Russell Taylor & Dan
Stoianovici talk with ScienceWatch.com and answer
a few questions about this month's Fast Moving Front in the
field of Engineering.
Article: Medical robotics in computer-integrated
Journal: IEEE TRANS ROBOTICS AUTOMAT, 19 (5): 765-781, OCT
Addresses: Johns Hopkins Univ, Baltimore, MD 21218
Johns Hopkins Univ, Baltimore, MD 21218 USA.
Why do you think your paper is highly
This survey article described the state of the art in medical robotics and
computer-integrated surgery at a time that this important research topic
was beginning to experience rapid growth and interest. It was the lead
article in a special issue on medical robotics in the leading engineering
journal devoted to robotics. One of the coauthors (Taylor) was one of the
founders of the field. The other author (Stoianovici) had already made many
contributions to the design of medical robots. This perhaps gave the paper
a high degree of credibility.
Does it describe a new discovery, methodology, or
synthesis of knowledge?
This was a survey article summarizing the state-of-the-art and research
themes in medical robotics and computer-integrated surgery. As such, it was
more a synthesis of knowledge than a paper devoted to a single research
innovation. In writing the paper, we focused strongly on the relationship
between technology (robotic devices, imaging systems, computation,
human-machine interfaces) and clinical application.
Would you summarize the significance of your paper
in layman's terms?
This survey paper provides a broad overview of medical robot systems used
in surgery. As such, it provided a very useful guide to researchers wishing
to enter the field. Although intended for an engineering audience, it is
written in a way that should make it accessible to clinicians and
non-specialized readers as well.
The survey uses two basic concepts, Surgical CAD/CAM and Surgical
Assistance, to organize the discussion. "Surgical CAD/CAM" refers to the
process of constructing a computer model of a patient from medical images
and other information, using this model to plan an intervention,
registering the computer model and plan to the actual patient, and using
robots and other technology to help carry out the plan. "Surgical
Assistance" refers to the use of robotics and information technology to
enhance the ability of human surgeons to perform surgical procedures.
After introducing the concepts, the paper discusses some of the major
design issues particular to medical robots. It then illustrates these
issues and the broader themes introduced earlier with examples of current
Surgical CAD/CAM and Surgical Assistant systems. Finally, it provides a
brief synopsis of current research challenges and closes with a few
thoughts on the research/industry/clinician teamwork that is essential for
progress in the field.
How did you become involved in this research and
were any particular problems encountered along the way?
Russell Taylor was one of the founders of the field of medical robotics.
While at IBM Research in the 1980s, he became interested in the notion that
medical robots and related technology could have the same sort of impact on
surgery and interventional medicine that industrial robots and related
technology have had on manufacturing.
After leading the development of the ROBODOC system for orthopedic surgery
and early robot systems for minimally invasive surgery, he moved to Johns
Hopkins in 1995, where he is the founding Director of the
NSF Engineering Research Center for Computer Integrated
Surgical Systems and Technology. Taylor's personal web site describes a number of his
current research activities in medical robotics and computer-integrated
Dan Stoianovici has had a manufacturing and robotics background before
joining the cross-disciplinary medical robotics research group at Johns
Hopkins in 1996. There he trained in urology research and built the Urology
Robotics program in the Medical School. Medical applications
rise challenging problems for robotic engineers above and behind
traditional robotic developments, such as medical safety, sterility,
compactness, and compatibility with medical imaging equipment.
Dan's design and hands-on manufacturing abilities gave him a competitive
edge in the field, which was also fueled by his ideally matched passion.
Today, his lab is a unique venue for medical robotic hardware and at the
forefront in the field. His
inventions include a new type of motor, PneuStep,
capable of operating within Magnetic Resonance Imaging scanners.
Where do you see your research leading in the
The technology in medical robots—the mechanisms, sensors, imaging,
human-machine interfaces (HMI), etc.—will continue to see rapid
development over the coming years. Several trends that seem especially
important include: 1) development of very small, highly dexterous robotic
devices for minimally invasive surgery; 2) development of extremely precise
robots for microsurgery; 3) development of specialized robots for
performing procedures inside MRI, CT, and other specialized imaging
environments; 4) integration of all of these systems with the information
infrastructure of the hospital, so that surgical procedures become truly
computer-integrated; and 5) much greater exploitation of the information
generated during robotic procedures to promote the improvement of surgical
plans and techniques through the comparison of (eventually) known outcomes
with analysis of what was done to improve surgical plans and processes.
Do you foresee any social or political implications
for your research?
Medical robots are already beginning to have significant impacts on surgery
and other medical interventions. By improving accuracy and by enabling
minimally invasive procedures that would otherwise be impractical or
impossible, they promise to improve outcomes while improving safety and
consistency of interventions. Despite the high capital costs associated
with some systems, the improvements in outcomes will ultimately lead to
more cost-effective treatments of serious medical conditions.
Russell H. Taylor, Ph.D.
Professor of Computer Science with joint appointments in
Mechanical Engineering, Radiology, and Surgery
Engineering Research Center for Computer-Integrated Surgical Systems and
Technology (CISST ERC)
Johns Hopkins University
Baltimore, MD, USA
Dan Stoianovici, Ph.D.
Associate Professor of Urology and Mechanical Engineering
Johns Hopkins University
Director, Urology Robotics Program
Johns Hopkins Medicine
Baltimore, MD, USA
Keywords: medical robotics, computer-integrated
surgery, robotic devices, imaging systems, human-machine interfaces,
surgical cad/cam systems, surgical assistance systems, pneustep.