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I, Robot, Will Help You, Human: Disruptive Innovation in Health Care

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I, Robot, Will Help You, Human: Disruptive Innovation in Health Care

The field of medical robotics, although still young, has already yielded remarkable breakthroughs. Advances in material science, telecommunications, high-precision engineering, and other fields are driving research and development efforts.

The list in this article is far from exhaustive, but impressive none the less.

Robotic Surgery

The operating theatre is where medical robotics has made its biggest impact to date. Surgical robots are built to assist surgeons in situations of limited operating site accessibility and with tasks that require substantial force or high-precision movements.

Can you image a robot as a surgeon? Nanorobots are a big piece of our current health-care puzzle. Nearly 80 percent of people surveyed by Budget Direct said they would allow robots to operate on them so long as their success was proven.

Neurosurgery systems, like NeuroMate (Renishaw), help with brain biopsies, deep brain stimulation, electroencephalography, radiosurgery and operations on the spinal cord.

Orthopedics robots can restrain the patient so that there are minimal movements in the affected limb and they can automatically drill and cut bones based on the collection of preoperative CT images. Systems like RIO (MAKO Surgical Corp.) are used for hip and knee surgeries.

Laparoscopy, known as a keyhole abdominal surgery, reduces patient trauma, risk of complications, morbidity and hospital stay. With more than one thousand systems sold worldwide, one system, the da Vinci (Intuitive Surgical, Inc.), is a champion in surgical robotics.

The operating theatre is where medical robotics has made its biggest impact to date. Surgical robots are built to assist surgeons in situations of limited operating site accessibility and with tasks that require substantial force or high-precision movements.

It is a telerobot — a surgeon operates the robot through instrument controls at a separate console while robotic hands (and there can be a lot of them) perform the tasks. At a price tag of more than $1M, the system doesn’t come cheap, but the benefits to the surgeon and the patient are many.

Telesurgery can bring specialist surgical services to places where immediate access to the specialist facilities is unavailable. The on-site surgeon ensures that the relevant robotic attachments are positioned correctly within the patient’s body, while the specialist team controls the robot from miles away.

Robotic Systems in Medical Imaging

Robotic systems are used for ultrasound, computer tomography (CT) and magnetic resonance imaging (MRI). Robotic manipulation brings significant advantages to medical imaging: consistency, dexterity and maneuverability.

Apart from taking images, MRI and CT robotic systems, such as InnoMotion (Innomedic) and MAXIO (Promedica Bioelectronics) are used for biopsy, drainage, drug delivery and high energy tumour destruction. These systems allow remote manipulation of the instruments inside the scanner while the images continue to be taken in real-time.

Ultrasound robotic probes can generate a precise 3D image of the area of interest. They allow for great targeting accuracy, improve ergonomics for the ultrasonographer, and can be teleoperated. The system can also conduct needle biopsy and brachytherapy (an insertion of a low-dose radioactive implants into cancer locations).

Radiosurgery

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Radiosurgery is a non-surgical treatment aimed to destroy localised tumours with focused beams of ionising radiation. CyberKnife (Accuray, Inc.) and Novalia (BrainLab, Inc.) can deliver targeted beam of radiation directly into the tumour site while minimising the radiation dose received by the surrounding tissues.

Assistive Robotic Systems

Assistive robots are designed to help with everyday tasks, such as eating, shaving or operating a wheelchair, in order to increase personal autonomy.

Assistive robots are designed to help with everyday tasks, such as eating, shaving or operating a wheelchair, in order to increase personal autonomy. A great example is the Neater Eater (Neater Solutions), a device useful to those with special needs. It uses modular variants to enable people to use their own movements to feed themselves.

Rehabilitation Systems

Rehabilitation systems are designed to facilitate the recovery of motor functions, lost due to stroke or spinal injury. The aim of these systems is to allow repetitive, intensive treatment forcing the affected muscles to re-learn what they are supposed to do.

For bedridden patients, there are electromechanically assisted gait training devices, such as robot-driven footplates. Examples include The Mobility System (MYOMO) and InMotion (Interactive Motion Technologies).

Robotic Prosthetics and Exoskeletons

Prosthetics has moved a long way since the National Academy of Sciences (U.S.) started the Artificial Limb Program in 1945. The very recent advances in robotic technology make it possible to create prosthetics that can virtually duplicate the natural movement of human limbs.

This is achieved by osseointegration, a direct connection between the bone and the prosthetics, combined with connecting the robot’s control system directly to the patient’s nerves and muscles.

This kind of prosthetics (an arm developed by researchers at Sweden’s Chalmers University of Technology) was used in January 2013 on a truck driver in Sweden. It allows the recipient to operate machinery, handle eggs and even tie shoelaces.

Brace-like exoskeletons give support to people with minimal lower body strength, such as in paraplegia following a spinal cord injury. Robotic exoskeletons, such as ReWalk (Argo Medical Technologies) and Ekso (Ekso Bionics), are equipped with motors and tilt sensors to allow a person to stand, walk and sit with minimal assistance.

Robotic Pharmacy

Pharmacy robots, such as PillPick (SwissLog) and Consis (Willach Pharmacy Solutions), automatically label and dispense the right medicine to the right patient, keep an eye on expiry dates, and take stock.

These systems are becoming common in hospital and commercial pharmacies as they increase patient safety by reducing dosing and dispensing errors.

Disinfection Robots

Hospitals are enlisting robots in the fight against deadly hospital-acquired infections.

Reminiscent of R2D2 design, Xenex (Xenex Disinfection Services) and Tru-D SmartUVC (Tru-D SmartUVC) use high-intensity UV-C light to kill the bacteria present on surfaces, without the need for chemical disinfectants.

Therapy Robots

Equipped with voice recognition, adaptive programming and accurate sensors, therapy robots are designed to invoke calming response and positive emotions.

Social therapy robots, such as PARO (Paro) are used in psychological treatment of dementia, mood disorders and autism.

Equipped with voice recognition, adaptive programming and accurate sensors, therapy robots are designed to invoke calming response and positive emotions and can enhance social and coping skills.

Robots in Disaster Zones and on the Battlefield

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It is difficult to create a system suitable for outdoor use in the extremes of a disaster response or a battlefield. Encouraged by the military, recent research efforts are focused on removal of victims from danger zones, quick injury assessment and the delivery of life-saving interventions.

Current systems, such as the LS-1 (Integrated Medical Systems, Inc.), are capable of delivering active ventilation, monitoring blood gases, heart rate and blood pressure. These systems can also include infusion pumps for drug and fluid delivery.

Robots Training Doctors

Robotic and virtual patient simulators provide a safe environment for medical students to learn and practice high-risk surgeries and handle uncommon medical conditions rarely encountered during normal training. With repeated hands-on experience in simulated environment, students can make mistakes and learn from them without putting real patients at risk.

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The simulations systems are built using technologies from the fields of virtual reality, 3D visualisation and haptics (a force-feedback technology that enables users to feel virtual objects).

As technologies continue to evolve, medicine continues to find more applications for the robotics.

From pacemakers to robotic surgery, the acceptance of robots in medicine is growing among the medical fraternity and the wider society. As technologies continue to evolve, medicine continues to find more applications for the robotics.

While the jury is still out on the long-term benefits of some robotic applications, the medical robotics is here to stay for as long as it addresses real problems faced by the health-care providers, improve patient outcomes and expand our capabilities.

http://www.makosurgical.com/physicians/products/rio
http://www.intuitivesurgical.com/
http://www.promedicasrl.eu/en/products/item/98-ct-guided.html
http://www.cyberknife.com/
https://www.brainlab.com/en/
http://www.neater.co.uk/
http://interactive-motion.com/healthcarereform/upper-extremity-rehabilitiation/inmotion2-arm/
http://www.eksobionics.com/
http://www.rewalk.com/
http://www.swisslog.com/en/Products/HCS/Medication-Management-Systems/PillPick-Automated-Packaging-and-Dispensing-System
http://www.willach-pharmacy-solutions.com/en/products/consis-start.php
http://www.xenex.com/
http://tru-d.com/
http://www.parorobots.com/

Survey Stats: Survey was conducted by Budget Direct in the month of April 2015 with a random selection of 1,000 people.

Kateryna Babina

Kateryna Babina

Dr. Kateryna Babina is a medical scientist with more than 15 years of experience in clinical, research, higher education and regulatory settings. Kateryna has a medical degree and a PhD. Kateryna has worked in the fields of public health medicine, epidemiology, human toxicology, biomarker development, human health risk assessment and clinical microbiology. Kateryna’s business, Scripta Medical Communications, is based in Adelaide, South Australia.