Purchase this article with an account.
Haoran Yu, Rohan J Shah, Jin H Shen, Karen M Joos, Nabil Simaan; Preliminary Evaluation of a Robotic Retinal Surgical Manipulator. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2317.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Although robotic surgery remains in the experimental phase for ophthalmic surgery, it has had a tremendous impact on other surgical fields. We developed a telemanipulation system for retinal surgery and present experimental results evaluating the potential benefits of using robot-assistance for membrane peeling and micro-manipulation close to and on the retina surface.
A seven degrees-of-freedom (DoF) manipulator with a 6 DoF robot and a 1 DoF motor-driven surgical gripper were used to comprise a robotic telemanipulation slave. A manual gripper (Grieshaber Revolution® DSPs forceps (Alcon)) and a modified motor-driven gripper were used. An experimental hardware and control setup was designed to obey the pars plana incisional constraints of the eye. This setup was built accordingly with agar gel as the phantom mimicking retinal surface, liquid bandage coating as the phantom membrane, and a plastic ring with phantom mimicking 1 mm (20-gauge) ocular pars plana surgical ports. Surgical phantom interventions of intraocular manipulation and membrane peeling were performed. The robot’s performance was evaluated by comparing one surgeon’s (RS) telemanipulative ability versus the surgeon’s manual manipulation during surgical tasks. Several experimental trials were used to evaluate the manual approach and robot-assisted approach to the retina. Similarly, robot-assisted membrane peeling experiments were performed on the phantom retinal model. The depth of excursion into the retinal substrate, average completion time, stability of the tool and success rates during membrane peeling were used as evaluation metrics.
The surgeon was able to manipulate the robot without instruction after one practice session. The data showed that the average penetration depth for both methods were very similar (P= 0.6479). However robotic assistance improved the success rates in the membrane peeling task by more than 2 times (P= 0.0041). Robotic assistance also improved the task average completion time and the tool tip stability.
A retinal telemanipulation system was developed and evaluated. The results indicated potential advantages of using robot-assistance for retinal surgery. These advantages manifest in increased efficiency of micro-manipulation and membrane peeling.
This PDF is available to Subscribers Only