Toward the Art of Robotic-assisted Vitreoretinal Surgery

New technological progress in robotics has brought many beneficial clinical applications. Currently, computer integrated robotic surgery has gained clinical acceptance for several surgical procedures. Robotically assisted eye surgery is envisaged as a promising solution to overcome the shortcomings inherent to conventional surgical procedures as in vitreoretinal surgeries. Robotics by its high precision and fine mechanical control can improve dexterity, cancel tremor, and allow highly precise remote surgical capability, delicate vitreoretinal manipulation capabilities. Combined with magnified three-dimensional imaging of the surgical site, it can enhance surgical precision. Tele-manipulation can provide the ability for tele-surgery or haptic feedback of forces generated by the manipulation of intraocular tissues. It presents new solutions for some sight-threatening conditions such as retinal vein cannulation where, due to physiological limitations of the surgeon's hand, the procedure cannot be adequately performed. In this paper, we provide an overview of the research and advances in robotically assisted vitreoretinal eye surgery. Additionally the barriers to the integration of this method in the field of ocular surgery are summarized. Finally, we discuss the possible applications of the method in the area of vitreoretinal surgery.

[1]  Tsu-Chin Tsao,et al.  A Prototype Surgical Manipulator for Robotic Intraocular Micro Surgery , 2009, MMVR.

[2]  Russell H. Taylor,et al.  Cooperative Robot Assistant for Retinal Microsurgery , 2008, MICCAI.

[3]  Cameron N. Riviere,et al.  Toward active tremor canceling in handheld microsurgical instruments , 2003, IEEE Trans. Robotics Autom..

[4]  Marc D de Smet,et al.  Release of experimental retinal vein occlusions by direct intraluminal injection of ocriplasmin , 2016, British Journal of Ophthalmology.

[5]  Cameron N. Riviere,et al.  Micron: An Actively Stabilized Handheld Tool for Microsurgery , 2012, IEEE Transactions on Robotics.

[6]  Cameron N. Riviere,et al.  Physiological tremor amplitude during retinal microsurgery , 2002, Proceedings of the IEEE 28th Annual Northeast Bioengineering Conference (IEEE Cat. No.02CH37342).

[7]  Russell H. Taylor,et al.  A comparative study for robot assisted vitreoretinal surgery: Micron vs. the Steady-Hand Robot , 2013, 2013 IEEE International Conference on Robotics and Automation.

[8]  Dominiek Reynaerts,et al.  Design of a teleoperated robotic system for retinal surgery , 2014, 2014 IEEE International Conference on Robotics and Automation (ICRA).

[9]  Lynette A. Jones,et al.  A Teleoperated Microsurgical Robot and Associated Virtual Environment for Eye Surgery , 1993, Presence: Teleoperators & Virtual Environments.

[10]  Berk Gonenc,et al.  Robot-assisted retinal vein cannulation with force-based puncture detection: Micron vs. the steady-hand eye robot , 2016, EMBC.

[11]  H. Das,et al.  Dexterity-enhanced telerobotic microsurgery , 1997, 1997 8th International Conference on Advanced Robotics. Proceedings. ICAR'97.

[12]  Mohammad Hossein Maghami,et al.  Visual Prostheses: The Enabling Technology to Give Sight to the Blind , 2014, Journal of ophthalmic & vision research.

[13]  Jake J. Abbott,et al.  A Compact Telemanipulated Retinal-Surgery System that Uses Commercially Available Instruments with a Quick-Change Adapter , 2016, J. Medical Robotics Res..

[14]  Robert Macherner,et al.  The development of pars plana vitrectomy: a personal account , 2004, Graefe's Archive for Clinical and Experimental Ophthalmology.

[15]  Alois Knoll,et al.  The introduction of a new robot for assistance in ophthalmic surgery , 2013, 2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[16]  Wei Wei,et al.  Design and Theoretical Evaluation of Micro-Surgical Manipulators for Orbital Manipulation and Intraocular Dexterity , 2007, Proceedings 2007 IEEE International Conference on Robotics and Automation.

[17]  Hamid D. Taghirad,et al.  Kinematic and workspace analysis of DIAMOND: An innovative eye surgery robot , 2015, 2015 23rd Iranian Conference on Electrical Engineering.

[18]  Sungwook Yang,et al.  Towards vision-based control of a handheld micromanipulator for retinal cannulation in an eyeball phantom , 2012, 2012 4th IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics (BioRob).

[19]  T. Tsao,et al.  Robot-assisted intraocular surgery: development of the IRISS and feasibility studies in an animal model , 2013, Eye.

[20]  Wei Wei,et al.  Performance Evaluation for Multi-arm Manipulation of Hollow Suspended Organs , 2009, IEEE Transactions on Robotics.

[21]  Hcm Thijs Meenink,et al.  A master-slave robot for vitreo-retinal eye surgery , 2010 .

[22]  A. Mitra,et al.  Ocular Drug Delivery , 1990 .

[23]  R B Wallace.  The 45 degree tilt: improvement in surgical ergonomics. , 1999, Journal of cataract and refractive surgery.

[24]  J-P Hubschman,et al.  ‘The Microhand’: a new concept of micro-forceps for ocular robotic surgery , 2010, Eye.

[25]  Mark S Humayun,et al.  Retinal vein cannulation with prolonged infusion of tissue plasminogen activator (t-PA) for the treatment of experimental retinal vein occlusion in dogs. , 2002, American journal of ophthalmology.

[26]  Cameron N. Riviere,et al.  Design and implementation of active error canceling in hand-held microsurgical instrument , 2001, Proceedings 2001 IEEE/RSJ International Conference on Intelligent Robots and Systems. Expanding the Societal Role of Robotics in the the Next Millennium (Cat. No.01CH37180).

[27]  I J Constable,et al.  Robotic ocular ultramicrosurgery. , 1998, Australian and New Zealand journal of ophthalmology.

[28]  Russell H. Taylor,et al.  New steady-hand Eye Robot with micro-force sensing for vitreoretinal surgery , 2010, 2010 3rd IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics.

[29]  A. Lanfranco,et al.  Robotic Surgery: A Current Perspective , 2004, Annals of surgery.

[30]  J. Edward Colgate,et al.  Toward robot-assisted vascular microsurgery in the retina , 2005, Graefe's Archive for Clinical and Experimental Ophthalmology.

[31]  Hari Das,et al.  Development of a new high-dexterity manipulator for robot-assisted microsurgery , 1995, Other Conferences.

[32]  Anthony Atala,et al.  3D bioprinting of tissues and organs , 2014, Nature Biotechnology.

[33]  Daniel Rueckert,et al.  Medical Image Computing and Computer-Assisted Intervention − MICCAI 2017: 20th International Conference, Quebec City, QC, Canada, September 11-13, 2017, Proceedings, Part II , 2017, Lecture Notes in Computer Science.

[34]  Charles Woolley,et al.  Quantitative posture analysis of 2D, 3D, and optical microscope visualization methods for microsurgery tasks. , 2012, Work.

[35]  Russell H. Taylor,et al.  A Steady-Hand Robotic System for Microsurgical Augmentation , 1999, Int. J. Robotics Res..

[36]  Ahmed Ahdy Haggag.  Robotic Surgery: When Technology Meets Surgical Precision , 2005 .

[37]  Hcm Thijs Meenink.  Vitreo-retinal eye surgery robot : sustainable precision , 2011 .

[38]  Matthew R. Glucksberg,et al.  A six degree of freedom micromanipulator for ophthalmic surgery , 1993, [1993] Proceedings IEEE International Conference on Robotics and Automation.

[39]  T. Stout.  Gene therapy in ocular disease. , 1995, Ophthalmology.

[40]  George D. Stetten,et al.  Hand-Held Force Magnifier for Surgical Instruments , 2011, IPCAI.

[41]  Dominiek Reynaerts,et al.  Precision experiments on a comanipulated robotic system for use in retinal surgery , 2011 .

[42]  Jake J. Abbott,et al.  A Compact Retinal-Surgery Telemanipulator that Uses Disposable Instruments , 2015, MICCAI.

[43]  D. Jolly,et al.  Automatic analysis of weariness during a micromanipulation task by SMOS , 1989, Images of the Twenty-First Century. Proceedings of the Annual International Engineering in Medicine and Biology Society,.

[44]  A. Guerrouad,et al.  SMOS: stereotaxical microtelemanipulator for ocular surgery , 1989, Images of the Twenty-First Century. Proceedings of the Annual International Engineering in Medicine and Biology Society,.

[45]  Jake J. Abbott,et al.  OctoMag: An Electromagnetic System for 5-DOF Wireless Micromanipulation , 2010, IEEE Transactions on Robotics.

[46]  Mamoru Mitsuishi,et al.  A parallel robot to assist vitreoretinal surgery , 2009, International Journal of Computer Assisted Radiology and Surgery.

[47]  Marc D de Smet,et al.  Robotic Assisted Cannulation of Occluded Retinal Veins , 2016, PloS one.

[48]  C. Pournaras,et al.  New ocular micromanipulator for measurements of retinal and vitreous physiologic parameters in the mammalian eye. , 1991, Experimental eye research.

[49]  Steven D. Schwartz,et al.  Robotic Surgery in Ophthalmology , 2010 .

[50]  Alois Knoll,et al.  Kinematics and dynamics analysis of a hybrid parallel-serial micromanipulator designed for biomedical applications , 2013, 2013 IEEE/ASME International Conference on Advanced Intelligent Mechatronics.