Head-Mounting Surgical Robots for Passive Compensation of Patient Motion.

A variety of robot-assisted surgical systems have been proposed to improve precision in the most challenging eye surgeries. However, little attention has been paid to patient motion due to breathing, snoring, talking, and other events that are common during eye surgery. This is problematic because patient motion is typically relative to a grounded surgical robot. In this paper, we characterize the benefits of a new paradigm in which robots are mounted semirigidly and noninvasively to the patient's head. This paradigm utilizes compact high-precision telerobotic systems that have been designed for this use. We present an initial design concept focused on eye surgery, and demonstrate an order-of-magnitude improvement of within-breathing-cycle motion relative to the robot compared to a pillow rest, with an optional head strap, which is the current standard of care, while essentially eliminating gross relative motion. We conduct a human-subjects study to quantify the relative motion that remains. Finally, we present an alternative design concept that leaves the patient's face unobstructed, which may be of interest for other kinds of surgery as well.