Bone-mounted miniature robot for surgical procedures: concept and clinical
applications

M. Shoham (1,2), M. Burman (2), E. Zehavi (2), L. Joskowicz (3),
E. Batkilin (2), and Y. Kunicher (2)

(1) Faculty of Mechanical Engineering, Technion -- Israel Institute of Technology, ISRAEL.
(2) Mazor Surgical Technologies Ltd., ISRAEL.
(3) School of Computer Science and Engineering, The Hebrew University of Jerusalem, ISRAEL.

Abstract

This paper presents a new approach to robot-assisted spine and trauma
surgery in which a miniature robot is directly mounted on the patient's
bony structure near the surgical site. The robot is designed to operate in
a semi-active mode to precisely position and orient a drill or a needle in
various surgical procedures. Since the robot forms a single rigid body with
the anatomy, there is no need for immobilization or motion tracking, which
greatly enhances and simplifies the robot's registration to the target
anatomy. To demonstrate this concept, we developed MARS (MiniAture Robot
for Surgical procedures), a 5x5x7 cm3, 150-gram, six-degree-of-freedom
parallel manipulator. We are currently developing two clinical orthopaedic
applications to demonstrate the concept: (1) surgical tools guiding for
spinal pedicle screws placement, and; (2) drill guiding for distal locking
screws in intramedullary nailing. In both cases, a tool guide attached to
the robot is positioned at a planned location with a few intraoperative
fluoroscopic X-ray images.  Preliminary in-vitro experiments demonstrate
the feasibility of this concept.

Keywords: medical robotics, surgical robots, orthopaedics, image-based
robot registration and targeting.

Published in: 

IEEE Transactions on Robotics and Automation, Special issue on Medical Robotics,
R.H. Taylor guest editor, Vol 19(5), 2003, pp 893--901.