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12 Advances In Medical Robotics

Jan 29, 2011 (01:01 AM EST)

Read the Original Article at http://www.informationweek.com/news/showArticle.jhtml?articleID=229100383


It resembles something from a Hollywood sci-fi movie, but Hybrid Assistive Limb 5, or HAL 5, as it is known, is an artificially powered ecoskeleton that helps double the amount of weight someone can carry unaided. Developed by Yoshiyuki Sankai, a professor at Tsukuba University of Japan, the invention is backed by venture capitalist firm Cyberdyne. Expanding beyond Japan, last year Odense University Hospital announced it would use HAL 5 for clinical trials on worker augmentation.

Hospitals may initially want to introduce robots to replace repetitive, necessary, and time-consuming tasks such as some pharmacy operations and pill dispensing. Some hospitals and specialists in remote care are using telepresence robots to deliver specialists to rural or under-served regions. Doctors are asking for surgical robots that eliminate large incisions, reduce patient pain, and minimize the need for more medication and longer hospital stays, allowing the person to return home and start therapy sooner. Simultaneously -- and not surprisingly -- patients want, if not demand, minimally invasive surgeries.

The medical community wants more. For example, physicians want more devices that perform their functions autonomously; they'd like to see automated scrub and circulating nurses; they encourage the implementation of tele-consulting solutions within the operating room, and they'd like to see automation in tissue suturing, bonding and anesthesiology, according to the Robot Review.

As the world's population ages and the available medical community shrinks, governments and healthcare communities around the world are striving to address how they will address this issue. Japan, which has a large elderly population, has developed a number of robot-based technologies that appear to help slow down the advent of dementia, while others help older people with household chores, thereby reducing the risk of injury and the need for confinement in a nursing home or hospital.

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Intuitive Surgical developed the da Vinci robotic system to perform minimally invasive surgeries through superior visualization, enhanced dexterity, greater precision, and ergonomic comfort. With incisions of only 1 or 2 centimeters, surgeons can perform even complex procedures such as open-heart surgery, according to Intuitive Surgical. The system reduces hospital stays by half, reducing costs by about one-third, because of less pain and speedier recovery, according to the company.

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Image (c) 2010 Intuitive Surgical, Inc.


Dr. Linda van den Bedem created Sofie -- the simpler moniker for Surgeon's Operating Force-feedback Interface Eindhoven -- as part of her Ph.D. thesis at the Eindhoven University of Technology in the Netherlands. The robot incorporates force feedback, allowing surgeons to feel the pressure they apply when making a suture or pushing aside a bit of tissue. Sofie consists of a master/slave robotics setup, as well as joysticks and a surgeon's control panel. The small slave is not on the floor, but mounted on the operating table. Van den Bedem built the robot with assistance from Eindhoven University's technical department, which patented the process. Although Van den Bedem expects she is about five years away from developing a commercially available system, she expects Sofie to be attractively priced and cost much less than currently available technology that does not include the tactile capability.

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Image courtesy of Bart van Overbeeke


The CyberKnife Robotic Radiosurgery System is a non-invasive alternative to surgery for the treatment of both cancerous and non-cancerous tumors anywhere in the body. Developed by Accuray, CyberKnife uses continual image guidance technology and computer controlled robotic mobility to automatically track, detect, and correct tumor and patient movement in real-time throughout the treatment, according to the vendor. The CyberKnife system precisely delivers high-dose radiation, reducing damage to surrounding healthy tissue and eliminating the need for invasive head or body stabilization frames. As a result, recovery rates are shorter and costs are lowered, the vendor said. Typically, patients require five or fewer visits -- often to smaller medical facilities, such as the CyberKnife Center of Miami, because the equipment's comparatively lower cost makes it affordable for smaller providers.

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The aging population, coupled with advances in medicine that enable people to overcome once deadly conditions, have created a nursing shortage. To help combat this situation, researchers at the University of Pittsburgh, the University of Michigan, and Carnegie Mellon University have been working on mobile robots -- such as Nursebot -- that are designed specifically to help elderly people cope with day-to-day activities. This allows them to live at home, reducing strains on infrastructure and costs of nursing homes and rehab centers. It also helps eliminate the pain, additional medical complications, and expenses associated with trips and falls, many of which happen at the home when elderly or infirm individuals try to do household tasks. Some robots are equipped with telepresence capabilities, allowing live nurses or doctors to monitor medical conditions.

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Image courtesy of Carnegie Mellon University, University of Pittsburgh, Nursebot Project, and Project on People and Robots


With the face of a friendly teddy bear and the arm-power of a forklift, RIBA -- Robot for Interactive Body Assistance -- is designed to lift people who are too weak or ill to sit, walk, or stand by themselves. The robot, which is expected to begin testing in 2011, can lift people of up to 135 pounds, although inventor Toshiharu Mukai and the development team intend to increase the weight limit when the device is tested at Japanese nursing homes. There are 454 sensors built into RIBA's arms, along with a motor for lifting people, and a soft urethane foam skin for comfort. The robot responds to commands, and is trained to recognize both faces and voices, according to its developers. Prospective markets could include nursing homes, long- and short-term care facilities, and hospitals, especially when the robot is able to lift heavier weights.

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InTouch Technologies focuses on remote presence telehealth solutions, including its Remote Presence RP-7 robot, a full-featured remote presence platform for multiple medical specialties. Hamot Medical Center in Erie, Pa., for example, uses the RP-7 robot to connect four rural hospital systems and improves patient care in remote areas of northwestern Pennsylvania, western New York, and eastern Ohio, and to support the cardiology services it provides to 14 prisons in the state. InTouch's robot-based solution has increased collaboration, enhanced patient care and built relationships among medical professionals, according to the hospital, which estimated about 90% of patients have not been to the hospital.

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The National Institute of Advanced Industrial Science and Technology (AIST), Kimura Clinic and Brain Functions Laboratory in Japan developed Paro, a therapeutic seal robot for individuals suffering from Alzheimer's disease and other cognition disorders. Robot therapy has been implemented at various facilities for the elderly, such as adult day care facilities and nursing homes, in addition to pediatric units in Japan, which like many nations is grappling with an aging population.

In Japan, it is predicted that 26% of the population will be over 65 years of age by 2015, dramatically increasing costs. Private and government agencies are looking at ways in which robotics can delay cognitive problems to improve quality of life, reduce expenses and cut reliance on the social infrastructure by enabling people to live at home longer, with less need for health and social services. One half of one study group saw cognitive improvement, and AIST reports many nursing homes -- which first received Paro in 2003 -- continue to use the seals, which respond with movement and sound to human interaction.

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After suffering a stroke, traumatic brain injury, spinal cord damage, or other harm to the central nervous system, people may lose their ability to walk and turn to intensive gait rehabilitation. Robot-based technologies such as Sensory Motor Systems Lab's Lokomat are designed to combine medical and engineering approaches to help patients regain mobility faster, with less pain. Developed at the Balgrist University Hospital in Zurich, the Lokomat uses a robot to automate treadmill training, affording patients longer and more frequent sessions and resulting in a faster and improved return to mobility, according to professor Robert Riener. The robot intelligently adapts its behavior to the patient's individual capabilities. Improved pelvis and hip actuation and control can make walking with the Lokomat more natural, and virtual training environments can increase patients' motivation and engagement, he said.

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Solutions such as IntelliFill i.v. by Baxa are designed to automate hospital pharmacies' intravenous drug preparation process. It uses bar code scanning, vision systems, and weight confirmation steps to identify final products to reduce medication errors. The robot-based system promotes long-term hospital cost savings by preparing the final intravenous products in a syringe instead of an IV bag, according to developer Baxa.

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The University of Tokyo Hospital is using Geminoid, a female-looking robot, in patient-communication trials. Developed by Hiroshi Ishiguro of Osaka University, ATR Intelligent Robotics and Communication Laboratories, in conjunction with Kokoro, a Tokyo-based entertainment firm, Geminoid can move its eyes, shoulders, mouth, and head. The robot includes a camera and face-tracking software, but cannot walk. The robots are expected to sell for about $110,000, according to reports. They are intended to comfort patients, reducing blood pressure, stress, and other conditions associated with pre- and post-surgery and hospital stays.

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AFP Photo/Yoshikazu Tsuno


While they are learning to clean teeth, mount crowns, or drill for fillings, dental students can chip away without causing pain using Simroid robot-based patients. Fellow students pursuing careers as physicians and surgeons also are tapping families of robots, ranging from faux pregnant women to elderly men needing knee replacements, to hone their craft on "patients" always willing and able to endure another round of surgery. Developed at theNippon Medical School, Simroid robots "feel" pain and react if touched inappropriately on the chest when a dental student reaches for an instrument.

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