". Translation into Russian by the editorial website

2.3 Medicine and robotics

2.3.1 Scope overview

Healthcare and robots

As a result of demographic changes in many countries, health care systems are facing increasing pressure to serve an aging population. As demand for services increases, procedures are being improved, leading to improved results. At the same time, the costs of providing medical services are rising, despite a decrease in the number of people employed in the provision of medical care.

The use of technology, including robotics, appears to be part of possible solution. IN this document The medical field is divided into three subfields:

- Robots for hospitals (Clinical Robotics): Relevant robotic systems can be defined as those that provide "caring" and "healing" processes. First of all, these are robots for diagnosis, treatment, surgery and medication administration, as well as in systems emergency assistance. Such robots are controlled by hospital staff or trained patient care professionals.

- Robots for rehabilitation (Rehabilitation): Such robots provide post-operative or post-traumatic care where direct physical interaction with the robotic system will either accelerate the recovery process or provide replacement for lost functionality (for example, when we're talking about about a prosthetic leg or arm).

- Assistive robotics: This segment includes other aspects of robotics used in medical practice, when the primary purpose of robotic systems is to provide support or to the person who provides medical care, or directly to the patient, regardless of whether we are talking about a hospital or another medical institution.

All of these subdomains are characterized by the fact that they require safety systems that take into account the clinical needs of patients. Typically, such systems are operated or configured by qualified hospital personnel.

Medical robotics is more than just technology

In addition to the development of robotic technology itself, it is important that appropriate robots are implemented as part of hospital treatment processes or other medical procedures. Requirements for the system should be formed on the basis of clearly identified needs of the user and recipient of services. When developing such systems, it is critical to demonstrate the added value they can provide when implemented, this is critical to continued success in the market. Achieving additional benefits requires the direct involvement of medical professionals and patients in the development of this technology, both at the design and implementation stages of robot development. Developing systems in the context of their future application environment ensures stakeholder involvement. A clear understanding of current medical practice, the obvious need to train medical personnel in using the system, and knowledge of various information that may be required for development are critical factors in creating a system suitable for further implementation. The introduction of robots into medical practice will require adaptation of the entire medical service delivery system. This is a delicate process in which technology and health care delivery practices interact and will need to adapt to each other. From the moment development begins, it is important to take this aspect of "interdependence" into account.

The development of robots for medical purposes includes a very wide range of different potential applications. Let's consider them below, in the context of the three main market segments identified earlier.

Robots for hospitals

This segment is represented by a variety of applications. For example, the following categories can be distinguished:

Systems that directly enhance the surgeon's capabilities in terms of dexterity (flexibility and precision) and strength;

Systems that allow remote diagnosis and intervention. This category can include both tele-controlled systems, when the doctor can be at a greater or lesser distance from the patient, and systems for use inside the patient’s body;

Systems that provide support during diagnostic procedures;

Systems that provide support during surgical procedures.

In addition to these hospital applications, there are a number of hospital support applications, including robots for sampling, laboratory testing of tissue samples, and other services needed in hospital practice.

Robots for rehabilitation

Rehabilitation robotics includes devices such as prosthetics or robotic exoskeletons or orthoses that provide training, support or replacement for lost activities or impaired functionality of the human body and its structure. Such devices can be used both in hospitals and in Everyday life patients, but usually require initial setup by medical specialists and subsequent monitoring of their proper work and interaction with the patient. Post-surgical recovery, especially in orthopedics, is predicted to be the main application area for such robots.

Expert support and assistive robotics

This segment includes assistive robots intended for use in hospitals or home environments that are designed to assist hospital staff or caregivers in performing routine tasks. One can note a significant difference in the design and implementation of robotic systems associated with the place and conditions of their use. In the context of use by skilled personnel, whether in a hospital setting or in a home setting when using the robot to care for an elderly person, developers can rely on the robot being controlled by a skilled person. Such a robot must meet the requirements and standards of the hospital and healthcare system and have the appropriate certificates. These robots will assist the staff of relevant medical institutions in their daily work, especially nurses and caregivers. Such robotic systems should allow caregivers to spend more time with patients, reducing physical activity, for example, the robot will be able to lift the patient in order to perform the necessary routine operations on him.

2.3.2 Opportunities now and in the future

Medical robotics is an extremely challenging area to develop due to its multidisciplinary nature and the need to meet various stringent requirements, and also due to the fact that in many cases medical robotic systems physically interact with people who may also be in a very vulnerable state . Let us present the main opportunities that exist in the segments of medicine we have identified.

2.3.2.1 Hospital robots

These are robots for surgery, diagnostics and therapy. The surgical robot market is large in size. Robot-assistive capabilities can be used in almost all areas - cardiology, vascular medicine, orthopedics, oncology and neurology.

On the other hand, there are many technical challenges due to size limitations, capacity limitations, environmental constraints, and few technologies that are available for immediate use in hospital settings.

In addition to technological problems, there are also commercial ones. For example, related to the fact that the United States is trying to maintain a monopoly position in this market due to its extensive intellectual property. This situation can only be circumvented through the development of fundamentally new hardware, software and management concepts. Such developments also require substantial financial support for high-cost but necessary development and associated clinical trials. Typical areas where there are opportunities now:

Minimally Invasive Surgery (MIS)

Success can be achieved here by developing systems that can extend the flexibility of instrument movement beyond the limits provided by the anatomy of the surgeon's hands, increase efficiency, or complement the systems feedback(for example, allowing you to judge the force of pressing), or additional data to help carry out the procedure. Successful market adoption may depend on price efficiency product, reduced deployment time (getting ready for work) and reduced additional training required to learn how to use the robotic system. Any system developed must clearly demonstrate the “added value” in the context of surgery. Clinical pilot implementation and evaluation of such testing in clinics are mandatory for the system to be accepted by the surgical community.

Compared with other areas of minimally invasive surgery, robotic-assistive systems potentially provide the surgeon with better control of surgical instruments, as well as best review during the operation. The surgeon is no longer required to stand throughout the operation, so he does not tire as quickly as with the traditional approach. Hand tremors can be almost completely filtered out by the robot's software, which is especially important for applications in surgery that deals with microscale surgery, such as eye surgery. In theory, a surgical robot could be used almost 24 hours a day, replacing the teams of surgeons who work with it.

Robotics can provide fast recovery, reducing injuries and reducing the negative impact on the patient’s tissue, as well as reducing the required radiation dose. Robotic surgical instruments can free up the doctor's brain, shorten the learning curve, and improve workflow ergonomics for the surgeon. Therapy methods that are constrained by the limits of the human body are also becoming possible with the transition to the use of robotic technologies. For example, a new generation of flexible robots and instruments that allow access to organs deeply hidden in the human body, making it possible to reduce the size of the entrance incision in the human body or make do with natural openings in the human body to perform surgical operations.

In the long term, the use of learning systems in surgery can reduce the complexity of surgery by increasing the flow of useful information that the surgeon will receive during the operation. Other potential benefits include the ability to enhance the ability of paramedics to perform standard clinical emergency procedures using robots in the field, and to perform tele-surgery in remote locations where only a robot is available and no trained surgeon is available.

The following possibilities can be distinguished:

New compatible tools that provide increased safety while maintaining full handling capabilities, including rigid tools. Through the use of new control methods or special solutions (which, for example, can be built into the tool or external to it), the functioning of the tools can be adjusted in real time to ensure compatibility or stability, when that is most important;

The introduction of improved assistive technologies that guide and warn the surgeon during surgery, which allows us to talk about simplifying the solution of surgical problems and reducing the number of medical errors. This “training support” should improve “compatibility” between the equipment and the surgeon, ensuring that the system is used intuitively and without hesitation.

Application of suitable levels of robot autonomy in surgical practice up to full autonomy of specific well-determined procedures, for example: autonomous autopsy; taking blood samples (Veebot); biopsy; automation of some surgical actions (tightening knots, supporting the camera...). Increasing autonomy has the potential to improve efficiency.

- “Smart” surgical instruments are essentially controlled by surgeons. These instruments are in direct contact with the tissue and enhance the surgeon's skill level. Miniaturization and simplification of surgical instruments in the future, as well as the availability of surgical procedures inside and outside the "operating theater" is the main way for the development of such technologies.

Education: Providing physically accurate models, achieved through the use of tools with haptic feedback, has the potential to improve learning, both in the early stages of learning and when achieving confident performance skills. The ability to simulate a wide variety of conditions and challenges can also enhance the effectiveness of this type of training. Currently, the quality of tactile feedback still contains a number of limitations, which creates difficulties in demonstrating the superiority of this type of training.

Clinical samples: There are many applications for autonomous sampling systems, from systems for collecting blood samples and tissue samples for biopsy to less invasive autopsy techniques.

2.3.2.2 Robotics for rehabilitation and prosthetics

Robotics for rehabilitation covers a wide range various forms rehabilitation and can be divided into sub-segments. Europe has a fairly strong industry in this sector and active interaction with it will accelerate technological development.

Rehabilitation means

These are products that can be used after injury or after surgery to train and support recovery. The role of these products is to support recovery and accelerate recovery, while protecting and supporting the user. Such systems can be used in a hospital setting under the supervision of medical staff or act as a stand-alone exercise where the device controls or limits movements, depending on what is required in a given case. Such systems can also provide valuable data on the recovery process and monitor the condition more directly than even monitoring a patient in a hospital setting.

Functional replacement means

The purpose of such a robotic system is to replace lost functionality. This may be a result of aging or traumatic injury. Such devices are developed to improve the patient's mobility and motor skills. They can be designed as prosthetics, exoskeletons or orthopedic devices.

In developed rehabilitation systems, it is critical that existing European manufacturers are involved in the process as known market participants, and that relevant clinics and clinic partners are involved in the development process. Europe currently leads the world in this area.

Neuro-rehabilitation

(COST Network TD1006, European Network of Robotics for Neuro-Rehabilitation provides a platform for sharing standardization of definitions and examples of developments across Europe).

Currently, few robotic devices are used for neuro-rehabilitation because they have not yet been widely used. Robotics is used for post-stroke rehabilitation in the post-acute phase and other neuromotor pathologies such as Parkinson's disease, multiple sclerosis and ataxia. Positive results using robots (as good or better than using traditional therapy) for rehabilitation purposes are beginning to be confirmed by research results. Recently, positive results have also been confirmed by neuroimaging studies. It has been proven that integration with FES has shown increased positive outcomes (both for the muscular system and for the peripheral and central motor systems). Exercises with biofeedback and gaming interfaces are beginning to be seen as solutions that can be implemented, but such systems are still in the early stages of development.

In order to develop workable systems, several problems must be solved. These include low device costs, proven clinical trial results, and a well-defined patient assessment process. The systems' ability to correctly identify the user's intent and thereby prevent injury currently limits the effectiveness of such systems. Control and mechatronics integrated to meet the capabilities of the human body, including cognitive load, are in the early stages of development. Improvements in reliability and operating time must be achieved before commercially usable systems can be developed. Development goals should also include rapid deployment time and adoption by therapists.

Prosthetics

Significant progress can be made in the production of smart prostheses that can adapt to the user's movement patterns and environmental conditions. Robotics has the potential to combine improved self-learning capabilities with increased flexibility and control, especially for upper limb prostheses and hand prostheses. Particular areas of research include the ability to adapt to personal, semi-autonomous control, providing artificial sensitivity through feedback, improved verification, improved energy efficiency, self power recovery, improved myoelectric signal processing. Smart prosthetics and orthoses controlled by the patient's muscle activity will allow large groups of users to take advantage of such systems.

Mobility support systems

Patients with reduced physical capacity, either temporary or permanent, may benefit from increased mobility. Robotic systems can provide the support and exercise needed to increase mobility. There are already examples of the development of such systems, but they are at an early stage of development.

In the future, it is possible that such systems could even compensate for cognitive impairment, preventing falls and accidents. The limitations of such systems are related to their cost, as well as the ability to wear such systems for a long time.

In a number of rehabilitation applications, it is possible to use natural interfaces such as myoelectrics, brain signals, as well as interfaces based on speech and gestures.

2.3.2.3 Specialist support and assistive robots.

Expert support and assistive robotics can be divided into a number of application areas.

Caregiver support systems: Support systems used by caregivers who interact with patients or systems used by patients. These may include robotic systems that enable the use medicines, take samples, improve hygiene or recovery processes.

Lifting and moving the patient : Patient lifting and positioning systems can range from precise positioning during surgery or radiation therapy to assisting nursing staff or caregivers in lifting a person out of or into a bed, or in transporting patients around the hospital. . Such systems can be designed to be configured depending on the patient's condition and used so that the patient has a certain degree of control over their position. Limitations here may be related to the need to obtain safety certifications and safely manage sufficient forces to move patients in a manner that avoids potential patient injury. Energy-efficient structures and space-saving designs will be critical for efficient implementations.

When developing assistive robotics solutions, it is important to adhere to a set of basic principles. Development should focus on supporting functionality gaps rather than creating specific conditions. Solutions must be practical in terms of their use and provide tangible benefits to the user. This may include using technology to motivate patients to do as much as possible for themselves while maintaining safety. The implementation of such systems will not be viable and in demand if they do not provide the ability to reduce the workload on personnel, creating an economic case for implementation, while simultaneously being reliable and safe to use.

Biomedical laboratory robots for medical research

Robots are already finding their way into biomedical laboratories, where they sort and manipulate samples during research. Applications to create complex robotic systems are expanding the capabilities even further, such as into advanced cell screening and manipulations related to cell therapy and selective cell sorting.

2.3.2.4 Requirements in the medium term

The following list represents "growth points" in the field of medical robotics

Lower torso exoskeletons that adapt their function to the patient's individual behavior and/or anatomy, optimizing support depending on the user or environmental conditions. The systems can be adapted by the user to different conditions and to perform different tasks. Areas of application: neuro-rehabilitation and support for workers.

Robots designed for autonomous rehabilitation (e.g., play-based rehabilitation, upper limb rehabilitation after stroke) must perceive the patient's needs and reactions, and also adapt the therapeutic intervention to them.

Robots designed to support patient mobility and manipulation must support natural interfaces to ensure safety and performance in life-like environments.

Rehabilitation robots designed to enable sensor and motor integration by providing bidirectional communication, including multi-mode command input (myoelectric + inertial sensing) and multi-mode feedback (electro-tactile, vibro-tactile and/or visual).

Prosthetic arms, wrists, hands that automatically adapt to the patient, allowing him to control individually any finger, thumb rotation, wrist DOFs. This should be accompanied by the use of multiple sensors and pattern recognition algorithms to ensure natural control (constant force control) through possible DOFs. Areas of application: restoration of hand functionality for amputees.

Prosthetics and rehabilitation robots equipped with semi-automatic control systems to improve the quality of functioning and/or reduce the cognitive load on the user. Systems must allow perception and interpretation of the environment down to a certain level to enable autonomous decision making.

Prosthetics and rehabilitation robots are capable of using a variety of online resources (information storage, processing) through the use of cloud computing to implement advanced functionality that is significantly beyond the capabilities of on-board electronics and/or direct user control.

Inexpensive prosthetics and robotic solutions created using additive technologies or mass production (3D printing, etc.)

Home-based therapy that reduces intensity neuropathic pain or phantom upper limb pain through improved interpretation of muscle signals through the use of robotic limbs (with less flexibility than previous examples) and/or “virtual reality”.

Biomimetric control of interaction with a robot surgeon.

Adequate mechanical actuation and sensing technologies for the development of flexible miniature robots with force feedback, as well as instruments for advanced and advanced minimally invasive surgery.

Environmental charging systems for implantable micro-robots.

To obtain biomimetric control of rehabilitation processes: integration of volitional “impulses” during the movement of the subject, with the support of FES for improved re-learning of motor skills, when controlling the robot.

Developing hospital-applicable methods for restoring mobility that goes beyond the paradigm of commonly used static, manually adjusted mechanisms.

On low TRL

Automated cognitive understanding of required tasks in an ongoing environment. Seamless physical combination of man and robot for “normal” environmental conditions based on an additional control interface. Full, no-adjustment adaptability to the patient. Reliability of intent detection.

Introduction

In the era of rapid development of science and technology, many different innovations appear in a variety of fields. Medicine also does not stand still; new, complex devices for human life support are appearing, an example of this can be many devices, for example, a machine for artificial ventilation of the lungs, or a machine artificial kidney and so on. Miniature blood sugar meters, electronic pulse and blood pressure meters have appeared, and this list can be expanded many times.

More specifically, I would like to dwell on the example of the introduction of robotics in the medical industry. Various robots have been created by humans since approximately the end of the 20th century; over the past time they have been significantly improved and modernized.

Robots in medicine

Figure 1 - Robot surgeon "Da Vinci"

One of the most famous and celebrated achievements of recent times was the Da Vinci robot, named after the great engineer, artist and scientist Leonardo Da Vinci, who at one time designed the first anthropomorphic robot capable of moving its legs and arms, and performing other actions (Figure 1 ). This advanced technique combines all the advantages of classical and laparoscopic operations. During the operation, the surgeon is located at a convenient control panel, and a three-dimensional image of the operated area is displayed on the screen. The convenience of working with such a remote control has a beneficial effect on the work of the surgeon, since he does not get tired, as during standard surgery.

Figure 2 - Thermal manipulator joysticks

The surgeon controls the telemanipulator using special joysticks that respond to the touch of the fingertips (Figure 2). His movements are reproduced with absolute precision by robotics. This provides high quality operation and increases the safety of its implementation. In real time, the surgeon's movements are transmitted to the operating table of the system.

The Da Vinci surgical robot is equipped with ultra-precise manipulators of 4 arms, one of which has a built-in camera that transmits images in real time to the remote control, two more replace the surgeon's arms during the operation, and the fourth serves as an assistant (Figure 3).

Figure 3 - Robot manipulators

Using a tip placed at the end of the laparoscopic arms, incisions of 1-2 cm in size are made. Due to such small incisions, the level of tissue trauma is reduced.

The precision of movement of mechanical manipulators exceeds the capabilities of human hands. With seven degrees of freedom and the ability to bend 90 degrees, the robot's arms have a wide range of motion. This is indispensable when performing surgery in a confined space, for example, when working with the heart sac or small pelvis. A team of human assistants monitor the work of the da Vinci robot, preparing the site for incisions, monitoring the progress of the operation, and bringing sterile instruments.

Currently, the robot is equipped with the most advanced “eyes” in the world. 3D vision He had it before, but only now achieved high clarity. The new version allows two surgeons to monitor the operation at once. One of them can both assist and learn skills from senior colleagues. The working display can display not only the image from the cameras, but also two additional parameters, for example, ultrasound and ECG data.

The multi-armed da Vinci allows you to operate with great precision, and therefore with minimal intervention in the patient’s body. As a result, recovery from surgery is faster than usual.

Figure 4 - Robot diagnostician “Rosie”

Robot pharmacist "Rosie" works in Albuquerque, New Mexico.

Rosie's task is to prepare and distribute hundreds of medications. He works around the clock, takes virtually no breaks, and does not make any mistakes. In two and a half years of service in the hospital pharmacy, there was not a single case when a patient was sent the wrong medicine. Rosie's accuracy rate is 99.7 percent, which means that the sorting and dosage of prescribed drugs is never different from those specified in doctors' prescriptions.

The device weighing more than 4.5 tons was developed by a division of the corporate community projects department of Intel Corporation (Intel Community Solutions). Sliding along a metal rail, Rosie uses a mechanical “arm” to collect pill-filled bags hanging along the walls. She then places the bags, each barcoded, into envelopes and mails them to patients' rooms in pneumatic mail containers.

In the room, a nurse uses a small device to scan the patient's wristband and receive information about what medicine he should take, when and how much. The nurse then scans the barcode on the medicine package - this allows you to check whether the medicine is really intended for this patient, and whether the frequency and dosage of the drug are the same.

Rosie also helped to detect many errors in a timely manner. Rosie will never send expired medicine to a patient. The key to its accuracy is the state quality control standards embedded in the electronic brain of the machine. Meanwhile, according to the National Institutes of Health in Washington, about 50 thousand people die every year in the country due to medication errors. But compounding and distributing medications isn't the only problem Presbyterian Hospital has solved with Rosie's help. Before his appearance, it was very difficult to monitor the dispensing of narcotic drugs: employees spent a lot of time counting pills so that none of them went unaccounted for. Today the robot Rosie freed them from this routine work.

Figure 5 - Robot nanny

The robot nanny takes care of sick people, in particular those suffering from Alzheimer's disease (Figure 5).

It makes it easier for patients to communicate with doctors and relatives. Equipped with a camera, screen and everything necessary for wireless communication via the Internet, the Companion robot allows the doctor to contact the patient who is in a specialized clinic. The robot is also used to train staff, help patients with mobility problems, and communicate between patients and children. Oddly enough, the patients, who are usually reluctant to accept anything new, reacted quite well to the mechanical interlocutor: they pointed at him, laughed, and even tried to talk to him.

According to Yulin Wang, executive director of the company that created the machine, InTouch Health, the use of robots in caring for the elderly can alleviate the problem of an aging nation. In the meantime, the company plans to rent out its robots to nursing homes.

Figure 6 - Robot physiotherapist

A real step into the future was taken by engineers from the Massachusetts Institute of Technology, who replaced a physical therapist with a robot. As you know, people who have suffered a stroke forget about their usual life for a long time. Over the course of many months and even years, they learn to walk again, hold a spoon in their hands, and perform those everyday actions that they had never even thought about before. Now not only doctors, but also robots can help them.

We are talking about physiotherapy sessions necessary to restore coordination of hand movements. Nowadays, patients usually work out with doctors who show them the appropriate exercises. In the rehabilitation department of Boston City Hospital, where a new device is being tested, a stroke patient is asked to use a joystick to move a small cursor on the screen along a given path. If a person cannot do this, a computer-controlled joystick with the help of built-in electric motors will automatically move his hand to the required position.

Doctors were pleased with the performance of the new product. Unlike a human, a robot can perform the same movements thousands of times a day without getting tired.

Figure 7 - KineAssist complex

There is also a KineAssist complex (Figure 7). It is a joint development of the Chicago Rehabilitation Institute and kinea Design (formerly Chicago PT). Doctors and engineers who worked on this project, as a result of research, identified the main problems that arise during the rehabilitation of patients with musculoskeletal disorders. The main purpose of KineAssist is to provide more intensive and effective treatment to patients without disrupting their physical and psychological connection with physical therapists and eliminating the fear of falling.

The 227 kg device is a powered platform with intelligent belts that support the human torso to help patients with neurological impairment learn to balance and walk. KineAssist was designed to assist therapists, not to replace them. Sensors built into the belts predict the patient's movements and help him maintain balance. Given that the patient is now safe, physical therapists may encourage the patient to do more challenging exercises, such as stair walking or side steps. Despite its weight, the simulator moves forward, backward and sideways with the ease of a ballet dancer, depending on the direction of the patient’s movement. Thanks to special software, the physiotherapist can adjust the load and intensity during exercise.

KineAssist offers a large number of modes and types of exercises, the main of which are:

• - walking (it is possible to use KineAssist together with a treadmill);
• - balance training. During this exercise, the instructor tries to expand the patient’s usual “safety zone,” for example, by placing an obstacle in front of him that he will have to go around or step over;
• - strength training, where the simulator applies resistance when the patient moves (it is possible to train various muscle groups);
• - posture training. In this mode, the instructor fixes the patient’s body in a certain position, and during the exercises the simulator maintains this particular body position.

KineAssist can be used both for the treatment of patients who have recovered their motor functions relatively well, and for the initial rehabilitation of weaker patients immediately after an injury or illness. Since 2004, KineAssist has been successfully tested in rehabilitation centers USA (currently at Alexian Rehabilitation Hospital). Preliminary statistics on stroke survivors show that the rehabilitation of those who exercised on a robotic simulator is at least twice as effective. Unfortunately, due to the high price (more than 200,000 US dollars), only the largest medical institutions can afford this complex.

Figure 8 - RIBA Patient Carrying Robot

The Japan Institute of Physical and Chemical Research (BMC RIKEN) and Tokai Rubber Industries (TRI) have unveiled a “bear-like” robot designed to assist nurses in hospitals. New car literally carries patients in her arms (Figure 8).

RIBA (Robot for Interactive Body Assistance) is an improved version of the android RI-MAN.

Compared to its predecessor, RIBA has made significant progress.

Like RI-MAN, the beginner is able to carefully lift a person from a bed or wheelchair, carry him in his arms, for example, to the toilet, and then bring him back and just as carefully put him in bed or put him in a stroller. But if RI-MAN carried only dolls weighing 18.5 kg fixed in a certain position, RIBA already transports living people weighing up to 61 kilos.

The height of the “bear” is 140 centimeters (RI-MAN - 158 cm), and it weighs 180 kilograms with batteries (its predecessor - 100 kg). RIBA recognizes faces and voices, executes voice commands, navigates by collected video and audio data, which it processes 15 times faster than RI-MAN, and “flexibly” responds to the slightest changes in the environment.

The arms of the new robot have seven degrees of freedom, the head has one (later there will be three), and the waist has two degrees. The body is covered with a new soft material developed by TRI, like polyurethane foam. The engines are fairly quiet (53.4 dB), and the omnidirectional wheels allow the vehicle to maneuver in tight spaces.

Figure 9 - Robot assistant Yurina

Assistant robots will gradually be introduced, whose task will be to directly assist doctors; these models are already used in some foreign medical clinics. Yurina, a robot from the Japanese company Japan Logic Machine, which is capable of transferring bedridden patients in the manner of a hospital gurney, only much more smoothly (Figure 9).

What's even more interesting is that Yurina can transform into a wheelchair controlled by a touch screen, controller or voice. The robot is dexterous enough to navigate narrow corridors, which makes it a really good assistant for real doctors.

Figure 10 - Rapuda auxiliary robot arm

The latest development from the Japanese Intelligent Systems Research Institute also has a purely practical use. The Rapuda robotic arm is aimed at making life easier for people with disabilities who have problems with upper limb mobility (Figure 10). The hand, controlled by a joystick, takes a glass of water from the table and even picks up objects that have fallen on the floor.

So far the creators cannot say when and at what price Rapuda will be available to a wide range of buyers. It is definitely worth working on the speed of manipulation. But we can say for sure that such technology will clearly be in demand, so development continues.

Robot surgeon

At a California conference, the manufacturer NVIDIA voiced a very bold idea - to perform heart surgery without stopping the heart and opening the chest.

The robotic surgeon will perform the operation using manipulators connected to the heart through small holes in the patient's chest. On-the-fly imaging technology digitizes the beating heart, presenting the surgeon with a 3D model that he can navigate just as he would if he were looking at the heart through an open chest. The main difficulty is that the heart makes a large number of movements in a short time - but, according to the developers, the power of modern computing systems based on NVIDIA GPUs is enough to visualize the organ, synchronizing the movements of the robot's instruments with the heartbeat. Due to this, the effect of immobility is created - the surgeon does not care whether the heart is “standing” or working, because the robot’s manipulators make similar movements, compensating for the beat!

So far all information about this incredible technology consists of a short video demo, but we'll be eagerly awaiting more information from NVIDIA. Who would have thought that a video card manufacturer was planning to revolutionize surgery?

Today, research groups around the world are trying to figure out the concept of using robots in medicine. Although it would probably be more correct to say “already found it.” Judging by the number of developments and the interest of various scientific groups, it can be argued that the creation of medical microrobots has become the main direction. This also includes robots with the prefix “nano-”. Moreover, the first successes in this area were achieved relatively recently, just eight years ago.

In 2006, a team of researchers led by Sylvain Martel conducted a world-first successful experiment by inserting a tiny robot the size of a pen ball into the carotid artery of a living pig. At the same time, the robot moved along all the “waypoints” assigned to it. And over the years since then, microrobotics has advanced somewhat.

One of the main goals for engineers today is to create medical robots that will be able to navigate not only large arteries, but also relatively narrow blood vessels. This would make it possible to carry out complex types of treatment without such traumatic surgery.

But this is far from the only potential advantage of microrobots. First of all, they would be useful in the treatment of cancer, specifically delivering the drug directly to the malignant formation. The value of this opportunity is difficult to overestimate: during chemotherapy, drugs are given through an IV, causing a severe blow to the entire body. In fact, it is a strong poison that damages many internal organs and, for company, the tumor itself. This is comparable to carpet bombing to destroy a small single target.

The task of creating such microrobots is at the intersection of a number of scientific disciplines. For example, from the point of view of physics - how to make such a small object move independently in a viscous liquid, which for it is blood? From an engineering point of view, how to provide a robot with energy and how to track the movement of a tiny object throughout the body? From a biological point of view, what materials should be used to make robots so that they do not harm the human body? And ideally, robots should be biodegradable, so that the problem of removing them from the body does not have to be solved.

One example of how microrobots can “contaminate” a patient’s body is the “biorocket.”

This version of the microrobot is a titanium core surrounded by an aluminum shell. The robot diameter is 20 microns. Aluminum reacts with water, during which hydrogen bubbles form on the surface of the shell, which push the entire structure. In water, such a “biorocket” floats in one second a distance equal to 150 of its diameters. This can be compared to a two-meter tall person who swims 300 meters in a second, 12 pools. Such a chemical engine runs for about 5 minutes thanks to the addition of gallium, which reduces the intensity of the formation of the oxide film. That is, the maximum power reserve is about 900 mm in water. The direction of movement is set to the robot by an external magnetic field, and it can be used for targeted delivery of drugs. But only after the “charge” has dried up, the patient will find a scattering of microballs with an aluminum shell, which does not have a beneficial effect on the human body, unlike biologically neutral titanium.

Microrobots must be so small that traditional technologies simply cannot be scaled to the required size. They also do not produce any standard parts of suitable size. And even if they did, they simply would not be suitable for such specific needs. And therefore, researchers, as has happened many times in the history of inventions, seek inspiration from nature. For example, in the same bacteria. At the micro, and even more so at the nanoscale, completely different physical laws apply. In particular, water is a very viscous liquid. Therefore, it is necessary to apply other engineering solutions to ensure the movement of microrobots. Bacteria often solve this problem with the help of cilia.

Earlier this year, a team of researchers from the University of Toronto created a prototype of a 1mm-long microrobot, controlled by an external magnetic field and equipped with two grippers. The developers managed to build a bridge with its help. Also, this robot can be used not only for drug delivery, but also for mechanical tissue restoration in the circulatory system and organs.

Muscular robots

Another interesting direction in microrobotics is robots driven by muscles. For example, there is such a project: a muscle cell stimulated by electricity, to which a robot is attached, whose “spine” is made of hydrogel.

This system essentially copies a natural solution found in the bodies of many mammals. For example, in the human body, muscle contractions are transmitted to bones through tendons. In this biorobot, when a cell contracts under the influence of electricity, the “ridge” bends and the transverse bars, which act as legs, are attracted to each other. If one of them moves a shorter distance when bending the “ridge”, then the robot moves towards this “leg”.

There is another vision of what medical microrobots should be: soft, repeating the shapes of various living beings. For example, here is a robotic bee (RoboBee).

True, it is not intended for medical purposes, but for a number of others: pollination of plants, search and rescue operations, detection of toxic substances. The authors of the project, of course, do not blindly copy the anatomical features of the bee. Instead, they carefully analyze all sorts of “designs” of organisms of various insects, adapting and implementing them in mechanics.

Or another example of the use of “structures” available in nature - a microrobot in the form of a bivalve mollusk. It moves by flapping the flaps, thereby creating a jet stream. At about 1mm in size, it can float inside the human eyeball. Like most other medical robots, this “mollusk” uses an external magnetic field as an energy source. But there is an important difference - it only receives energy for movement, the field itself does not move it, unlike most other types of microrobots.

Big robots

Of course, the fleet of medical equipment is not limited to microrobots alone. In science fiction films and books, medical robots are usually presented as replacements for human surgeons. Like, this is some kind of large device that quickly and very accurately performs all kinds of surgical manipulations. And it is not surprising that this idea was one of the first to be implemented. Of course, modern surgical robots are not capable of replacing a person entirely, but they are already fully trusted for stitching. They are also used as an extension of the surgeon's hands, as manipulators.

However, debates continue in the medical community regarding the advisability of using such machines. Many experts are of the opinion that such robots do not provide any special benefits, and due to their high price, they significantly increase the cost of medical services. On the other hand, there is a study showing that patients with prostate cancer who underwent robotic surgery later required less intensive use of hormonal agents and radiotherapy. In general, it is not surprising that the efforts of many scientists were aimed at creating microrobots.

An interesting project is Robonaut, a telemedicine robot designed to assist astronauts. This is still an experimental project, but this approach can be used not only to provide training to such important and expensive people as astronauts. Telemedicine robots can also be used to provide assistance in various hard-to-reach areas. Of course, this will only be advisable if it is cheaper to install a robot in the infirmary of some remote taiga or mountain village than to keep a paramedic on the payroll.

And this medical robot is even more highly specialized; it is used to treat baldness. ARTAS is engaged in automatic "digging" hair follicles from the patient's scalp, based on high-resolution photographs. A human doctor then manually injects the “harvest” into the bald areas.

Still, the world of medical robots is not at all as monotonous as it might seem to an inexperienced person. Moreover, it is actively developing, ideas and experimental results are being accumulated, and the most effective approaches are being sought. And who knows, perhaps in our lifetime the word “surgeon” will mean a doctor not with a scalpel, but with a jar of microrobots that will only need to be swallowed or introduced through an IV.

In my last post about telemedicine there was a mention of the Da Vinci robot surgeon, of which about 1000 were installed in the world as of 2010. But this is far from the only achievement of robotics used in medicine.

In what areas and for what are robots used? In surgery, as caregivers for children and the elderly, in telemedicine and even for drug delivery. More details - please, under the hack.

RIBA

The robot Riba comes from Japan. It was introduced in 2009. Its main purpose is, with the help of its long and strong hands rock sick and elderly people to sleep. This great helper in clinics, as it can transfer patients from place to place, or from a wheelchair to a bed.

RIBA II was introduced in 2009. This version of the robot can lift patients directly from the floor, whereas the first robot could only pick them up from a stroller or bed. Also, the load capacity has increased to 176 pounds, that is, about 80 kg, which is 41 pounds, or 18.5 kg more than in the first version.

Why do the Japanese even need such a robot? It's all about longevity. In Japan, by 2015, the number of elderly people who will need care is projected to reach five and a half million people. Just imagine how many nurses and orderlies will have to lift patients every day from a futon to a wheelchair, from a wheelchair to a bed, back, and so on. Robots are better suited for these purposes, and let nurses do their job - just take care of the elderly.

And this robot is listed in the Guinness Book of Records as “The most therapeutic robot in the world.” It is equipped with many sensors - touch, light, sound, temperature and position. This is necessary for good communication with the patient and helps to calm the patient.

Keepon does the same thing, but I think it's less cute. He dances and reacts to touch.

Robot on hand

Another way to relieve nurses from routine work, occupying their time with more useful things is a robot from Murata Machinery Ltd, designed to dispense medicines.

Panasonic's robot is also designed to deliver medications from the pharmacy to patients. The first version of this robot could already store information about 400 patients and dispense medications in accordance with the prescription upon request of the patient or nurse.

Telepresence

Returning to the issue of telemedicine (which on Habré, judging by the comments, is considered TV shows with Malysheva), it is worth mentioning telepresence robots. These are complexes capable of moving independently, equipped with cameras, displays, speakers and microphones, and in addition to them - tools for diagnostics and analysis. Such means can be either the ability to connect to devices, for example ultrasound, or built-in devices - for example, for blood analysis.

In Russian realities, the use of such robots is almost impossible, because we have problems with ramps everywhere - both at the entrance to clinics and inside them. So the robot will be able to move only within one floor at most, and at least within a room, unable to overcome a hefty threshold.

PR-7

Vgo - control is carried out via 4G.

Surgery

PUMA 560 was the first robot used in neurosurgery. This is a robot assistant introduced in 1985.

In orthopedics, RoboDoc began to be used for joint replacement in 1992.

Later, assistants Zeus and Aesop appeared, but still the main character in the operation was the surgeon. In the late 1990s, this changed with the advent of Da Vinci, a robot for remote surgery.

The surgeon at the console sees the area in 3D format with multiple magnification and works with joysticks. At this time, the four-armed robot performs the operation. Initially, the image was not three-dimensional, of course, but then this problem was solved.

A moment of transformers: ARES from Italian scientists is designed to perform operations without damaging the skin. Because the patient swallows it in parts, and it also comes out through the intestines. Inside, the robot assembles itself, after which the surgeon performs the operation.

Training: Patient Simulators

Sending living patients to newcomers is not very humane. It's much better to practice first on robots that can handle natural needs, which have a beating heart and are more or less human-like.

The most functional robot of this type is considered to be HPS (Human Patient Simulator). It stores 30 different patient profiles, differing in physiology and individual reactions to medications. These could be profiles of a healthy child of a pregnant woman and an elderly alcoholic. The pulse, palpable in the carotid, brachial, femoral, and radial popliteal arteries, changes depending on the pressure, the robot exhales carbon dioxide, which is displayed on the monitors, and its pupils react to light.

It's the same story with dentists. Stop cutting up poor people with bad teeth! Train on cats first. In the photo - Hanako 2, originally from Japan, which is immediately obvious.

Please write in the comments what other robots should be in this publication.

The second half of the twentieth century was a time of intensive development in all areas of science, technology, electronics and robotics. Medicine has become one of the main vectors for the introduction of robots and artificial intelligence. The main goal The development of medical robotics is high accuracy and quality of service, increasing the efficiency of treatment, reducing the risks of harm to human health. Therefore, in this article we will look at new treatment methods, as well as the use of robots and automated systems in various fields of medicine.

Back in the mid-70s, the first medical mobile robot ASM appeared in a hospital in Fairfax, Virginia, USA, which transported containers with trays for feeding patients. In 1985, the world first saw the PUMA 650 robotic surgical system, designed specifically for neurosurgery. A little later, surgeons received a new PROBOT manipulator, and in 1992 the RoboDoc system appeared, which was used in orthopedics for joint replacement. A year later, Computer Motion Inc. introduced the Aesop automatic arm for holding and repositioning a video camera during laparoscopic operations. And in 1998, the same manufacturer created a more advanced ZEUS system. Both of these systems were not completely autonomous; their task was to assist doctors during operations. In the late 90s, the developer company Intuitive Surgical Inc created a universal remote-controlled robotic surgical system - Da Vinci, which is being improved every year and is still being implemented in many medical centers around the world.

Classification of medical robots:

Currently, robots play a colossal role in the development of modern medicine. They contribute to accurate work during operations, help to diagnose and make the correct diagnosis. They replace missing limbs and organs, restore and improve a person’s physical capabilities, reduce hospitalization time, provide convenience, responsiveness and comfort, and save financial costs of care.

There are several types of medical robots, differing in their functionality and design, as well as their scope of application for various fields of medicine:

Robotic surgeons and robotic surgical systems- used for complex surgical operations. They are not stand-alone devices, but a remotely controlled instrument that provides the doctor with precision, increased dexterity and controllability, additional mechanical strength, reduces the surgeon’s fatigue, and reduces the risk of the surgical team contracting hepatitis, HIV and other diseases.

Patient simulator robots- designed to develop decision-making skills and practical medical interventions in the treatment of pathologies. Such devices fully reproduce human physiology, simulate clinical scenarios, respond to drug administration, analyze the actions of trainees and respond accordingly to clinical influences.

Exoskeletons and robotic prostheses- exoskeletons help increase physical strength and help with the recovery process of the musculoskeletal system. Robotic prostheses - implants that replace missing limbs, consist of mechanical-electrical elements, microcontrollers with artificial intelligence, and can also be controlled by human nerve endings.

Robots for medical institutions and robotic assistants- are an alternative to orderlies, nurses, caregivers, nannies and other medical personnel, capable of providing care and attention to the patient, assisting in rehabilitation, ensuring constant communication with the attending physician, and transporting the patient.

Nanorobots- microrobots operating in the human body at the molecular level. Developed for the diagnosis and treatment of cancer, research blood vessels and restoration of damaged cells, can analyze the structure of DNA, correct it, destroy bacteria and viruses, etc.

Other specialized medical robots- There are a huge number of robots that help in one or another process of human treatment. For example, devices that are capable of automatically moving, disinfecting and quartzing hospital premises, measuring pulses, taking blood for analysis, producing and dispensing medications, etc.

Let's take a closer look at each type of robot using examples of modern automated devices developed and implemented in many areas of medicine.

Robotic surgeons and robotic surgical systems:

The most famous robotic surgeon in the whole world is the Da Vinci device. The device, manufactured by Intuitive Surgical, weighs half a ton and consists of two blocks, one is a control unit designed for the operator, and the second is a four-armed machine that acts as a surgeon. The manipulator with artificial wrists has seven degrees of freedom, similar to the human hand, and a 3D visualization system that displays a three-dimensional image on a monitor. This design increases the accuracy of the surgeon’s movements, eliminates hand tremors and awkward movements, reduces the length of incisions and blood loss during surgery.

Robot surgeon Da Vinci

Using the robot, it is possible to perform a huge number of different operations, such as mitral valve repair, myocardial revascularization, ablation of cardiac tissue, installation of an epicardial electronic cardiac stimulator for biventricular resynchronization, thyroid surgery, gastric bypass, Nissen fundoplication, hysterectomy and myomectomy, operations on spine, disc replacement, thymectomy - surgery to remove the thymus gland, lung lobectomy, operations in urology, esophagectomy, mediastinal tumor resection, radical prostatectomy, pyeloplasty, bladder removal, tubal ligation and ligation, radical nephrectomy and kidney resection, ureteral reimplantation and other.

Currently, there is a struggle for the market for medical robots and automated surgical systems. Scientists and medical device companies are eager to implement their devices, which is why more and more robotic devices are appearing every year.

Competitors to Da Vinci include the new MiroSurge surgical robot designed for heart surgery, a robotic arm from UPM for precise insertion of needles, catheters and other surgical instruments in minimally invasive surgery procedures, a surgical platform called IGAR from CSII, a robotic system -Sensei X catheter, manufactured by Hansen Medical Inc for complex heart surgeries, ARTAS hair transplant system from Restoration Robotics, Mazor Renaissance surgical system, which helps perform surgeries on the spine and brain, robot surgeon from scientists from SSSA Biorobotics Institute, and a robotic assistant for tracking surgical instruments from GE Global Research, currently in development, and many others. Robotic surgical systems serve as assistants or assistants to physicians and are not completely autonomous devices.

Robot surgeon MiroSurge

Robot surgeon from UPM

Robot surgeon IGAR

Robot catheter Sensei X

Robotic hair transplant system ARTAS

Robot surgeon Mazor Renaissance

Robot surgeon from SSSA Biorobotics Institute

Surgical Instrument Tracking Robot from GE Global Research

Patient simulator robots:

To practice the practical skills of future doctors, there are special robotic mannequins that reproduce functional features cardiovascular, respiratory, excretory systems, and also involuntarily react to various actions of students, for example, when administering pharmacological drugs. The most popular robotic patient simulator is HPS (Human Patient Simulator) from the American company METI. You can connect a bedside monitor to it and track blood pressure, cardiac output, ECG and body temperature. The device is capable of consuming oxygen and releasing carbon dioxide, just like real breathing. During anesthesia, nitrous oxide may be absorbed or released. This function provides training in artificial lung ventilation skills. The pupils in the robot's eyes are able to react to light, and the movable eyelids close or open depending on whether the patient is conscious. The pulse is felt in the carotid, brachial, femoral, and radial popliteal arteries, which changes automatically and depends on blood pressure.

The HPS simulator has 30 patient profiles with different physiological data, simulating a healthy husband, a pregnant woman, an elderly person, etc. During the training process, a specific clinical scenario is simulated, which describes the scene and condition of the patient, goals, necessary equipment and medicines. The robot has a pharmacological library consisting of 50 drugs, including gaseous anesthetics and intravenous drugs. The mannequin is controlled via a wireless computer, allowing the instructor to monitor all aspects of the learning process directly next to the student.

It should be noted that maternity simulator mannequins, for example GD/F55, are very popular. It is designed for training medical personnel in departments of obstetrics and gynecology, allowing you to develop practical skills and abilities in gynecology, obstetrics, neontology, pediatrics, intensive care and nursing care in the maternity ward. The Simroid robot imitates a patient in a dentist's chair; its oral cavity exactly replicates a human's. The device is capable of simulating the sounds and groans that a person makes if he is in pain. There are robotic simulators for teaching manipulation techniques. This is, in fact, a dummy of a person with simulators of veins and vessels made of elastic tubes. On such a device, students practice the skills of venesection, catheterization, and venipuncture.

Exoskeletons and robotic prostheses:

One of the most famous medical devices is the robotic suit - the exoskeleton. It helps people with physical disabilities move their bodies. When a person tries to move his arms or legs, special sensors on the skin read small changes in the body's electrical signals, leading to working condition mechanical elements of the exoskeleton. Some of the popular devices are the Walking Assist Device from the Japanese company Honda, the HAL rehabilitation exoskeleton from Cyberdyne, widely used in Japanese hospitals, the Parker Hannifin apparatus from Vanderbilt University, which makes it possible to move the joints of the hips and knees, powerful NASA X1 exoskeleton, designed for astronauts and paralyzed people, Kickstart exoskeleton from Cadence Biomedical, powered not by a battery, but using the kinetic energy generated by a person when walking, eLEGS, Esko Rex, HULC exoskeletons from the manufacturer Ekso Bionics, ReWalk from ARGO, Mindwalker from Space Applications Services, helping paralyzed people, as well as a unique brain-machine interface (BMI) or simply an exoskeleton for the brain MAHI-EXO II for restoring motor functions by reading brain waves.

The widespread use of exoskeletons helps many people around the world feel full. Even completely paralyzed people today have the ability to walk. A striking example is the robotic legs of physicist Amit Goffer, which are controlled using special crutches and can automatically determine when to take a step and recognize speech signals “forward”, “sit”, “stand”.

Exoskeleton for walking Walking Assist

Exoskeleton HAL from Cyberdyne

Parker Hannifin exoskeleton

Exoskeleton NASA X1

Kickstart exoskeleton from Cadence Biomedical

Exoskeleton HULC from Ekso Bionics

ARGO ReWalk exoskeleton

Mindwalker exoskeleton from Space Applications Services

Exoskeleton for the brain MAHI-EXO II

Exoskeleton by Amit Goffer

But what to do when limbs are missing? This applies mainly to war veterans, as well as victims of accidental circumstances. In this regard, companies such as Quantum International Corp (QUAN) and their exoprosthetics and the Defense Advanced Research Projects Agency (DARPA), together with the Department of Veterans Affairs, the Center for Rehabilitation and the US Development Service, are investing huge amounts of money in the research and development of robotic prosthetics (bionic hands or feet) that have artificial intelligence, capable of sensing the environment and recognizing the user's intentions. These devices accurately imitate the behavior of natural limbs, and are also controlled using one's own brain (microelectrodes implanted in the brain, or sensors, read neural signals and transmit them as electrical signals to a microcontroller). The owner of the most popular bionic arm, costing $15,000, is Briton Nigel Ackland, who travels around the world promoting the use of artificial robotic prostheses.

One of the important scientific developments was the iWalk BiOM artificial robotic ankles, developed by MIT professor Hugh Herr and his biomechatronics group at the MIT Media Lab. iWalk receives funding from the US Department of Veterans Affairs and the Department of Defense, and as such, many disabled veterans who served in Iraq and Afghanistan have already received their bionic ankles.

iWalk BiOM robotic ankles

Scientists from all over the world are striving not only to improve the functional features of robotic prostheses, but to give them a realistic appearance. American researchers led by Zhenan Bao from Stanford University ( Stanford University) in California, created nanoskin for medical prosthetic devices. This polymer material has high flexibility, strength, electrical conductivity and pressure sensitivity (reading signals like touch panels).

Nanoskin from Stanford University

Robots for medical institutions and robotic assistants:

The hospital of the future is a hospital with minimal human staff. Every day, robotic nurses, robotic nurses and telepresence robots are increasingly being introduced into medical institutions to contact the attending physician. For example, robotic nurses from Panasonic, robot assistants Human Support Robot (HSR) from Toyota, the Irish robot nurse RP7 from the developer InTouch Health, the Korean robot KIRO-M5 and many others have been working in Japan for a long time. Such devices are a platform on wheels and are able to measure pulse, temperature, control the time of food and medication intake, promptly notify about problematic situations and necessary actions, maintain contact with live medical personnel, collect scattered or fallen things, etc.

Robotic nurses from Panasonic

Toyota HSR robot assistant

Robot nurse RP7 from InTouch Health

Robot nurse KIRO-M5

Often, in conditions of continuous medical care, doctors physically cannot pay enough attention to patients, especially if they are located at a great distance from each other. Developers of robotic medical equipment have tried and created telepresence robots (for example, LifeBot 5, or RP-VITA from iRobot and InTouch Health). Automated systems allow you to transmit audio and video signals through 4G, 3G, LTE, WiMAX, Wi-Fi, satellite or radio networks, measure the patient’s heartbeat, blood pressure and body temperature. Some devices can perform electrocardiography and ultrasound, have an electronic stethoscope and otoscope, and navigate hospital corridors and wards around obstacles. These medical assistants provide timely care and process clinical data in real time.

Telepresence robot LifeBot 5

Telepresence robot RP-VITA

Robotic couriers have been used with great success to safely transport samples, medications, equipment and supplies in hospitals, laboratories and pharmacies. Assistants have a modern navigation system and on-board sensors, allowing them to easily move in rooms with complex layouts. Prominent representatives of such devices include the American RoboCouriers from the company Adept Technology and Aethon from the University of Maryland Medical Center, the Japanese Hospi-R from Panasonic and Terapio from the company Adtex.

Robot courier RoboCouriers from Adept Technology

Robot courier Aethon

Robot courier Hospi-R from Panasonic

Robot courier Terapio from Adtex

A separate direction in the development of robotic medical equipment is the creation of transformable wheelchairs, automated beds and special vehicles for the disabled. Let us recall such developments as the chair with rubber tracks Unimo from the Japanese company Nano-Optonics, (Chiba Institute of Technology) under the leadership of Associate Professor Shuro Nakajima, which uses wheeled legs to overcome stairs or ditches, the Tek Robotic Mobilization Device robotic wheelchair from by Action Trackchair. Panasonic is ready to solve the problem of transferring a patient from a chair to a bed, which requires great physical effort from medical personnel. This device independently converts from a bed to a chair and vice versa when necessary. Murata Manufacturing Co has teamed up with Kowa to make an innovative medical vehicle, the Electric Walking Assist Car, an autonomous bicycle with a pendulum control system and a gyroscope. This development is mainly intended for the elderly and people who have problems walking. Separately, we note the series of Japanese RoboHelper robots from Muscle Actuator Motor Company, which are indispensable assistants to nurses in caring for bedridden patients. The devices are capable of lifting a person out of bed sitting position or pick up the physical waste of a bedridden person, excluding the use of pots and ducks.

Nanorobots:

Nanobots or nanobots are robots the size of a molecule (less than 10 nm) that are capable of moving, reading and processing information, as well as being programmed and performing specific tasks. This is a completely new direction in the development of robotics. Areas of use of such devices: early diagnosis of cancer and targeted delivery of drugs to cancer cells, biomedical instruments, surgery, pharmacokinetics, monitoring of diabetic patients, production of devices from individual molecules according to its drawings through molecular assembly by nanorobots, military use as means of surveillance and espionage, and also as weapons, space research and development, etc.

On this moment known developments of medical microscopic robots for detecting and treating cancer from South Korean scientists, biorobots from scientists from the University of Illinois, which can move in viscous liquids and biological environments on their own, a prototype of the sea lamprey - nanorobot Cyberplasm, which will move in the human body, identifying diseases on early stage, nanorobots by engineer Ado Pun, which can travel through the circulatory system, deliver medications, take tests and remove blood clots, magnetic nanorobot Spermbot - developed by scientist Oliver Schmidt and his colleagues from the Institute of Integrative Nanosciences in Dresden (Germany) for the delivery of sperm and drugs , nanobots for replacing proteins in the body from scientists from the University of Vienna together with researchers from the University of Natural Resources and Life Sciences Vienna.

Microrobots Cyberplasm

Nanobots Ado Pune

Magnetic nanorobot Spermbot

Nanorobots for protein replacement

Other specialized medical robots:

There is a huge number of specialized robots that perform individual tasks, without which it is impossible to imagine effective and quality treatment. Some of these devices are the Xenex Robotic Quartz Machine and the TRU-D SmartUVC Robotic Disinfector from Philips Healthcare. Undoubtedly, such devices are simply irreplaceable assistants in the fight against nosocomial infections and viruses, which are one of the most serious problems in medical institutions.

Xenex robotic quartz device

TRU-D SmartUVC Disinfecting Robot from Philips Healthcare

Blood test collection - most common medical procedure. The quality of the procedure depends on the qualifications and physical condition medical worker. Often, trying to take blood the first time ends in failure. Therefore, to solve this problem, the Veebot robot was developed, which has computer vision, with which it determines the location of the vein and carefully guides the needle there.

Veebot blood collection robot

The Vomiting Larry vomiting robot allows you to study noroviruses, which lead to 21 million diseases, including symptoms of nausea, watery diarrhea, abdominal pain, loss of taste, general lethargy, weakness, muscle pain, headache, cough, low-grade fever, and, of course, severe vomiting.

Vomiting Larry robot for studying vomiting

The most popular robot for children remains PARO - a fluffy children's toy in the shape of a harp seal. The therapeutic robot can move its head and paws, recognize voice, intonation, touch, measure temperature and light in the room. Its competition is a huge cuddling teddy bear called HugBot, which measures your heart rate and blood pressure.

PARO therapeutic robot

HugBot robot bear

A separate branch of medicine that deals with the diagnosis and treatment of diseases, injuries and disorders in animals is veterinary medicine. To train qualified professionals in this field, the College of Veterinary Medicine in the development of robotic pets creates unique robotic simulators in the form of dogs and cats. To get closer to an accurate model of the animal's behavior, the software is being developed separately at Cornell University's Center for Advanced Computing Systems (ACC).

Robotic simulators in the form of dogs and cats

Efficiency of robots in medicine:

It is obvious that the use of robots in medicine has a number of advantages over traditional treatment involving the human factor. Usage mechanical arms in surgery, prevents many complications and errors during operations, reduces postoperative recovery period, reduce the risk of infection and infection of the patient and staff, eliminate large blood loss, reduce painful sensations, contribute to a better cosmetic effect (small scars). Robotic medical assistants and rehabilitation robots make it possible to pay close attention to the patient during treatment, monitor the healing process, limit living staff from labor-intensive and unpleasant work, and allow the patient to feel better. a full-fledged person. Innovative treatments and equipment bring us closer to healthier, safer and longer lives every day.

Every year, the global market for medical robots is replenished with new devices and is undoubtedly growing. According to research company Research and Markets, by 2020 the market for rehabilitation robots, bioprostheses and exoskeletons alone will grow to $1.8 billion. The main boom in medical robots is expected after the adoption of a single standard ISO 13482, which will become a set of rules for design elements, materials and software, used in devices.

Conclusion:

Without a doubt, we can say that medical robots are the future of medicine. The use of automated systems significantly reduces medical errors and reduces the shortage of medical personnel. Nanorobotics helps overcome severe diseases and prevent complications at an early stage, and widely use effective nanomedicines. Over the next 10-15 years, medicine will reach a new level using robotic care. Unfortunately, Ukraine is in a deplorable state with regard to this sector of development. For example, in Russia in Yekaterinburg, the famous robot surgeon “Da Vinci” performed its first operation back in 2007. And in 2012, President Dmitry Anatolyevich Medvedev instructed the Russian Ministry of Health, together with the Ministry of Industry and Trade, to work on the development of new medical technologies using robotics. This initiative was supported by the Russian Academy of Sciences. The reality is that in the absence of real support from the Ukrainian authorities in the development of the field of medical robotics, our state lags behind other civilized countries every year. This implies an indicator of the level of development of the country as a whole, because concern for the health and life of a citizen, mentioned in the main law - the Constitution of Ukraine, is the “highest social value”.