MiroSurge - Telemanipulation in minimally invasive surgery

The DLR MiroSurge robotic system, consisting of three MIRO robots, actuated minimally invasive instruments MICA and a stereo endoscope . The DLR MiroSurge command devices for the surgeon   Please cite DLR as the source for the images: "Images: DLR"

Conventional minimally invasive surgery (MIS) is per­formed through small incisions in the patient’s skin, pre­serving healthy tissue. The surgeon works with long slender instruments, and is separated from the operation area. This arrangement challenges the surgeon’s skills due to lost hand-eye-coordination and missing direct manual con­tact to the operation area. Therefore, many sophisticated procedures still cannot be performed minimally invasive. To overcome the drawbacks of conventional MIS, telepresence and telemanipulation techniques play an im­portant role: In case of minimally invasive robotic surgery (MIRS) the instruments are not directly manipulated any­more. Instead, they are held by specialized robot arms and remotely commanded by the surgeon who comfortably sits at an input console. The surgeon virtually regains direct access to the operating field by having 3D endoscopic sight, force feedback, and restored hand-eye-coordination.

The DLR telesurgery scenario MIROSURGE includes an input (or master) console as well as a teleoperator consisting of 3 surgical robots (MIRO). Usually two MIROs carry surgical instruments (MICA) equipped with miniatur­ized force/torque sensors to capture reaction forces with manipulated tissue. One more MIRO can (automatically) guide a stereo video laparoscope. Both the stereo video stream and the measured forces are displayed to the surgeon at the master console. So users are not limited to see but can also feel what they are doing. An Omega.7 input device is used as force display.

Our ultimate ambition is robot supported surgery on the beating heart. The application of the heart-lung machine would become obsolete for a whole variety of procedures that way. Collaterally, the very traumatizing effects of the heart-lung machine on the patient could be avoided (e.g. blood contact with extrinsic surfaces, inevitable blood clotting attenuation, typical generalized inflammation reaction). Therefore, performance characteristics of the MIROs are designed to follow a stabilized beating heart motion. Additionally, the endoscopic video stream can be stabilized by optical tracking in real time so that a virtually stationary video picture can be consistently presented to the surgeon.

Projects

• MIROSURGE, funded by the Bayerische Forschungstiftung
• ACCUROBAS, a project in the 6th EU Framework Programme for Research and Technological Development
• SFB 453, Collaborative Research Centre (SFB) 453 of the DFG

Selected Publications

Hirzinger, G. and hagn, U. (2010) Flexible Heart Surgery, German Research (Magazine of the German Research Foundation DFG), 1/2010, available online

Hagn, U.; Konietschke, R.; Tobergte, A.; Nickl, M.; Jörg, S.; Kuebler, B.; Passig, G.; Gröger, M.; Fröhlich, F.; Seibold, U.; Le-Tien, L.; Albu-Schäffer, A.; Nothelfer, A.; Hacker, F.; Grebenstein, M.; Hirzinger, G. (2009) DLR MiroSurge - A Versatile System for Research in Endoscopic Telesurgery. In: International Journal of Computer Assisted Radiology and Surgery, Volume 5, (2) 2010, pages 183-193. published online  Doi: 10.1007/s11548-009-0372-4, 2009

Tobergte, A.; Konietschke, R.; Hirzinger, G. (2009) Planning and Control of a Teleoperation System for Research in Minimally Invasive Robotic Surgery. In Proceedings of the 2009 IEEE International Conference on Robotics and Automation (ICRA).

Hirzinger, G., Hagn, U. (2009) MiroSurge - ein innovatives Robotik-System, Zentralbl Chir, 134(5): 397-400, DOI: 10.1055/s-0029-1241106

Konietschke, R.; Hagn, U.; Nickl, M.; Jörg, S.; Tobergte, A.; Passig, G.; Seibold, U.; Le.Tien, L.; Kuebler, B.; Gröger, M.; Fröhlich, F.; Rink, Ch.; Albu-Schäffer, A.; Grebenstein, M.; Ortmaier, T.; Hirzinger, G. (2009) The DLR Miro Surge - A Robotic System for Surgery. Video contribution presented at ICRA 2009, Finalist for best video award

Hagn, U., Nickl, M., Jörg, S., Tobergte, A., Kübler, B., Passig, G., Gröger, M., Fröhlich, F., Seibold, U., Konietschke, R., Le-Tien, L., Albu-Schäffer, A., Grebenstein, M., Ortmaier, T. & Hirzinger, G. (2008) DLR MiroSurge -- towards versatility in surgical robotics 7. Jahrestagung der Deutschen Gesellschaft für Computer- und Roboterassistierte Chirurgie e.V. Proceedings of CURAC, 2008, pp. 143 - 146

Videos

 

The DLR MIRO robot as part of the MiroSurge system. Please reference: Konietschke R, Hagn U, Nickl M, Jörg S, Tobergte A, Passig G, Seibold U, Le-Tien L, Kuebler B, Gröger M, Fröhlich F, Rink Ch, Albu-Schäffer A, Grebenstein M, Ortmaier T, Hirzinger G (2009) The DLR Miro Surge - A Robotic System for Surgery. Video presented at ICRA 2009

First robot-assisted ostetomy tests with the DLR MIRO robot in collaboration with the Clinic for Orthopaedics and Traumatology, Clinic of Oral and Maxillofacial surgery, Klinikum Rechts der Isar Munich, 2009 Please cite DLR as the source for the videos. For example: "Credit: DLR", "Image: DLR", "Images: DLR", "Image copyright: DLR", "Copyright: DLR"