Page 89 - Read Online

Nawrat. Mini-invasive Surg 2020;4:28 I http://dx.doi.org/10.20517/2574-1225.2020.08 Page 9 of 16

2
2008 (for video surgery, one arm robot); modular robot Robin Heart mc from 2009; TeleRobin form 2014
(new solution of the tool platform), followed by subsequent versions of the video surgery robot; ultra light
2
Pelikan and Robin Heart PortVisionAble in the preclinical version. At that time, Robin Heart mc was the
largest surgical robot in the world. It consists of three arms: two arms working as an assistant and a middle
arm equipped with a tool platform (two tools of the main surgeon and vision endoscope). Robin Heart
Shell console is equipped with a 3D monitor and an additional touch screen to change control parameters
(tremor removal or motion scaling) and an advisory system (that shows the necessary diagnostic data as
2
well as the results of planning and simulating operations). Robin Heart mc is a modular robot with the
tools, which can be quickly removed from the robot arm and used as manually controlled mechatronic
tools. The Robin Heart system was tested in animal experiments at the Experimental Medicine Center of
the Medical University of Silesia in 2009-2010 (gallbladder surgery, coronary artery bypass grafting and
[14]
heart valve repair) .
The surgery planning system is based on the use of an original virtual operating room. The simulation of
operations was prepared by the team at the Biocybernetics Laboratory to allow the introduction of physical
features (pressure and blood flow) to hemodynamic models of heart surgery. The Polish team is preparing
to introduce robots to the market, for clinical implementation. Elements of artificial intelligence will, in
the first version, be applied to the advisory program presented online when controlling the robot from the
Robin Heart Shell console. Subsequently, semi-automatically performed tasks and selected elements of the
procedure (e.g., tying the knot while sewing or cutting a hole of a certain shape) will be introduced. The
key to introducing AI to surgical robotics are sensors, image analysis and processor speed. We believe that
in the future, these robots will be completely independent.

Purposes and necessary conditions for using AI in MIS:
1. In advisory programs and planning support systems, AI serves as a method of linking the current
situation during a surgical operation with the results obtained earlier in clinics (if they are digitized, i.e.
form elements of the Big Data base) or obtained from physical modeling, computer simulations or the
use of models theoretical in calculations.
2. In mechatronic surgical instruments, if the instruments are equipped with sensors (determining the
features of local surgical intervention), soft & harware to understand what specific signals mean for the
task being performed and monitors presenting data to the surgeon online.
3. In surgical telemanipulators, if robots are equipped with sensors (determining the features of local
surgical intervention and force feedback), AI can be used in a system of supervision and control
of performed surgical tasks and creating the basis for working with the image of augmented reality
technoology. Innovative surgical instruments equipped with force sensors and/or performing semi-
automatic tasks (such as sewing) play a key role in this process.
4. In independent surgical robots, if robots can on-line process information available from sensors, their
own computer and cloud database, creating information loop containing physical/chemical/biological
data, data from memory resources regarding the practice and theory of selected surgical procedures
(imitating the medical knowledge of the surgeon), as a element of central decision making system (AI)
and the implementation of surgical tasks.

Of course, we must remember that surgery is collective work, and the team consists of an anesthesiologist
and many other specialties including nursing and technical support. There is also information about robots
being developed to replace the work of people from the team accompanying the surgeon. It is possible that
the entire operation will be robotic. Contrary to common belief, this is not an impossible task, if we were to
seriously consider plans to build settlements on the moon or Mars by comparison.

In my Robin Heart Team in Zabrze, we conduct research and design work, and we build and test
mechatronic robots and tools. The FRK Biocybernetics Laboratory is also a pioneer in the field of