Computer-aided (or -assisted) surgery (CAS) utilizing robotic- or image-guided technologies has been introduced into various orthopedic fields. Navigation and robotic systems are the most advanced parts of CAS, and their range of functions and applications is increasing. To study surgical procedures of the bone and joint system and to develop novel robotic CAS systems, this project team started research on orthopaedic procedures in 1999. Surgical navigation is a visualization system that gives positional information about surgical tools or implants relative to a target organ (bone) on a computer display. We have developed a CT-based navigation system for spine, hip, and knee surgery. We have also developed a laser guidance system which presents navigational information directly into the surgical field. To overcome the inaccuracy of hand-controlled positioning of surgical tools, a needle insertion robot has been developed for vertebroplasty. For safe and smooth manipulation of a fracture of the lower extremity, a robot to hold the leg and to reduce the fracture under fluoronavigation has been developed. For preoperative and postoperative evaluation and the patients' function, a 4-dimensional motion analysis has been developed. In this article, we explain these systems and future direction of our research.

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Minimally invasive surgery (MIS) is getting popularity in the world. Patients are thankful to MIS, but MIS put a lot of stress on surgeons. The main reason of this discrepancy between the patients and surgeons is technical difficulty via small hole in surgical procedures. The aim of our Future Project on surgical robotic system is to overcome this technical difficulty in MIS by developing a new system of image-guided robotic surgery. The first new product, Naviot, obtained approval from Ministry of Health, Welfare and Labour. Overlaying technique of 3-D ultrasonography on the endoscopic image with hybrid sensors, compensatory technique of intraoperative deformity of pre-operatively-taken image, and master-slave manipulator system developed by our project team are herein introduced.

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In this paper, we described the overview of JSPS research for the future program, Development of Robotic System for surgery and introduced some researches in this project. The aims of this project are 1) development of the master-slave manipulator system for minimally invasive liver surgery including deformable biomechanical liver model development and 2) development of the laser guidance system, the needle insertion robot and related technologies for orthopedic surgery. We made this study collaborating with Kyushu University and Osaka University. We also aim for practical use of surgical robot through promotion of business-academia collaboration.

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Under robotic surgery and telemedicine, information system must treat all communication channels required for medical treatments. Advanced interface suitable for each medical staffs are indispensable for smooth medical treatments. On the other hand, highly integrated information system with such advanced interface may produce highly advanced information supported telemedicine. This paper presents several research trials under “Development of collaborative communication and supporting system for telesurgery” project developing information systems toward information supported telemedicine, such as virtual reality based surgical simulation, augmented reality based telementoring and integrated telesurgery support information system named Surgical Cockpit.

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In the MR-guided interventional procedures, an optical tracking system for the scan plane control plays an important role. Two types of new assistive devices for the system were developed, in which the needle guide was placed away from the center of the hand piece or its direction was changed. The system was modified to determine the image planes with the new path of the needle similar to the conventional setting. Since the needle guides were off-center, surgical instruments, endoscope or surgeons' hands did not disturb the image plane determination even during the procedures. One of them (torch type) enabled punctures from the sides of the patient, which were previously impossible. The errors caused by these devices were negligible. They were quite helpful to accomplish more accurate MR image guidance and to increase the availability of the MR-guided interventional procedures.

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