μRALP and Beyond: Micro-Technologies and Systems for Robot-Assisted Endoscopic Laser Microsurgery.

Autor:	Mattos LS; Istituto Italiano di Tecnologia, Genoa, Italy., Acemoglu A; Istituto Italiano di Tecnologia, Genoa, Italy., Geraldes A; Istituto Italiano di Tecnologia, Genoa, Italy., Laborai A; Department of Otorhinolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy., Schoob A; Yuanda Robotics GmbH, Hannover, Germany., Tamadazte B; Institut des Systèmes Intelligents et de Robotique, Sorbonne Université, CNRS, Paris, France., Davies B; Imperial College London, London, United Kingdom., Wacogne B; FEMTO-ST Institute, Univ. Bourgogne Franche-Comte, CNRS, Besançon, France.; Centre Hospitalier Régional Universitaire, Besançon, France., Pieralli C; FEMTO-ST Institute, Univ. Bourgogne Franche-Comte, CNRS, Besançon, France., Barbalata C; Mechanical and Industrial Engineering Department, Louisiana State University, Baton Rouge, LA, United States., Caldwell DG; Istituto Italiano di Tecnologia, Genoa, Italy., Kundrat D; Imperial College London, London, United Kingdom., Pardo D; Istituto Italiano di Tecnologia, Genoa, Italy., Grant E; Department of Electrical and Computer Engineering, North Carolina State University, Raleigh, NC, United States., Mora F; Clinica Otorinolaringoiatrica, IRCCS Policlinico San Martino, Genoa, Italy.; Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università Degli Studi di Genova, Genoa, Italy., Barresi G; Istituto Italiano di Tecnologia, Genoa, Italy., Peretti G; Clinica Otorinolaringoiatrica, IRCCS Policlinico San Martino, Genoa, Italy.; Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università Degli Studi di Genova, Genoa, Italy., Ortiz J; Istituto Italiano di Tecnologia, Genoa, Italy., Rabenorosoa K; FEMTO-ST Institute, Univ. Bourgogne Franche-Comte, CNRS, Besançon, France., Tavernier L; Centre Hospitalier Régional Universitaire, Besançon, France., Pazart L; Centre Hospitalier Régional Universitaire, Besançon, France., Fichera L; Department of Robotics Engineering, Worcester Polytechnic Institute, Worcester, MA, United States., Guastini L; Clinica Otorinolaringoiatrica, IRCCS Policlinico San Martino, Genoa, Italy.; Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università Degli Studi di Genova, Genoa, Italy., Kahrs LA; Department of Mathematical and Computational Sciences, University of Toronto, Mississauga, ON, Canada., Rakotondrabe M; National School of Engineering in Tarbes, University of Toulouse, Tarbes, France., Andreff N; FEMTO-ST Institute, Univ. Bourgogne Franche-Comte, CNRS, Besançon, France., Deshpande N; Istituto Italiano di Tecnologia, Genoa, Italy., Gaiffe O; Centre Hospitalier Régional Universitaire, Besançon, France., Renevier R; FEMTO-ST Institute, Univ. Bourgogne Franche-Comte, CNRS, Besançon, France., Moccia S; The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy., Lescano S; FEMTO-ST Institute, Univ. Bourgogne Franche-Comte, CNRS, Besançon, France., Ortmaier T; Institute of Mechatronic Systems, Leibniz Universität Hannover, Garbsen, Germany., Penza V; Istituto Italiano di Tecnologia, Genoa, Italy.
Jazyk:	angličtina
Zdroj:	Frontiers in robotics and AI [Front Robot AI] 2021 Sep 08; Vol. 8, pp. 664655. Date of Electronic Publication: 2021 Sep 08 (Print Publication: 2021).
DOI:	10.3389/frobt.2021.664655
Abstrakt:	Laser microsurgery is the current gold standard surgical technique for the treatment of selected diseases in delicate organs such as the larynx. However, the operations require large surgical expertise and dexterity, and face significant limitations imposed by available technology, such as the requirement for direct line of sight to the surgical field, restricted access, and direct manual control of the surgical instruments. To change this status quo, the European project μRALP pioneered research towards a complete redesign of current laser microsurgery systems, focusing on the development of robotic micro-technologies to enable endoscopic operations. This has fostered awareness and interest in this field, which presents a unique set of needs, requirements and constraints, leading to research and technological developments beyond μRALP and its research consortium. This paper reviews the achievements and key contributions of such research, providing an overview of the current state of the art in robot-assisted endoscopic laser microsurgery. The primary target application considered is phonomicrosurgery, which is a representative use case involving highly challenging microsurgical techniques for the treatment of glottic diseases. The paper starts by presenting the motivations and rationale for endoscopic laser microsurgery, which leads to the introduction of robotics as an enabling technology for improved surgical field accessibility, visualization and management. Then, research goals, achievements, and current state of different technologies that can build-up to an effective robotic system for endoscopic laser microsurgery are presented. This includes research in micro-robotic laser steering, flexible robotic endoscopes, augmented imaging, assistive surgeon-robot interfaces, and cognitive surgical systems. Innovations in each of these areas are shown to provide sizable progress towards more precise, safer and higher quality endoscopic laser microsurgeries. Yet, major impact is really expected from the full integration of such individual contributions into a complete clinical surgical robotic system, as illustrated in the end of this paper with a description of preliminary cadaver trials conducted with the integrated μRALP system. Overall, the contribution of this paper lays in outlining the current state of the art and open challenges in the area of robot-assisted endoscopic laser microsurgery, which has important clinical applications even beyond laryngology. Competing Interests: Author AS was employed by the company Yuanda Robotics GmbH. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Mattos, Acemoglu, Geraldes, Laborai, Schoob, Tamadazte, Davies, Wacogne, Pieralli, Barbalata, Caldwell, Kundrat, Pardo, Grant, Mora, Barresi, Peretti, Ortiz, Rabenorosoa, Tavernier, Pazart, Fichera, Guastini, Kahrs, Rakotondrabe, Andreff, Deshpande, Gaiffe, Renevier, Moccia, Lescano, Ortmaier and Penza.)
Databáze:	MEDLINE
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