Supervised autonomous robotic soft tissue surgery

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Young's modulus of trabecular and cortical bone material: ultrasonic and microtensile measurements.

Jae Rho, Richard Ashman, Charles Turner (1993)

An ultrasonic technique and microtensile testing were used to determine the Young's modulus of individual trabeculae and micro-specimens of cortical bone cut to similar size as individual trabeculae. The average trabecular Young's modulus measured ultrasonically and mechanically was 14.8 GPa (S.D. 1.4) and 10.4 (S.D. 3.5) and the average Young's modulus of microspecimens of cortical bone measured ultrasonically and mechanically was 20.7 GPa (S.D. 1.9) and 18.6 GPa (S.D. 3.5). With either testing technique the mean trabecular Young's modulus was found to be significantly less than that of cortical bone (p < 0.0001). However, the specimens were dried before microtensile testing so Young's modulus values may have been greater than those of trabeculae in vivo. Using Young's modulus measurements obtained from 450 cubes of cancellous bone and 256 cubes of cortical bone, Wolff's hypothesis that cortical bone is simply dense cancellous bone was tested. A multiple regression analysis that controlled for group membership showed that Young's modulus of cortical bone cannot be extrapolated from the Young's modulus vs density relationship for cancellous bone, yet the Young's modulus of trabeculae can be predicted by extrapolation from the relationship between Young's modulus vs density of the cancellous bone. These results suggest that when considered mechanically, cortical and trabecular bone are not the same material.

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Minimally invasive surgery: national trends in adoption and future directions for hospital strategy.

Charlotte Tsui, Rachel Klein, Matthew Garabrant (2013)

Surgeons have rapidly adopted minimally invasive surgical (MIS) techniques for a wide range of applications since the first laparoscopic appendectomy was performed in 1983. At the helm of this MIS shift has been laparoscopy, with robotic surgery also gaining ground in a number of areas.

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Evolution of autonomous and semi-autonomous robotic surgical systems: a review of the literature.

S Hiridis, K M Deliparaschos, G Moustris … (2011)

Autonomous control of surgical robotic platforms may offer enhancements such as higher precision, intelligent manoeuvres, tissue-damage avoidance, etc. Autonomous robotic systems in surgery are largely at the experimental level. However, they have also reached clinical application. A literature review pertaining to commercial medical systems which incorporate autonomous and semi-autonomous features, as well as experimental work involving automation of various surgical procedures, is presented. Results are drawn from major databases, excluding papers not experimentally implemented on real robots. Our search yielded several experimental and clinical applications, describing progress in autonomous surgical manoeuvres, ultrasound guidance, optical coherence tomography guidance, cochlear implantation, motion compensation, orthopaedic, neurological and radiosurgery robots. Autonomous and semi-autonomous systems are beginning to emerge in various interventions, automating important steps of the operation. These systems are expected to become standard modality and revolutionize the face of surgery. Copyright © 2011 John Wiley & Sons, Ltd.