Robotique Médicale. FIP 3A, TIC pour la Santé (édition ) Christophe DOIGNON

Transcription

1 Robotique Médicale FIP 3A, TIC pour la Santé (édition ) RI-MAN, robot médical du RIKEN Bio-Mimetic Control Research Center, Japon (2006) Christophe DOIGNON Professeur Membre de l IEEE Robotics and Automation Society (depuis 1998) Télécom Physique de Strasbourg Bureau C418 courriel : c.doignon@unistra.fr Université de Strasbourg, FRANCE 1

2 Robotique médicale Du recalage à la navigation et l assistance par l imagerie médicale et autres capteurs... Christophe DOIGNON (coordinateur du cours) 1 1 Télécom Physique Strasbourg [edition FIP TIC-S 3A] Université de Strasbourg Christophe DOIGNON Robotique médicale

3 Contributeurs Sandrine VOROS (Laboratoire TIMC/GMCAO, CR INSERM), CHU Grenoble Alexandre KRUPA (IRISA/Lagadic, CR INRIA), Centre de Rennes Florent NAGEOTTE (UFR Physique et Ingénierie, MCF), Unistra, Michel de MATHELIN (Télécom Physique, PU - Dir. ICube), Unistra, Christophe DOIGNON (Télécom Physique, PU), Unistra Christophe DOIGNON Robotique médicale

4 Robotique Médicale Ch. DOIGNON Plan du cours Télécom Physique (Edition ) Chapitre 1 : Introduction (M. de MATHELIN et Ch. DOIGNON) Introduction à la robotique médicale et définitions Les problèmes ouverts Assistance médicale : un succès La robotique médicale en France Chapitre 2 : le recalage en robotique médicale (F. NAGEOTTE et Ch. DOIGNON) Introduction Matériel et méthodes pour le recalage Exemple de systèmes de recalage pour la robotique médicale (orthopédie, endoscopie, radiologie, neurologie) Chapitre 3 : La robotique médicale par l échographie à ultra-sons (A. KRUPA) Chapitre 4 : Les GMCAO (S. VOROS) 2

5 Robotique Médicale Ch. DOIGNON Télécom Physique (Edition ) Chapitre 1 Introduction 3

6 Robotique Médicale Ch. DOIGNON Télécom Physique (Edition ) 4

7 II.2 Robotex Equipex : network of robotics platforms of excellence Coordinator: Michel de Mathelin Partners: 15 main french laboratories in robotics with extensive experimental platforms Organized in 5 subnetworks: 1 I Medical robo.cs (J. Troccaz): TIMC, ICube, LIRMM, ISIR 2 I Humanoids and natural interac.ons (J.- P. Laumond) : ISIR, LAAS, ETIS, LIRMM, IRCCyN, PPRIME, GIPSA- Lab, INRIA Rennes 3 I Mobile robo.cs (Ph. Bonnifait): HEUDIASYC, LAAS, ISM, I3S, GIPSA- LAB, ISIR, Ins.tut Pascal, IRCCyN 4 I Micro- robo.cs (Y. Haddab): FEMTO- ST, ISIR 5 I Manufacturing robo.cs (F. Pierrot):LIRMM, PPRIME, Ins.tut Pascal, IRCCyN

8 II.2 Robotex

9 I.1 Definitions (1) Medical Robotics: I. Surgical and medical assistance systems: Robotics to assist doctors and surgeons This presentation II. Assistive technologies and rehabilitation robotics: Robotics to assist people (elderly, disabled, injured, ) Prothetic devices, artificial limbs, orthotic devices, Active implants, functional electro-stimulation, Robotic moving and manipulation aids, smart living spaces, Rehabilitation robotics for therapy and training

10 Robotique Médicale Ch. DOIGNON Télécom Physique (Edition ) 5

11 I.1 Definitions (1) Medical Robotics: I. Surgical and medical assistance systems: Robotics to assist doctors and surgeons This presentation II. Assistive technologies and rehabilitation robotics: Robotics to assist people (elderly, disabled, injured, ) Prothetic devices, artificial limbs, orthotic devices, Active implants, functional electro-stimulation, Robotic moving and manipulation aids, smart living spaces, Rehabilitation robotics for therapy and training

12 I.1 Definitions (2) What robotics can do (to assist doctors) Automation and Robotic tasks: 1. Registration: localization of the instrument with respect to the patient with reference to the pre-operative planning thanks to intra-operative imaging and 3D measurement devices. 2. Positioning : 3D positioning of instruments with respect to the patient 3. Trajectory tracking: tracking with the instrument of a planned trajectory with respect to the patient 4. Comanipulation : manual manipulation of an instrument constraint in position, velocity or force, by a robotic device 5. Telemanipulation : telemanipulation from a distance of an instrument 6. Exploration: exploration of a partially unknown environment 7. Simulation: execution of the previous tasks in a virtual environment with a physical human-machine interface

13 I.1 Definitions (3) A. Registration: Localization of the instrument with respect to the patient with reference to the pre-operative planning thanks to intra-operative imaging and 3D measurement devices. Devices: 3D measurements Cameras (ex. Polaris, NDI) Magnetic sensors Medical imaging (ultrasound, fluoroscopy, scanner, MRI, ) Any other 3D measurement device Research issues Physiological motion compensation Modalities Praxiteles OR integration Precision and robustness Neuromate Main medical applications Orthopedics Neurosurgery Maxillio-facial surgery Radiotherapy

14 I.1 Definitions (4) B. Positioning 3D positioning of instruments with respect to the patient. Also, 3D positioning of the patient with respect to the instrument or tracking of the instrument by the imaging device Devices: 3D measurements + robot holding the instrument Main medical applications: Orthopedics Neurosurgery Radiotherapy Radiology Minimally invasive surgery Research issues: Safety in the OR Physiological motion compensation HMI Robot structures Freehand Cyberknife Aesop Artis Zeego Protontherapy

15 I.1 Definitions (5) C. Trajectory tracking: Tracking with the instrument of a planned trajectory with respect to the patient. (trajectory tracking: position, velocity, acceleration control) Devices: 3D measurements + robot holding the instrument Research issues Physiological motion compensation Safety in the OR Robot architectures Main medical applications Orthopedics Neurosurgery Radiology Mars Path Finder Artis Zeego

16 I.1 Definitions (6) D. Co-manipulation: Manual manipulation an instrument constraint in position, velocity or force, by a robotic device Devices: 3D measurements + robot co-manipulating the instrument Research issues Physiological motion compensation Robot architectures Force feedback PIGalileo Main medical applications Orthopedics Neurosurgery Interventional radiology Innomotion Surgiscope

17 I.1 Definitions (7) E. Telemanipulation: Telemanipulation from a distance of an un instrument held by a slave robot Devices: 3D measurements + slave robot + master interface Research issues Physiological motion compensation Robot architectures Instrumentation Force/haptic feedback HMI Main medical applications Minimally invasive surgery Interventional radiology Echography Estele Sensei robotics Cathether system Da Vinci

18 I.2 Specific issues (1) Safety The robot is expected to create no injuries to the patient or the medical staff: Redundant sensors Workspace, velocity, force constrains Safe mechanical design Software, electronic and mechanical fuses Manual procedure remains possible Automatic docking Small relative increase of the duration of the surgery Surgeon in the loop Others

19 I.2 Specific issues (2) Operating Room constrains The OP Room constrains should be taken into account: Available space Human-machine interface and ergonomy Training of the medical staff Interoperability with other equipements Certification Others

20 I.2 Specific issues (3) Sterility Le robotic device should be compatible with the sterility procedures: The parts in contact with the patient should go into an autoclave or should be disposable or could go through a chemical cleansing The other part in the sterile area should be wrapped in sterile bags in order to avoid contamination of the medical staff performing the surgical act Others

21 I.3 Succesfull medical assistance (1) Expected added-values of robotics and automation: Speed Accuracy Repeatability Automatic registration with pre-operative data Simulation Force, velocity and positioning constrains Augmented reality (visual, haptics, ) Gravity compensation Scaling of motions and forces Telemanipulation Automatic planned trajectory tracking Hostile environment Real-time integration of intra-operative data Added dexterity Tremor filtering Recording of intra-operative data

22 I.3 Succesfull medical assistance (2) Technological success is different from medical or commercial success Conditions for success: 3 specific issues are taken into account : safety, sterility and OP room constrains Several competitive advantages of robot over human are realized The doctor is in the loop A significative improvement for the patient (validated through clinical trials) An advantageous trade-off between cost and benefit for the patient

23 Robotique Médicale Ch. DOIGNON Télécom Physique (Edition ) 6

24 Robotique Médicale Ch. DOIGNON Télécom Physique (Edition ) Visual servoing with lasers and LED for minimally invasive surgery 7