On 17 May 2010 experiment on animals was carried out by surgical robots Robin Heart in Experimental Center of Medicine, Medical University of Silesia in Katowice. Robin Heart mc2 new type of robot was evaluated in conditions similar to clinical.
Elements of the operations performed on heart-related coronary artery. There was collected a lot of experience of major importance for a completely new version of the medical robots designed for a wide field of application in surgery. Robot itself will be presented to the public shortly after completing the necessary work of protecting the intellectual property of the solution. The team, which participated in the preparation and conduct of this extraordinary experiment consisted of eminent surgeons, veterinarians, engineers and technicians of various specialties. The experiment was performed with the involvement of the following institutions: the Foundation for Cardiac Surgery Development in Zabrze (finance experiment, carrying out the project Robin Heart), CMD, Silesian Medical School in Katowice and the Silesian Centre for Heart Diseases and Department of Cardiac Surgery and Transplantation, Medical University of Silesia in Zabrze. Thanks for the important and necessary contribution to the experiment we will list them in alphabetical order: Mark Ciembroniewicz, Angela Grajoszek, Krzysztof Filipiak, Jolanta Kreis, Adam Smolka, Jerzy Stojko, Joanna plum, Michael Zembala and a team of the Laboratory of Biocybernetics: Mariusz Jakubowski, Adam Klisowski, Paul Kostka, Kamil Rohr, Claudius Wtorkowski.
Zbigniew Nawrat project manager - Foundation of Cardiac Surgery Development and the Department of Cardiac Surgery and Transplantation, Medical University of Silesia.

21 and 22 January this year, Doctors and engineers tested the robot in the operating room in Centre for Experimental Medicine, Medical University of Silesia in Katowice. Patients were ... two domestic pigs. Debut of Robin Heart went off perfectly!
Surgical verified were almost all models of the prototype robot arm tooling, including differing control and attachment concept, Robin Heart Vision - the robotic arm to control the position of the video track, and innovative, robotic surgical tools of the new generation (Robin Heart Uni System), which can be moved from a robot into a special hand-hold and perform the procedure manually. The essence of the animal experiments was to remove the gall bladder and performed at open heart, using cardiopulmonary bypass, mitral valve repair surgery (tricuspid). All this was performed to give developers the robot and its future users the widest possible of overview of the possibilities, advantages and disadvantages of the surgery developed system. Until now the usefulness of Robin Heart was checked in a virtual operating room and in the laboratory – on preparated animal hearts.
"We build tools for a new generation of surgeons. We want to see what is the area of necessary changes that must be made to the equipment being developed before the preparation of mass production technology and clinical implementation "- said Dr. Zbigniew Nawrat, Research Director of the Institute of Heart Prosthesis, Robin Heart robot and the experimental test project manager.
Groups of engineers, electronic engineers, computer scientists and engineers who worked on Robin continuously consulted the medical team, to catch any amendments to be made to it. However, two test operations proved that the robot - but will certainly be improved - now works fine. They praised him both performers of an experiment, young doctors: Joanna Śliwka and Michael Zembala from Silesian Centre for Heart Diseases and medical expert, holding the main control of control console - Assoc. Romuald Cichon, Science Director of Foundation.

Description of an operation

All surgery was executed by premedication and general anesthesia, in accordance with established procedure. On preparation of animals to the operation watched the veterinary and nurses team. Appropriate medications were given to animals, intubation was performed, connected the inhalant anesthesia. The first experiment, the easiest technically, was made in the abdominal cavity of pig – the idea was to remove the gall bladder. Using the robot the common bile duct and alveolar artery was dissected. At the operating table was placed all the complex of new prototype robots control system. Robot control console was located in an adjacent room. The experiment demonstrated the effectiveness of both the correct robot control system, as well as surgical instruments. Has been widely used - appropriately modified and mounted on the robot arm - laparoscopic electrocautery tool, obtained through cooperation with the Warsaw company EMED. Analysis of ergonomic surgeon indicated the need for a new monitor that displayed the view from the operating room, as well as the need to introduce a orientation system to monitor the image field operations, consistent with an intuitive tool orientation relative to the operator (left tool on the left side of image). At the end of the experiment an attempt was to set the robots in a way to perform another operation - called sewing  bypass on the beating heart (without cardiopulmonary bypass). One element of this procedure is to obtain a vessel (mammary artery), then used as a vascular graft to made by-pass. Unfortunately, it turned out that the plan of operations developed on a virtual human model, not worked well in terms of operations on the animal. Pig chest is much narrower than the chest of man of the same weight, so the problem appeared was a collision in an operational environment of a robot arm. For this reason, treatment of sewing bypass was delayed, and his perform will be possible after the relevant research and solve problematic issues in the technical - anatomical laboratory conditions. The last experiment consisted of surgery of tricuspid and mitral valve. Anatomy of the heart and chest pig perfectly exposes the valve and allows access to them through the hole in the intercostal space. The difficulty of the procedure recalls to the need of cardiopulmonary bypass - a mechanical pump and oxygenator (oxygenates the blood) - allowing open-heart surgery. Animal anesthesia was performed as in the previous procedure. In the first phase of treatment, under the control of endoscopic visualization, using the tools of electrocoagulation incised pericardial sack and discovered the heart. Then incised the right atrium, visualized tricuspid valve on which corrective surgery elements was performed. During the experiment it was the first time when surgical robotic tools were used and mounted on a Robin Heart Uni System robotic arm. After the experiment, surgeons have used them also in the traditional way (manually) to perform several tasks within an open heart. It turned out that to improve the efficiency of the tools it is necessary to make certain changes in technology (especially lining needle-holder forceps). Animals participating in the experiment, after its completion, were subjected to euthanasia.

Summary

On prepared for clinical trials, robotic Robin Heart system consisted of: program planning, training, software expert, as well as automatic telemanipulators and surgical instruments. The experiment was prepared by a team of the Laboratory of Biocybernetics Heart Prosthesis Institute of Foundation  of Cardiac Surgery Development in Zabrze, composed by Zbigniew Nawrat (project manager), Pawel Kostka, Wojciech Dybka, Kamil Rohr, Mariusz Jakubowski, Adam Klisowski. The experiment was also attended by excellent surgeons: Asst. Romuald Cichon (including 350 operations performed by da Vinci robot), Dr. Grzegorz Religa of the Cardiology Institute in Anin, Joanna Sliwka and Zembala Michael from Silesian Center of Heart Diseases. Adam Slomka was responsible for the perfusion, Szymon Kostrzewski for veterinary care and anesthesia, Barbara Duda for nursing care. Assessment of practical capabilities of Robin Heart system proposed conclusions regarding to the needs of introducing appropriate changes in  Robin Heart robot project and determining the full program of preclinical studies. One of the main issues is the acceptance by surgeons not intuitive method of controlling functions of the tools. Control by buttons, both in the Uni system tools, as well as in the Shell console, did not cause any trouble. However there are changes in technology tools and components comply with the console ergonomics wanted. One of the tested robot - Robin Heart Vision, used to control the position of the endovisual track, gained full acceptance of users. It is therefore possible to start preparations for implementing it into clinical practice. Polish Robin Heart robot Family has the potential to become widely used by high-class surgeons and telemedical technical system, enabling the execution of operations in a less invasive, precise, safe for the patient and surgeon way.

Acknowledgments

Robin Heart robot project was funded by research project KBN 8 T11E 001 18, ordered project PW-004/ITE/02/2004 as a research development project funded of science resources in the years 2006-2009 as a grant number R1303301, and by the Foundation of Cardiac Development (Foundation funded both the preparatory work, as well as the same experiment), and also by many sponsors. All sponsors, participants of the grant, researchers and students we sincerely thank for their contribution to the project. We also thank the companies who gave us assistance in the form of equipment and substantive comments. Among those are: Żywiec FAMED - manufacturer of hospital equipment and Warsaw EMED - producing surgical power tools.