In recent years, the Institute for Robotics and Cognitive System realized several projects with the focus on bringing modern robot based technology into clinical practise. New innovative imaging and navigation techniques were developed in close cooperation with our industrial partners such as Ziehm Imaging GmbH and Möller-Wedel GmbH. One example is the robotic C-arc, with which it is possible to acquire intraoperative CT data or so called “long bone” images. Further, a surgical microscope was automatized and upgraded by an OCT system, which enables the automatic acquisition of 3D volumes of the operation site. The system has an improved autofocus and new pivoting functions.
In cooperation with IBG Technology Hansestadt Lübeck GmbH, two robotic systems have been developed for stereotactic intervention in small animals and humans. These stereotactic systems enable examinations and operations on animals and humans with highest precision. Both systems have been tested under real life conditions.
The Institute for Robotics and Cognitive Systems is developping a prototype for motion compensation in intracranial radiotherapy in cooperation with Varian Medical, the world leading manufacturer of radiation therapy equipment. The aim of the project is to replace or to supplement conventional mask-based fixation systems by using non-invasive features to enable a high precision, real-time monitoring of the head during treatment.
The basis is a near infrared laser that samples the forehead of the patient multiple times per second. Beside the triangulated spatial surface structures, a high resolution camera can detect smallest variations of the skin by evaluating the laser- caused scatter and absorption characteristics. These optical features are used in combination with modern machine learning techniques to determine the local tissue thickness. The analysis enables the evaluation of subcutaneous structures and the localisation of the skull. For the first time, the additional information enables a precise and contact-free motion compensation of the head.
The development of the irradiation robot CyberKnife (Accuracy Inc.) enabled the possibility to precisely irradiate tumors at any position in the body and further to compensate for motion (caused by respiration, heartbeat, or motion by the patient) in 6 degrees of freedom. Thereby, the tumor position has to be acquired and transferred to the robotic system in real time. Clinical systems use a system which was first developed at our institute and is based on a correlation model between external optical markers and internal implanted gold fiducials. The position of the gold fiducials is acquired periodically by stereoscopic X-ray images.
Current development focuses on new probabilistic correlation methods. To increase the robustness and precision of the approach, the potential of multivariate information is investigated like respiratory flow and muscle activity. In the long run, direct tracking of the target by using volumetric images will replace correlation models. A new 4D ultrasound based tracking system is currently under development which can be used to compensate complex organ movements, such as the beating heart.
All conducted studies at the Institute for Robotics and Cognitive Systems, where animals or human subjects were involved, were coordinated in cooperation with our clinical partners and approved by the ethic committee of the Universität zu Lübeck.