Medical Robotics Research in Japan

Ichiro SakumaBiomedical Precision Engineering Lab.,Graduate School of Frontier Sciences,

The University of Tokyo,

2005/06/25

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Medical Robotic Study in Japan

Powered orthosis study was conducted in 1970s.Application of robotic technology to welfare engineering has long history of research.Surgical Robotics research stared in early In 1980’s.Research group on Computer Aided Surgery (CAS) was formulated in 1987 and the Japan Society of Computer Aided Surgery is established in 1992.New applications are studied in medical robotics.

Funakubo, early 1980 Takakura, Fujie, Dohi, et al.2000

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Academic Activities of Medical robotics

Examples:89 papers among papers 887 papers at 2005 Annual Meeting on Robotics-Mechatronics of Japan Society for Mechanical Engineers,

Annual meeting on JSCAS (Japan Society of Computer Aided Surgery) 25/122 in 2003, 30/126 in 2004

Many plenary programs on robotics in medical academic societies such as Endoscopic Surgery Society of Japan, Japan Society of Orthopedic Surgery, and etc.

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Assistive technology and welfare engineering

Robotics for rehabilitation

Robotics for augment human physical capability

Robotics for care Environmental control system

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Welfare robotics

Intelligent wheel chair with autonomous traveling ability(Matsumoto et al 2005, AIST, AISIN SEIKI CO.,LTD, FUJITSU LIMITED

GPS Antenna

Laser Range Sensor

Integrated Control System

Intelligent wheel chair with autonomous traveling ability(Matsumoto et al 2005, AIST, AISIN SEIKI CO.,LTD, FUJITSU LIMITED

GPS Antenna

Laser Range Sensor

Integrated Control System

6-DOF Rehabilitation Robot for Upper Limbs including Wrists (Furusho et al. 2005, Osaka Univeristy)

6-DOF Rehabilitation Robot for Upper Limbs including Wrists (Furusho et al. 2005, Osaka Univeristy)

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Commercialized Robotic System for Welfare Engineering

Hitatchi, Walking Rehabilitation Robot

DAIHEN, Patient Transfer Robot

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Surgical Robotics

Manipulator for Endosopic SurgeryBending forceps based on rigid linkage mechanism rather than wire driven mechanismIncorporation with surgical devicesIncorporation with flexible endoscopeMiniaturization of the system for neuro/fetus Surgery

Application of Robotic Technologies to surgical navigationImage guidance of surgical robotRobotic technology for minimally invasive precision target therapy.Robotic technology for basic medical research

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2 DOF Bending2 DOF Bending（Yamashita, Dohi 2003)

Linkage for constraints (blue) Linkage for drive (red)

0° -45° -90°+45°+90°

フレーム

Linkage for constraints (blue) Linkage for drive (red)

0° -45° -90°+45°+90°

フレーム

0° -45° -90°+45°+90°

フレーム

Bending forceps based on rigid linkage mechanism

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Master-Slave Combined Manipulator for MIS

Matsuhira, Jinno et al,2003, Toshiba Co.

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φ 11[mm]

Suzuki, Sakuma et al.: 2004, The Univ. of Tokyo

Incorporation with surgical devices

Bending US coagulator/CutterNakamura, Iseki, 2004, Tokyo Women’s Medical University

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Endoscopic Surgery SystemIkuta, 2004, Nagoya Univerisity

Endoscopic Surgery SystemIkuta, 2004, Nagoya Univerisity

OLYMPUS CO. http://www.olympus.co.jpOLYMPUS CO. http://www.olympus.co.jp

Image of Small Intestine

Flexible Endoscope type Robot and Capsule Endoscope

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Harada, Fujie 2005, Waseda Univ.

Miniaturization of Bending Forceps

Takakura, Fujie, Dohi, et al. Hitachi, ltd. 2000

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Application of Robotic Technologies to Surgical Navigation

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Image Guided Control of Surgical Robotics

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Puncture of a RFA Needle for Hepatic Tumor under the Navigation System as well as a direct vision with a MR compatible Endoscope

Endoscopic View

Navigation System

Polaris for Measurement

Manipulator for Needle

Manipulator for Endoscope

Open MRI

Hashizume 2005, Kyushu Univ.

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Volume Rendering Images

Volume rendering images changed as the operator wants

The images are changed at each 4 seconds per frame while following the tip of the needle

TargetRFA needle

Frame Rate:4s/frame

Needle

Image Guided Control of Surgical Robot

Hashizume 2005, Kyushu Univ.

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Precision-guided LASER Surgery System

real time segmentation

5-ALA2.8μ micro-Laser

log

real time segmentation

5-ALA2.8μ micro-Laser

log

2.8μ micro-Laser

log

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Research funding

Ministry of Science and TechnologiesBasic Research of medical robotics

Ministry of Economy Trade and IndustryFunding for Industries

Ministry of Welfare and LaborAiming for clinical application of medical robotics

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Problems in medical robotics application

Tight regulations by Ministry of Health and LaborsDaVinci surgical robot has not been yet approved as medical devices in Japan.Lack of risk assessment capability of medical robotics

Lack of engineering personnel to facilitate use of advanced technologies in hospital

Numbers of Ph.D. in engineering at hospitals are still limited in Japan.

Clinical use of medical robotics is still limited because of safety issues and medical insurance coverage.

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Actions for Medical Robotics Acceptance

Japan Industrial Robotic Association conducted researches on risk assessment of medical robotics.

Academic societies involving medical robotics started discussion on risk assessment and standardization.

Ministry of Economy Trade and Industry conducted pilot studies on personal robotics that interacts with human at Aichi EXPO 2005.

Ministry of Economy Trade and Industry and Ministry of Health and Labor started to establish guidelines for advanced medical devices for reduction of time and cost for approval as medical devices.

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Summary

In Japan, there are many active researches on medical robotics.Research grants are provided by several ministry of government depending on the stage of researches (basic/ industrialization/ clinical).Some commercially available products exists.There is tight regulation by ministry of health and labor.Clinical use of medical robotics is still limited because of safety issues and medical insurance coverage.Establishment of safety guideline and efficacy validation method is required to enhance application of robotics in clinical environment.