Research in surgical robotics has an established track record at Imperial College, and a number of research and commercial surgical robot platforms have been developed over the years. The Hamlyn Centre is a champion for technological innovation and clinical adoption of robotic, minimally invasive surgery. We work in partnership with major industrial leaders in medical devices and surgical robots, as well as developing our own platforms such as the i-Snake® and Micro-IGES platforms. The Da Vinci surgical robot is used extensively for endoscopic radical prostatectomy, hiatal hernia surgery, and low pelvic and rectal surgery, and in 2003, St Mary’s Hospital carried out its first Totally Endoscopic Robotic Coronary Artery Bypass (TECAB).

The major focus of the Hamlyn Centre is to develop robotic technologies that will transform conventional minimally invasive surgery, explore new ways of empowering robots with human intelligence, and develop[ing miniature 'microbots' with integrated sensing and imaging for targeted therapy and treatment. We work closely with both industrial and academic partners in open platforms such as the DVRK, RAVEN and KUKA. The Centre also has the important mission of driving down costs associated with robotic surgery in order to make the technology more accessible, portable, and affordable. This will allow it to be fully integrated with normal surgical workflows so as to benefit a much wider patient population.

The Hamlyn Centre currently chairs the UK Robotics and Autonomous Systems (UK-RAS) Network. The mission of the Network is to to provide academic leadership in Robotics and Autonomous Systems (RAS), expand collaboration with industry and integrate and coordinate activities across the UK Engineering and Physical Sciences Research Council (EPSRC) funded RAS capital facilities and Centres for Doctoral Training (CDTs).

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    Gras G, Yang GZ, 2016,

    Intention recognition for gaze controlled robotic minimally invasive laser ablation

    , 2016 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS), Publisher: IEEE, Pages: 2431-2437, ISSN: 2153-0858

    Eye tracking technology has shown promising results for allowing hands-free control of robotically-mounted cameras and tools. However existing systems present only limited capabilities in allowing the full range of camera motions in a safe, intuitive manner. This paper introduces a framework for the recognition of surgeon intention, allowing activation and control of the camera through natural gaze behaviour. The system is resistant to noise such as blinking, while allowing the surgeon to look away safely at any time. Furthermore, this paper presents a novel approach to control the translation of the camera along its optical axis using a combination of eye tracking and stereo reconstruction. Combining eye tracking and stereo reconstruction allows the system to determine which point in 3D space the user is fixating, enabling a translation of the camera to achieve the optimal viewing distance. In addition, the eye tracking information is used to perform automatic laser targeting for laser ablation. The desired target point of the laser, mounted on a separate robotic arm, is determined with the eye tracking thus removing the need to manually adjust the laser's target point before starting each new ablation. The calibration methodology used to obtain millimetre precision for the laser targeting without the aid of visual servoing is described. Finally, a user study validating the system is presented, showing clear improvement with median task times under half of those of a manually controlled robotic system.

    Leibrandt K, Bergeles C, Yang G-Z, 2016,

    Implicit active constraints for safe and effective guidance of unstable concentric tube robots

    , IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS), Publisher: IEEE, Pages: 1157-1163, ISSN: 2153-0866

    Safe and effective telemanipulation of concentric tube robots is hindered by their complex, non-intuitive kinematics. Guidance schemes in the form of attractive and repulsive constraints can simplify task execution and facilitate natural operation of the robot by clinicians. The real-time seamless calculation and application of guidance, however, requires computationally efficient algorithms that solve the non-linear inverse kinematics of the robot and guarantee that the commanded robot configuration is stable and sufficiently away from the anatomy. This paper presents a multi-processor framework that allows on-the-fly calculation of optimal safe paths based on rapid workspace and roadmap pre-computation The real-time nature of the developed software enables complex guidance constraints to be implemented with minimal computational overhead. A user study on a simulated challenging clinical problem demonstrated that the incorporated guiding constraints are highly beneficial for fast and accurate navigation with concentric tube robots.

    Seneci CA, Leibrandt KL, Wisanuvej PW, Shang JS, Darzi AD, Yang GZYet al., 2016,

    Design of a smart 3D-printed wristed robotic surgical instrument with embedded force sensing and modularity

    , IROS 2016, Publisher: IEEE, ISSN: 2153-0866

    This paper introduces the design and characterization of a robotic surgical instrument produced mainly with rapid prototyping techniques. Surgical robots have generally complex structures and have therefore an elevated cost. The proposed instrument was designed to incorporate minimal number of components to simplify the assembly process by leveraging the unique strength of rapid prototyping for producing complex, assemble-free components. The modularity, cost-effectiveness and fast manufacturing and assembly features offer the possibility of producing patient or task specific instruments. The proposed robot incorporates an integrated force measurement system, thus allowing the determination of the force exchanged between the instrument and the environment. Detailed experiments were performed to validate the functionality and force sensing capability of the instrument.

    Marcus HJ, Payne CJ, Hughes-Hallett A, Gras G, Leibrandt K, Nandi D, Yang G-Zet al., 2016,

    Making the Leap: the Translation of Innovative Surgical Devices From the Laboratory to the Operating Room.

    , Ann Surg, Vol: 263, Pages: 1077-1078

    OBJECTIVE: To determine the rate and extent of translation of innovative surgical devices from the laboratory to first-in-human studies, and to evaluate the factors influencing such translation. SUMMARY BACKGROUND DATA: Innovative surgical devices have preceded many of the major advances in surgical practice. However, the process by which devices arising from academia find their way to translation remains poorly understood. METHODS: All biomedical engineering journals, and the 5 basic science journals with the highest impact factor, were searched between January 1993 and January 2000 using the Boolean search term "surgery OR surgeon OR surgical". Articles were included if they described the development of a new device and a surgical application was described. A recursive search of all citations to the article was performed using the Web of Science (Thompson-Reuters, New York, NY) to identify any associated first-in-human studies published by January 2015. Kaplan-Meier curves were constructed for the time to first-in-human studies. Factors influencing translation were evaluated using log-rank and Cox proportional hazards models. RESULTS: A total of 8297 articles were screened, and 205 publications describing unique devices were identified. The probability of a first-in-human at 10 years was 9.8%. Clinical involvement was a significant predictor of a first-in-human study (P = 0.02); devices developed with early clinical collaboration were over 6 times more likely to be translated than those without [RR 6.5 (95% confidence interval 0.9-48)]. CONCLUSIONS: These findings support initiatives to increase clinical translation through improved interactions between basic, translational, and clinical researchers.

    Giannarou S, Ye M, Gras G, Leibrandt K, Marcus HJ, Yang GZet al., 2016,

    Vision-based deformation recovery for intraoperative force estimation of tool–tissue interaction for neurosurgery

    , International Journal of Computer Assisted Radiology and Surgery, Vol: 11, Pages: 929-936, ISSN: 1861-6410

    Purpose In microsurgery, accurate recovery of the deformationof the surgical environment is important for mitigatingthe risk of inadvertent tissue damage and avoiding instrumentmaneuvers that may cause injury. The analysis of intraoperativemicroscopic data can allow the estimation of tissuedeformation and provide to the surgeon useful feedbackon the instrument forces exerted on the tissue. In practice,vision-based recovery of tissue deformation during tool–tissue interaction can be challenging due to tissue elasticityand unpredictable motion.Methods The aim of this work is to propose an approachfor deformation recovery based on quasi-dense 3D stereoreconstruction. The proposed framework incorporates a newstereo correspondence method for estimating the underlying3D structure. Probabilistic tracking and surface mapping areused to estimate 3D point correspondences across time andrecover localized tissue deformations in the surgical site.Results We demonstrate the application of this method toestimating forces exerted on tissue surfaces. A clinically relevantexperimental setup was used to validate the proposedframework on phantom data. The quantitative and qualitativeperformance evaluation results show that the proposed3D stereo reconstruction and deformation recovery methodsachieve submillimeter accuracy. The force–displacementmodel also provides accurate estimates of the exerted forces.Conclusions A novel approach for tissue deformationrecovery has been proposed based on reliable quasi-densestereo correspondences. The proposed framework does notrely on additional equipment, allowing seamless integration with the existing surgical workflow. The performanceevaluation analysis shows the potential clinical value of thetechnique.

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