Purpose: Expectations for remote surgery in endovascular treatments are increasing. We conducted
the world's first remote catheter surgery experiment using an endovascular treatment-supported
robot. We considered the results, examined the issues, and suggested countermeasures
for practical use. Methods: The slave robot in the angiography room is an original machine that enables sensing
feedback by using an originally developed insertion force-measuring device, which
detects the pressure stress on the vessel wall and alerts the operator using an audible
scale. The master side was set in a separate room. They were connected via HTTP communication
using local area network system. The surgeon operated by looking at a personal computer
monitor that shared an angiography monitor. The slave robot catheterized and inserted
a coil for an aneurysm in the silicon blood vessel model in the angiography room.
Results: Our robot responded to the surgeon's operations promptly and to the joystick's swift
movements quite accurately. The surgeon could control the stress to the model vessels
using various actions, because the operator could hear the sound from the insertion
force. However, the robot required a time gradient to reach a stable advanced speed
at the time of the initial movement, and experienced a slight time lag. Conclusion: Our remote operation appeared to be sufficiently feasible to perform the surgery
safely. This system seems extremely promising for preventing viral infection and radiation
exposure to medical staff. It will also enable medical professionals to operate in
remote areas and create a ubiquitous medical environment.
Key-words:
Neuroendovascular intervention - remote surgery - robotics - sensor feedback
