ARTEMIS. A telemanipulator for cardiac surgery.

ARTEMIS, the Advanced Robotics and TElemanipulator System for Minimally Invasive Surgery, is designed as an integrated teleoperation and telepresence system for planning, training and performing different minimally invasive surgical procedures. The actual prototype was developed as an experimental device for exploring and testing the needed technologies and their capability and quality with respect to surgical application. The main components are two master-slave units guiding the surgical instruments and a remotely controlled endoscope guiding system. Each master-slave device consists of the slave or work unit and the master or control unit which are interconnected by a computer based control system. The work unit is operating at the patient by means of dexterous surgical instruments consisting of multifunctional endoeffectors with flexible distal section providing six degrees of freedom. The kinematic structure of the work unit ensures a precise motion around the incision point through the abdominal or thoracic wall. The master or control unit guided by the surgeon is designed to enable the surgeon to operate intuitively as if he were guiding the tip of the endoeffector manually. The powered endoscope guiding system is equipped with a 3D-endoscope. The computer based control system interconnecting control and work units has an open system architecture which allows to couple differently designed masters and slaves, monitoring systems, graphical system and user interfaces. The endoscope can be guided by a simple joystick, voice control or automatic camera tracking. For minimally invasive cardiac surgery a new concept has to be developed. In co-operation with the Cardiovascular Institute of the University of Dresden a step-by-step procedure was agreed. The state-of-the-art is described.