Clinical Implementation and Acceptance Issues on Robotic Surgery

Safety is an obvious concern for robotic surgery, and regulatory agencies require that it be addressed for every clinical implementation. As with most complex computer controlled systems, there is no accepted technique that can guarantee safety for all systems in every circumstance. Various robotic systems approach the problem in different ways. One common technique is to include passive and active safety mechanism in the mechanical design of the manipulator.

The end of the robot arm is attached to the endoscope through a gimbal and a magnetic coupling. Because the incision prevents lateral motion of the endoscope tube, as the robot moves the endoscope in space above the patient, the gimbal allows the endoscope tube to pivot about the incision. This makes it impossible for the robot to apply lateral forces on the incision. The magnetic coupling acts as an emergency release: if forces on the endoscope exceed the magnetic holding force, the endoscope disconnects and falls onto the patient’s abdomen, which is unlikely to cause injury.

Safety features of the software portion of the systems are also essential. In the context of a urology robot, it is used mathematical logic to analyze program flow and determine if it is possible for control to evade the safety features incorporated into the code. N addition, they implemented a completely independent safety monitor that can arrest a servo runaway and detect out of safe boundary conditions, using joint encoder signals as input.

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