Combined endo- and exoscopic semi-robotic manipulator system for image guided operations.

This paper describes the development of a robotic assistance system for image guided operations. To minimize operation time, a multimodal user interface enables freehand robotic manipulation of an extracorporeal stereoscopic digital camera (exoscope) and an endoscope. The surgeon thereby wears a head-mounted unit with a binocular display, a head tracker, a microphone and earphones. Different view positioning and adjustment modes can be selected by voice and controlled by head rotation while pressing a miniature confirmation button with a finger. Initial studies focused on the evaluation and optimization of the intuitiveness, comfort and precision of different modes of operation, including a user test with neurosurgeons in a virtual reality simulation. The first labtype of the system was then implemented and demonstrated in the operating room on a phantom together with the clinical partners.