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ZEUS Robotic Surgical System
The FDA cleared ZEUS in October 2001 to assist in the control of blunt dissectors, retractors, graspers, and stabilizers during laparoscopic and thoracoscopic surgeries.
ZEUS has three robotic arms that are mounted on the operating table. One robotic arm is called the Automated Endoscopic System for Optimal Positioning Robotic System (AESOP). AESOP is a voice-activated robot used to hold the endoscope. The FDA cleared AESOP to hold and position endoscopes in 1994, and voice activation was added later. ZEUS differs from the da Vinci system in that the AESOP part of ZEUS responds to voice commands. For example, a surgeon might say: "AESOP move right." The positioning arm then would move right until the "stop" command was given.
Like the da Vinci system, the other two arms of ZEUS are the extension of the left and right arms of the surgeon. Surgeons sit at a console and wear special glasses that create a three-dimensional image. Computer Motion has added a flexible wrist technology called Micro-Wrist, which is now included in FDA-approved clinical trials, Nolan says.
There are currently more than 30 ZEUS units installed in North America, 15 units installed in Europe and the Middle East, and five units installed in Asia.
Zeus robotic system being tested for wireless space surgery
Robotic Surgery with Zeus Robot
The Zeus robotic surgical system is being tested for remote, wireless surgery in an underwater experiment aimed at eventually enabling similar procedures in space. The underwater Aquarius lab in Key Largo, Florida, will host a gall bladder removal surgery on a dummy as a test for eventual remote surgery in space. The surgeons will be in Ontario, controlling the whole thing via the Zeus robotic system several thousand miles away. The hope is that eventually astronauts in need of surgery won't have to turn around and come back to Earth but instead will be able to slip into a gown and get that organ yanked out by a local robot.
ZEUS robot system reverses sterilization to enable birth of baby boy. Santa Barbara 29 September 1999
The ZEUS robotic surgical system, developed by Computer Motion Inc., has assisted a team of surgeons at the Cleveland Clinic in performing a fully endoscopic fallopian tube reconnection procedure. The intervention was carried out in July, last year. As a result, the world's first child, born ever after this kind of reversal operation, has been successfully delivered ten days ago......Continue reading
ZEUS robot at once involved in lawsuit and in clinical surgery primeur Pittsburgh 09 April 2001
The University of Pittsburgh is the first centre in the United States to use Computer Motion's ZEUS Robotic Surgical System during a beating heart cardiac bypass operation. Surgeons manipulated the three-armed robot during the most important part of the operation, when the artery being applied as the bypass graft is connected to the heart's main coronary artery. At the same time, Computer Motion Inc. was jointly sued by its competitor, Intuitive Surgical Inc., an expert in precision surgical robotics, and IBM in the U.S. District Court for the District of Delaware.
The Intuitive and IBM complaint alleges that by continuing to make, use, sell, and offer for sale its AESOP and ZEUS voice-controlled products, Computer Motion wilfully infringes U.S. Patent No. 6,201,984. Meanwhile, a 63-year-old male patient underwent multi-vessel off-pump coronary artery bypass surgery at the University of Pittsburgh Medical Center (UPMC) Presbyterian Hospital on April 5 as part of a national, multi-centre trial seeking to evaluate whether the ZEUS robotic system can be helpful to surgeons and be safely used for the surgical connection of the left internal mammary artery graft to the left anterior descending artery.
The University of Pittsburgh is one of 12 centres in the research study and the first U.S. centre to apply the ZEUS in a beating heart bypass operation. The robot had been used in 32 patients at three centres as part of a phase one trial, but in all of these cases, the operation involved the support of a heart-lung machine while surgeons operated on a stopped heart.
Marco A. Zenati, M.D., an assistant professor of surgery and the principal investigator at the Pittsburgh site, operated the robot while seated at a console about 10 feet from the patient. One arm of the robot, responding to his voice commands, positioned the endoscope, an instrument with a tiny camera that magnifies the operative site up to 10 to 15 times. While viewing the magnified image of the heart and vessels on a high-resolution monitor, Dr. Zenati controlled the action of surgical instruments attached to the two other robotic arms by operating handles that resemble conventional surgical instruments, in much the way joysticks are used to control the action of a video game.
"ZEUS is designed to give a surgeon greater precision while performing micro-surgical tasks and to be able to use it during a beating heart operation is extremely significant. Essentially, it may allow surgeons to perform superhuman tasks, because the robot overcomes our dexterity and precision limitations", commented Dr. Zenati. The surgeon's hand movements are scaled. For instance, one inch of movement by the surgeon results in a one fourth inch movement by the robotic surgical instruments. Hand tremor is filtered by the computer and translated via the robotic arms into precise micro-movements at the operative site.
According to Computer Motion Inc., the Santa Barbara-based company that developed ZEUS, the possible benefits of using ZEUS in a closed-chest heart bypass surgery include less patient pain and trauma, quicker recovery times and reduced health care costs. The reason is that robotics and computers provide enhanced dexterity, steady visualisation, and improved ergonomics for the surgeon. The reduced trauma to the patient, from a minimal incision and the avoidance of the heart-lung machine, can translate into reduced costs.
"The use of robotics for cardiac surgery is a very exciting development for the field. Medical experts anticipate that the future will soon see all cardiac procedures employing such technology, and surgery will become less and less invasive for the patient", commented Bartley P. Griffith, M.D., Henry T. Bahnson professor of surgery and chief, division of cardio-thoracic surgery at the University of Pittsburgh School of Medicine. Dr. Griffith is a co-investigator of the study and assisted Dr. Zenati during the operation. Dr. Zenati also was assisted by Larry Shears, M.D.
On March 13, 2001, U.S. Patent No. 6,201,984 was issued to IBM and is exclusively licensed to Intuitive under the terms of Intuitive's 1997 License Agreement with IBM. This patent concerns various aspects of controlling movement of surgical instruments with voice commands, and predates by several years Computer Motion's development of voice-controlled surgical robots. Because this company's voice-controlled HERMES product interfaces with the AESOP and ZEUS products, HERMES is also implicated in the patent infringement complaint. More news on the ongoing conflict between Computer Motion and Intuitive is available in the VMW June 2000 article
Computer Motion to enhance ZEUS Robotic Surgical System with MicroWrist technology
Santa Barbara 13 July 2001Computer Motion Inc., an expert and pioneer in medical robotics, has enhanced the ZEUS Robotic Surgeon with MicroWrist technology. With this new version of the ZEUS system, the surgeon uses familiar open surgery movements while performing endoscopic procedures through tiny 5-mm ports. This dramatically increases the ease at which these procedures can be performed.
"We are very optimistic about the forth-coming results for ZEUS with MicroWrist Technology", commented Robert W. Duggan, Chairman and CEO of Computer Motion. "Surgeon response to this advancement during customer preference testing, hands-on demonstrations at recent surgical meetings, and within clinical settings has been extremely positive."
Douglas Boyd, MD of London Health Sciences Centre in London, Ontario, stated: "The initiation of MicroWrist has substantially facilitated the performance of total endoscopic coronary artery bypass surgery. This technology has the ability to largely overcome the limitations we previously experienced with this challenging procedure."
Mr. Duggan added that the company has designed the ZEUS system with upgradability in mind. "The forty-six ZEUS systems currently in use worldwide can be upgraded to the MicroWrist technology. We expect the majority of our current customers to upgrade. It is anticipated the cost of upgrading will be less than $200.000 per system."
ZEUS with MicroWrist provides a fundamental change in surgeon ease of use and system functionality while maintaining the previous advantages of the ZEUS product platform, which include:
5-mm articulating wrist instruments which mimic open-surgery movements in endoscopic procedures
an open platform design that supports easy integration of key complimentary technologies, such as 3D visualisation and bi-polar/ultrasonic devices
a small system footprint which provides ample room for the surgical assistant and scrub nurse at the operating table, and
lightweight, modular arms that attach separately to the operating table for easy set-up, flexible positioning, rapid disassembly, and portability.
With plans for a product launch in the third quarter of 2001 and a seamless upgrade path for existing customers, the company expects the ZEUS with MicroWrist to have a significant impact on second half revenues. "The low level of ZEUS sales relative to our first half expectations were due in part to the impending third quarter release of ZEUS with MicroWrist", said Mr. Duggan. "The customer feedback for the new ZEUS system is very positive and bodes well for our second half results."
Computer Motion is a high-tech medical device company evolving surgical practices to enhance patient lives. The company develops, manufactures and markets proprietary computer-enhanced and robotic surgical systems, which optimise surgeons' capabilities, improve outcomes, and reduce costs. The company plays a significant role in transitioning the surgical community from current open procedures to increasingly demanded endoscopic procedures.
Products include the voice-controlled Aesop Robotic Endoscope Positioner; the Hermes Control Center, a centralised system which enables the surgeon to voice control a network of "smart" medical devices; and the ZEUS Robotic Surgical System for new minimally invasive microsurgery procedures, such as endoscopic, beating heart bypass surgery.
The Aesop Robotic Endoscope Positioner is the first FDA-cleared surgical robot. The ZEUS Robotic Surgical System is CE-Marked for commercial sale in the European Community. Computer Motion has completed an FDA-approved Phase 1 Investigational Device Exemption (IDE) coronary bypass study and has initiated an IDE mitral valve surgery, general laparoscopic, and thoracic studies with the ZEUS system. Also, the company has begun the second phase of its tubal reanastomosis study.
SRI is collaborating with researchers and surgeons from the University of Cincinnati to evaluate the benefits of robotic surgery on air and space flights. The extreme environment experiments will be performed on September 25 Ė 28 aboard a NASA C-9 aircraft, which will simulate the microgravity of space and variable gravity of military critical care air transport through parabolic flights. During the flight week, four microgravity flights will be completed, with each flight consisting of 40 parabolas. The microgravity period will last approximately 18 to 25 seconds per parabola.
SRI-developed software will help the robot compensate for errors in movement that can occur in moments of turbulence and transition in gravity. A major component of the experiment is to compare manual surgical tasks conducted by a surgeon with robotic surgery. Both the human surgeon and the robot will be tasked with making incisions on a tissue model and suturing a wound or incision. Post-flight evaluations will compare the precision and speed of procedures performed by hand versus those performed by robot. "SRI is at the forefront of medical robotics technology that can benefit humans in dynamic, moving environments," said Thomas Low, director of SRI's Medical Devices and Robotics program. "In previous experiments, SRI successfully demonstrated how robots can be manipulated remotely and set-up with minimal training. We are now extending that technology to movement and weightlessness, critical elements of any space travel program."
While the possible benefits to the space bound are obvious, the research could also prove beneficial to those of us back on planet Earth. Telerobotic capabilities could be useful for remote battlefield surgery, and care during patient evacuation and transport. The technology may also someday allow time-critical procedures requiring specialized skills to be performed in a moving vehicle, reducing the time between injury and treatment for victims of motor vehicle accidents or natural disasters.
For NASA, SRIís M7 surgical robot conducted the first-ever acceleration-compensated medical procedure in zero-gravity flight.
SRIís M7 surgical robot conducted the first-ever acceleration-compensated medical procedure in zero-gravity flight for NASA.
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