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into the existing workflow. The operation robot can be attached to the surgical microscope with a ring. Because the ring is mounted to the microscope, access to the operating table is flexible. In addition, the robot arms can simply be ‘clicked’ to the ring in any arrangement. Because the system is modular it is possible to create a co-operative arrangement using multiple robot arms. The joysticks used by the surgeon to control the arms are mounted to the side rail of the operating table. The robot arms are designed to work with existing surgical instruments that fit into the robot’s ‘hands’.

Using the robot The MSR consists of two masters and a foot

pedal that are operated by the surgeon. The tools are used to control the compact robot arms – which weigh just 1.5 kilo each. The surgeon’s relatively wide arm movements are translated into hyper precise movements of the robot arms handling the surgical instruments. The scale (freely adjustable) is 1 to 10 – if the surgeon’s hand moves 1cm, the robot arm will move 1mm. The movements are ‘scaled’. The foot pedals are intended to actually couple the master with the robot arm – if the foot pedal is not pressed, the robot arm remains perfectly idle the surgeon is able to relax. The system with the joysticks (master) filters

hand tremors and supports ‘force feedback’ in order to provide the surgeon with a clear indication of minuscule touches. Unexpected or oversized movements are corrected and a safety stop is built-in in case of sudden movements or if the master is released.

The prototype robot… offers surgeons the possibility to stitch blood vessels and nerves with a diameter of just 1mm together and it is five times more precise than the hands of the best surgeons.

‘It is expected that it will take approximately three years of testing before the robot can be applied to humans.’

Eye surgery “If we have to estimate a price for this

modular robot, including four arms, I would say that price would be approximately

€300.000,” said Raimondo Cau. From an economic point of view, especially when compared to existing commercial robots, this is a bargain. That is due to the modularity of the system and to the materials used. Further, because the robot arms can be attached to existing operating room equipment and can use existing instruments, hospitals do no face high costs when setting up an operating room

Preceyes The MSR is not the only specialist robot that

is being developed at Eindhoven University. Indeed, the engineer partially based his design on another robot in the faculty laboratory – a robot names Preceyes. This robot is specifically designed for eye surgery and is capable of injecting fluids into capillaries with a diameter of 0.05mm.

The surgical robot is 20 times more accurate than has been achieved to date and enables ophthalmologists to perform operations that in the past would have been impossible. Preceyes can simply be attached to any operating table – just as the MSR – and can be moved sideways if a surgeon wishes to perform a task manually. And then there is Sofie. Sofie is a robot

designed for minimally invasive surgery – laparoscopic surgery. This robot is somewhat older than the others and was developed by mechanical engineer Linda van den Bedem. At its core, Sofie is an improved and cheaper version of the Da Vinci robot. Sofie is, however, a prototype that lives in the laboratory and is only used for research. In terms of technique Sofie is further developed. The instruments she uses for laparoscopy, for example, were given an

additional elbow hinge allowing for more flexible movements. However, the main feature is the built in force feedback enabling surgeons to actually feel the tissue resistance – as they do during ‘normal’ procedures. In this way, the surgeon, for example, can feel how hard the instrument pulls a suture.

The future The future looks bright for Preceyes. The Eindhoven team is focussing primarily on developing robots with applications that have a good chance of entering the market. The eye robot is currently used for

preclinical research into new surgical procedures, while the team is working hard to find an investor for the development of this robot into a fully operational system. The aim is to have a certified system ready three years from now. The expectation is that by this time, 300 such robots will be sold worldwide on a yearly basis. In the Netherlands there is a demand for up to five such eye robots. The MSR is essentially finished and

working. However, before the robot can enter the market, the system must be thoroughly tested and approved by medical authorities. It will take some time before hospitals can purchase the robot. Maastricht University Medical Centre has already indicated a wish to buy one and the prospects look promising. It is expected that it will take approximately three years of testing before the robot can be applied to humans. To get to that stage, a great deal of financial investment is required. At least €200,000 will be required to go through the admission procedure and once certified it will cost more to actually set up a production and sales network. But when the day finally comes and the

MSR can do what it is was designed to do, many women will be thankful. Hopefully some day the waiting list for reconstructive breast surgery will disappear. .

Providing insights into the vast field of healthcare engineering and facility management


Photo courtesy of Bart van Overbeeke.

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