Towards Patient-Specific 3D-Printed Robotic Systems for Surgical Interventions

Abstract

Surgical robots have been extensively researched for a wide range of surgical procedures due to the advantages of improved precision, sensing capabilities, motion scaling, and tremor reduction, to name a few. Though the underlying disease condition or pathology may be the same across patients, the intervention approach to treat the condition can vary significantly across patients. This is especially true for endovascular interventions, where each case brings forth its own challenges. Hence it is critical to develop patient-specific surgical robotic systems to maximize the benefits of robot-assisted surgery. Manufacturing patient-specific robots can be challenging for complex procedures and furthermore the time required to build them can be a challenge. To overcome this challenge, additive manufacturing, namely 3D-printing, is a promising solution. 3D-printing enables fabrication of complex parts precisely and efficiently. Although 3D-printing techniques have been researched for general medical applications, patient-specific surgical robots are currently in their infancy. After reviewing the state-of-the-art in 3D-printed surgical robots, this paper discusses 3D-printing techniques that could potentially satisfy the stringent requirements for surgical interventions. We also present the accomplishments in our group in developing 3D-printed surgical robots for neurosurgical and cardiovascular interventions. Finally, we discuss the challenges in developing 3D-printed surgical robots and provide our perspectives on future research directions.

Keywords: 3D-printed actuators; 3D-printed sensors; 3D-printing; Surgical robots; accuracy; biocompatibility; neurosurgical robot; patient-specific; robotic catheter; shape memory alloy; smoothness; sterilizability; stiffness; tendon-driven; thermal stability.

Fig. 1.

Three-segment MINIR-II robot equipped with electrocautery probes and suction/irrigation tubes.

Fig. 2.

(a) MINIR-II robotic system consisting of the switching mechanism, linkage mechanism, and the quick-connect module. (b) Detailed CAD model of the switching mechanism.

Fig. 3.

MR images showing the MINIR-II robot in the human cadaver study: (a) immediately after being inserted, (b) robot deflected rightward, and (c) robot deflected leftward.

Fig. 4.

Development of the NICHE robot: (a) NICHE robot prototype mounted on a fixed headframe, (b) design of the SMA torsion actuator and fiberoptic rotation sensor, (c) prototype of the sensor rotor with the brass reflector, and (d) demonstration of tip articulation under feedback control.

Fig. 5.

Skull-mounted robotic headframe: (a) demonstration of the headframe mounted on a skull model, (b) linear actuation module, (c) connection between the gear rack and robot stem via the snap-fit mechanism.

Fig. 6.

Ex vivo evaluation of the NICHE robot system using a human cadaver head: (a) setup for CT imaging-guided test, (b) 3D imaging reconstruction by the DynaCT technique, (c) setup for MR imaging-guided test, and (d) large-deflection of the robot tip in brain.

Fig. 7.

Development and evaluation of the robotic catheter for AFib treatment: (a) prototype of the robotic catheter, (b) routing nichrome coils around the SMA wire, (c) manipulation of the catheter tip under MR imaging guidance, and (d) ex vivo demonstration of the catheter using an explanted human heart.