Robotic assisted surgery (RAS) systems, such as the da Vinci (Intuitive Surgical), incorporate highly dexterous tools, hand tremor filtering, and motion scaling to enable a minimally invasive surgery (MIS) approach, reducing collateral damage and patient recovery times. However, current state-of-the-art tele-robotic surgery requires a surgeon operating every motion of the robot, resulting in long procedure times and inconsistent results. The advantages of autonomous robotic functionality have been demonstrated in applications outside of medicine, ranging from manufacturing to self-driving cars. A limited form of autonomous RAS with pre-planned functionality was introduced in bony orthopedic procedures, radiotherapy, and cochlear implants. Efforts in automating deformableand unstructured soft tissue surgeries have been limited so far to elemental tasks such as knot tying, needle insertion, and executing predefinedmotions.
The goal of this research is to develop a robotic surgical system to perform complex soft tissue surgeries such as anastomosis and tumor resections autonomously ? with the ultimate goal of improving surgical outcome and reducing procedure times. The system consists of a lightweight robot arm, custom interchangeable robotic tools for suturing and electro-cautery, a plenoptic three-dimensional and near-infrared fluorescent (NIRF)imaging system, and autonomous robot control algorithms. We demonstratedthat the outcome of supervised autonomous anastomoses is superior to surgery performed by expert surgeons and RAS techniques in ex vivo and in vivoporcine studies. We also demonstrated autonomous tumor resection results using visual servoing with consistent tumor margins.
Assistant Professor Dr. Axel Krieger joined the University of Maryland, Department of Mechanical Engineering in the Clark School of Engineering, in 2017. He is leading a group of students, scientists, and engineers in the research and development of robotic tools and laparoscopic devices. Projects include the development of a surgical robot called smart tissue autonomous robot (STAR) and the use of 3D printing for surgical planning and patient specific implants. Professor Krieger holds several licensed patents for biomedical devices. Before joining the University of Maryland, Professor Axel Krieger was Assistant Research Professor and program lead for Smart Tools at the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National. He has several years of experience in private industry at Sentinelle Medical Inc and Hologic Inc. His role within these organizations was Product Leader developing devices and software systems from concept toFDA approval and market introduction. Dr. Krieger completed his undergraduate and master’s degrees at the University of Karlsruhe in Germany and his doctorate at Johns Hopkins, where he pioneered an MRI guided prostate biopsy robot used in over 50 patient procedures at three hospitals.