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 invasively. 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 a master 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 a master console with a 3D-display and two haptic devices as well as a teleoperator consisting of three MIRO robot arms. Usually two MIROs carry surgical instruments (MICA) equipped with miniaturized force/torque sensors to capture reaction forces with manipulated tissue. The third MIRO can (automatically) guide a stereo video laparoscope. The stereo video stream as well as the measured forces are displayed to the surgeon at the master console. Therefore the surgeon is not limited to seeing but can via force feedback in the input devices also feel what he is doing.
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.
Andreas Tobergte, Patrick Helmer, Ulrich Hagn, Patrice Rouiller, Sophie Thielmann, Sebastien Grange, Alin Albu-Schäffer, Francois Conti, and Gerd Hirzinger, "The sigma.7 haptic interface for MiroSurge: A new bi-manual surgical console" in Proc. of the IEEE International Conference on Intelligent Robots and Systems (IROS), San Francisco, USA, September 2011.
Andreas Tobergte, Patrick Helmer, Ulrich Hagn, Sophie Thielmann, and Gerd Hirzinger, "Eine Chirurgenkonsole für MiroSurge", in 10. Jahrestagung der Deutschen Gesellschaft für Computer- und Roboterassistierte Chirurgie (CURAC), Magdeburg, Germany, September 2011. elib
G. Hirzinger, and U. Hagn, "Flexible Heart Surgery", German Research (Magazine of the German Research Foundation DFG), 1/2010.
Andreas Tobergte, Georg Passig, Bernhard Kübler, Ulrich Seibold, Ulrich Hagn, Florian Fröhlich, Rainer Konietschke, Stefan Jörg, Mathias Nickl, Sophie Thielmann, Robert Haslinger, Martin Gröger, Alexander Nothhelfer, Luc Le-Tien, Robin Gruber, Alin Albu-Schäfer, and Gerd Hirzinger, "MiroSurge - Advanced User Interaction Modalities in Minimally Invasive Robotic Surgery", MIT Press Journals: PRESENCE - Teleoperators and Virtual Environments, vol. 19, no. 5, pp. 400-414, October 2010. DOI: 10.1162/pres_a_00022 2010 elib
U. Hagn, R. Konietschke, A. Tobergte, M. Nickl, S. Jörg, B. Kübler, G. Passig, M. Gröger, F. Fröhlich, U. Seibold, L. Le-Tien, A. Albu-Schäffer, A. Nothelfer, F. Hacker, M. Grebenstein, and G. Hirzinger, "DLR MiroSurge - A Versatile System for Research in Endoscopic Telesurgery", International Journal of Computer Assisted Radiology and Surgery, vol. 5, no. 2, pp. 183-193, March 2010. doi: 10.1007/s11548-009-0372-4 elib
A. Tobergte, R. Konietschke, and G. Hirzinger, "Planning and Real Time Control of a Minimally Invasive Robotic Surgery System", in Proc. of the IEEE International Conference on Robotics and Automation, Kobe, Japan, May 2009. elib
R. Konietschke, U. Hagn, M. Nickl, S. Jörg, A. Tobergte, G. Passig, U. Seibold, L. Le-Tien, B. Kübler, M. Gröger, F. Fröhlich, Ch. Rink, A. Albu-Schäffer, M. Grebenstein, T. Ortmaier, and G. Hirzinger, "The DLR MiroSurge - A Robotic System for Surgery", video contribution presented at ICRA 2009, Finalist for best video award, Kobe, Japan, May 2009. elib
G. Hirzinger, and U. Hagn, "MiroSurge - ein innovatives Robotik-System für die minimal invasive Chirurgie", Zentralbl Chir 2009, vol. 134, no. 5, pp. 397-400. doi: 10.1055/s-0029-1241106 elib
U. Hagn, M. Nickl, S. Jörg, A. Tobergte, B. Kübler, G. Passig, M. Gröger, F. Fröhlich, U. Seibold, R. Konietschke, L. Le-Tien, A. Albu-Schäffer, M. Grebenstein, T. Ortmaier, and G. Hirzinger, "DLR MiroSurge - towards versatility in surgical robotics", in Proc. of 7. Jahrestagung der Deutschen Gesellschaft für Computer- und Roboterassistierte Chirurgie (CURAC), Leipzig, Germany, September 2008, pp. 143-146. elib
U. Hagn, T. Ortmaier, R. Konietschke, B. Kübler, U. Seibold, A. Tobergte, M. Nickl, S. Joerg, and G. Hirzinger, "Telemanipulators for Remote Minimally Invasive Surgery", IEEE Robotics and Automation Magazine (RAM), vol. 15, no. 4, pp. 28-38, 2008. doi: 10.1109/MRA.2008.929925 elib