Apr. 3, 2000 HAIFA, Israel and NEW YORK, N.Y., March 29, 2000 -- When surgery can't be avoided, you would want to have the best surgeon perform the procedure. Or would you?
Thanks to recent technological innovations, it turns out that for some procedures the best surgeon may be a robot with a steadier hand than a human's.
A mini-surgical robot, developed by mechanical engineering professor Moshe Shoham of the Technion—Israel Institute of Technology, is currently being tested in human knee replacement surgeries without the guidance of a physician's hand.
Orthopedic procedures involving rigid bone particularly lend themselves to automated surgery. Using X-axis and Y-axis coordinates, as on a graph, which are gleaned from computerized tomography scans, the surgeon can feed precise information about the surgical site into the robot's computer prior to surgery. The unshakeable robotic hand does the rest.
Of the estimated 200,000 knee replacements done in the U.S. each year, 10 percent need to be repeated due to surgical error, according to Shoham. The precision of robotic surgery has the potential of greatly reducing this figure.
To ensure the safety of the surgical robot, Shoham applied to it the physicians' "first do no harm" credo. He measured the actual force a surgeon exerts in an operation, and added force sensors that monitor and limit the robot's force so it cannot exceed that of the human hand.
Further, just as a pilot oversees the flight of an aircraft operating on autopilot and can take control at any time, so too can the physician monitoring the knee replacement procedure take control by manipulating a "joystick" whenever he deems it necessary.
Though robots are currently in use for hip replacements and to hold cameras steady inside the body during laparoscopic surgery, Shoham says the unique design of his device enables it to be smaller and more accurate than similar systems. Further, the system performs by itself, without assistance from a surgeon.
That is because currently used surgical robots have links and joints connected in series, or essentially end-to-end. The Technion robot is of a parallel configuration, in which the "end-effector," or hand of the robot, is connected directly to several motors contained in the robot's base.
This allows the robot to achieve six degrees of freedom (rotate around all axes), giving it much greater dexterity. It also allows it to be made so small that it can be mounted directly on the operating table, alongside the patient. This level of intimacy enables it "to be attached to the organ so you overcome the problem of alignment and the accuracy is much higher," says Shoham.
The robot's size, high degree of accuracy, and ability to eliminate the slightest tremor of the human hand has led surgeons from many specialties to contact Shoham about its potential for use in other procedures. He is working on perfecting the robot for spinal procedures, in which a slip of the hand can result in paralysis for the patient. He also sees a future for the Technion robot in brain, eye, ear, nose and throat surgery.
The Technion-Israel Institute of Technology is the country's premier scientific and technological center for applied research and education. It commands a worldwide reputation for its pioneering work in communications, electronics, computer science, biotechnology, water-resource management, materials engineering, aerospace and medicine, among others. The majority of Israel's engineers are Technion graduates, as are most of the founders and managers of its high-tech industries. The Technion's 13,000 students and 700 faculty study and work in its 19 faculties and 30 research centers and institutes in Haifa.
The American Technion Society (ATS) supports the Technion. Based in New York City, it is the leading American organization supporting higher education in Israel, with more than 20,000 supporters and 17 offices around the country. Technion societies are located in 24 countries around the world.
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