Surgical and interventional robotics: Part II

A large family of medical interventions can be represented by a model that is analogous to industrial manufacturing systems. If the right information is available, they can be planned ahead of time and executed in a reasonably predictable manner. We, therefore, have classified them as surgical computer-aided design (CAD)-computer-aided manufacturing (CAM) systems, having three key concepts: 1) surgical CAD, in which medical images, anatomical atlases, and other information are combined preoperatively to model an individual patient; the computer then assists the surgeon in planning and optimizing an appropriate intervention 2) surgical CAM, in which real-time medical images and other sensor data are used to register the preoperative plan to the actual patient and the model and the plan are updated throughout the procedure; the physician performs the actual surgical procedure with the assistance of the computer, using appropriate technology (robotics, mechatronics, optical guidance, perceptual guidance, etc.) for the intervention 3) surgical total quality management (TQM), which reflects the important role that the computer can play in reducing surgical errors and in promoting more consistent and improved execution of procedures. Successful procedures are also included in procedural statistical atlases and fed back into the system for pre- and intraoperative planning. This article, primarily concerned with robotics and mechatronics, concentrates on the surgical action (surgical CAM), although for the sake of completeness, major issues in surgical planning (surgical CAD) and postoperative data analysis (surgical TQM) are also included. This article is the second installment of a three-part series on surgical and interventional robotics.