Visual Servoing for Beating Heart Surgery - Visual Servoing via Advanced Numerical Methods - page 87

Chapter 6
Visual Servoing for Beating Heart Surgery

Wael Bachta, Pierre Renaud, Ezio Malis, Koichi Hashimoto, and Jacques Gangloff

Abstract. Off-pump coronary artery bypass grafting (CABG) is still a technically
challenging procedure. The existing mechanical stabilizers used for local suppres-
sion of the heart excursion have demonstrated significant residual motion, which
could lead to a lack of accuracy in the surgical task, particularly in a minimally in-
vasive surgery (MIS) context. Robots can help the surgeon by actively compensating
for the heart motion using visual servoing. Various sensors like endoscopic camera,
ultrasound imaging or even magnetic resonance imaging (MRI) can be used to pro-
vide the feedback of the visual loop. Advanced control approaches like predictive,
repetitive or robust control can enhance the compensation accuracy. They rely on
a model that uses physiological inputs to predict the motion of the myocardium in
real-time.

6.1 Introduction

For many patients, CABG is still the only solution for myocardium revascular-
ization. CABG is one of the most common surgical intervention in Europe and
especially in North America. According to the organization for economic coop-
eration and development (OECD) 2008 health database [33], 12 European countries
reported in 2006 an average of approximately 50 CABG procedures per 100,000
in-patient population. In 2004, the United States reported 145 procedures per
100,000 in-patient population. So, improving the quality of this intervention by