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Mathias Maier, M. Ali Nasseri, Daniel Zapp, Martin Eder, Karin Kobuch, Chris Lohmann, Alois Knoll; Robot-assisted vitreoretinal surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3318.
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To find a way performing current ophthalmic operations with more precision and getting future possibilities for new treatment options. Retinal Vein Occlusion (RVO) is an example of such a disease with currently no generally approved surgical treatment. One promising treatment concept of RVO is injecting clot-dissolving drugs like tissue Plasminogen Activator (tPA) directly into the blocked vessel. The procedure of placing a needle and specifically holding the needle tip perfectly still during the injection is practically impossible for human surgeons. This work investigates the design and development of a surgical assistance robot which overcomes the current limitations and moreover provides new surgical abilities.
Based on 23G pars-plana vitrectomy equipment, an additional interface tool was designed to dock to the patients eye and stabilize the instrument. The robot itself consists of 6 piezo motors (5 prismatic, 1 rotational) with sub-nanometer precision but the encoders used have micrometer precision. Therefore the final linear precision of the device is around 5µm and the angular precision of the robot is 5.88X10^(-5)rad which should be largely sufficient for all ophthalmic applications. The working volume of the robot resembles a box of 50X50X50 mm with 360 degree of free tool rotation while the maximum linear velocity of the tool motion in different directions is 40mm/s and the maximum linear velocity of the robot is 1.11 rad/s. The robot was designed with an adjustable RCM (remote center of motion) point that allows it to be configured to manipulate the tool pivoting around the insertion point.
A compact 6DOF robot smaller than a human hand and with the weight of 312gr was developed. This robot is mounted on the patient’s head and is able to use conventional surgical tools. The surgeon controls the robot using a master console located close to the head of the patient. The compatibility in an ophthalmic operation environment was evaluated. This evaluation approved that the robot won’t conflict other surgical devices such as the microscope and assured that the surgical area remains accessible for the surgeon. The entire setup was already tested successfully in pig eyes.
This abstract introduced the developed robot to assist the surgeons during vitreoretinal surgery. Although vein cannulation is the main objective of this project, it enables other retinal micro manipulation procedures as well.
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