
• Robots can serve as waiters and cooks . Some fast-food restaurants do not have humans take orders; instead customers use touchscreens to order food

Military applications

As of 2006 there is a large robot development program in the US military. Ground robots and UAVs are already used in Iraq. Robotic border defenses are being developed in Korea, US and the EU.

It is likely that 20 or 30 years from now that the UN will make guns illegal in war because of newly developed non lethal weapons that cans be used by robots instead. (what's the point of having non lethal weapons in war??! that's not gonna do anything people, get a life!!!) Most of war in the future will take place in urban environments. The manufacturing of military robots that kill people will be considered a war crime. Unfortunatly, the UN's decreasing power and credibility, and their complete inability to outlaw WMDs so far will make this entirely meaningless. Countries that are non-compliant, such as China, North Korea, and several others scattered across the globe will continue undercover advanced weaponry programs. Of course, in the name of its own defense, the United States and the European Union will do the same, leading to a second arms race. It is also likely that robots with non lethal weapons will be rented or purchased by a country to keep the peace as law enforcers. Growing anarchist forces, particularly based in Greece and Eastern Europe will oppose these new robots and vandalism and citizen non-compliance will be a major issue.

The use of Robot Flys will revolutionize Urban combat.

See also War Technology.

Technical challenges

• hands & grips
• miniaturization

Timeline

Scenario:Robotics

Developments related to robotics from the NISTEP 2030 report:

• 2013-2014 — agricultural robots
• 2013-2017— robots that care for the elderly
• 2017— medicle robots performing low-invasive surgery
• 2017-2019 — household robots
• Unknown — Nanorobot US Department of Defense plans:
• 2015— to have one third of its fighting capacity provided by robots
• 2035 — to have first completely autonomous robot soldiers on the battlefield

Robotics in 2020

Robots will be commonplace: in home, factories, agriculture, building & construction, undersea, space, mining, hospitals and streets for repair, construction, maintenance, security, entertainment, companionship, care.

Purposes of these Robots:

• Robotized space vehicles and facilities
• Anthropomorphic general-purpose robots with hands like humans used for factory jobs - Intelligent robots for unmanned plants - totally automated factories will be commonplace.
• Robots for guiding blind people
• Robots for almost any job in home or hospital, including Robo-surgery.
• Housework robots for cleaning, washing etc - Domestic robots will be small, specialized and attractive, e.g. cuddly

Intelligent robots will be everywhere

Industrial robots

The vast majority of robots are used by the manufacturing industry, for repetitive tasks such as painting auto-bodies and simple assembly. Some 100,000 new robots were installed worldwide in 2000, nearly half of them in Japan, the biggest user. There were nearly 800,000 industrial robots in existence at the end of 2002 and this is likely to rise to almost 1 million by the end of 2004.

In the last decade the performance of robots has increased radically while at the same time prices have been plummeting. Today, manufacturing robots have a payback period as short as 1-2 years. In N. America, the price of robots relative to labor costs have fallen to 26, and as low as 12 if quality improvements are taken into consideration.


Sales of industrial robots have risen to record levels and there is huge, untapped potential for domestic chores like mowing lawns and vacuuming carpets.

New robot applications abound

As robot intelligence increases, and as sensors, actuators and operating mechanisms become more sophisticated, other applications are now multiplying. There are now thousands of underwater robots, demolition robots and even robots used in long-distance surgery. Dozens of experimental search-and-rescue robots scoured the wreckage of the World Trade Center's collapsed twin towers. Teams of robotics experts were at Ground Zero operating experimental robots to probe the rubble and locate bodies. During the war in Afghanistan, robots were being used by the US military as tools for combat. They were sent into caves, buildings or other dark areas ahead of troops to help prevent casualties.
After the recent anthrax scares, work has been ongoing to replace postal workers with robots. Indeed, there is huge potential to mechanize the U.S. postal service and some 1,000 robots were installed last year to sort parcels. The U.S. postal service has estimated that it has the potential to use up to 80,000 robots for sorting work, although existing models are not suitable for sorting letters.
A giant walking robot is used to harvests forests, moving on six articulated legs, advancing forward and backward, sideways and diagonally. It can also turn in place and step over obstacles.

At UC Berkeley, a tiny robot called Micromechanical Flying Insect has wings that flap with a rhythm and precision matched only by natural equivalents. The goal is to develop tiny, nimble devices that can, for example, surreptitiously spy on enemy troops, explore the surface of Mars or safely monitor dangerous chemical spills.

A big increase is predicted for domestic robots for vacuum cleaning and lawn mowing. Robots to do these chores are practical today. An inexpensive house-cleaning robot was recently introduced – a little battery-powered vacuum cleaner that scurries around the floor, sweeping up dust and dirt as it travels. Called Roomba, it costs just $199 and, by all accounts, is selling very well.

Rodney Brooks – iRobot

Roomba is made by Massachusetts-based iRobot, one of many companies planning to launch a host of new robots over the next few years. New robotics products that will soon be introduced include autonomous floor cleaners and industrial tools built to do boring, dirty and dangerous work like inspecting oil wells. Of course, autonomous oil well inspectors aren't as thrilling as the robotic servants that some visionaries have predicted. But robotics and artificial intelligence are working their way into everyday life, albeit in less dramatic ways.

Rodney Brooks, Director of the MIT Artificial Intelligence Laboratory and Chairman of iRobot Corporation, has been involved in this transformation for decades. His latest book "Flesh & Machines" explores many themes related to life with robots. The book centers on Brooks' own passion for creating what he calls "situated creatures" which we can eventually regard as our teachers and companions.

Brooks' MIT A.I. Lab is filled with robotic machines, from mechanical legs to humanoids that use human-like expressions and gestures as intuitive human-robot interfaces – something Brooks believes will be critical to people accepting robots in their lives. The first generation of relatively mundane versions of these machines is already marching out of the lab.
Rodney Brooks has a vision of a post-PC future in which sensors and microprocessors are wired into cars, offices and homes – and carried in shirt pockets to retrieve information, communicate and do various tasks through speech and gesture interfaces. He insists that the age of smart, mobile machines is already beginning. You just have to know where to find them – in oil wells, medical labs, financial services and construction companies.

Military & defense applications

Now iRobot has a US Defense contract to build a robot, about the size of a suitcase, which can climb stairs, crawl over ditches, survive three-story falls. Instead of carrying bombs, this robot has eyes and ears, transmitting what it sees and hears over a wireless link. This is a "Packbot" which can be thrown into a vehicle and then hurled through windows of buildings where the enemy may have hostages.

In general, robotic systems are of great interest to the Department of Defense because they offer the ability to perform military actions at greater stand-off distances, allow dangerous missions to be performed with minimal risk to people.

The Defense Advanced Research Projects Agency (DARPA) is the central research and development organization for the Dept. of Defense. The DARPA "Distributed Robotics Program" seeks to work with qualified companies to develop tiny, biologically-inspired robot designs and new methods of robot control for military applications. DARPA is particularly interested in micro-miniature robots because they can be produced at relatively low unit cost and offer unique mission advantages. They can be carried and deployed by individuals and small teams to augment human capability, perform hazardous missions, and accomplish tasks that previously could not be unimagined.

Potential applications include surveillance, reconnaissance, path finding, deception, weapon delivery, and small-scale actuation. For minefield detection, small sensors are mounted on hopping robots. Small robots can be sent into city pipelines for intelligence gathering. Robots used in large numbers can be used as decoys. Extremely small robots might be injected into small spaces to pick door locks.

Because micro robots are similar to small animals and insects, biologically inspired designs (jumping, climbing, crawling, slithering, etc.) coupled with the use of MEMS and smart materials offer possibilities for novel and unique locomotion mechanisms. MEMS technology enables the integration of mechanical and electronic functions on a single silicon chip. Advanced microelectronic packaging using multi-chip modules and incorporating mixed signal electronics allows development of new ideas, integrating robotic form and function.

Robots for military applications can either be fully controlled by humans, semi-autonomously controlled, or operate autonomously. To allow miniature robots to perform for extended periods of time in varied environments, innovative methods are needed to reduce power requirements, regulate energy use and provide rapid recharging.

Robotics – an exciting new development arena

The typical Automation techie has knowledge and experience in instruments, PLCs, computers, displays, controls, sensors, valves, actuators, data-transmission, wireless, networking, etc. These are exactly the key requirements for development of robots and robotic systems. During this time of economic recession, Robotics can surely be a new arena of exciting and rewarding business development.