Table 5 Challenges and areas for future developments in medical telerobotics
From: Medical telerobotic systems: current status and future trends
1 | Regulatory approvals | Approvals take a significant amount of the development time and cost. Lack of worldwide acceptable regulatory standards makes the clearance process inefficient and costly |
2 | Clinical acceptance | Acceptance by clinicians and patients is required but also by third-party payers in the health-care system including insurance companies |
3 | Cost of acquisition and maintenance of telerobotic systems | These are mainly attributed to the high development costs related to the strict safety and reliability requirements |
4 | Interdisciplinary development approach | The development of telerobotic systems requires an interdisciplinary approach to deal effectively with both clinical and engineering aspects |
5 | Human factors | Human factors considerations need to be an integral part of the design to yield safer, more usable and effective devices. Decreased interaction among the healthcare professionals and patients during application needs attention |
6 | Telepresence enhancement | Available means include the development of effective user interfaces and use of force feedback haptic systems |
7 | Software tools | Emphasis required on preoperative planning tools. They may analyze imaging information, present the operator with optimal courses of action, and facilitate decision making |
8 | Radiological imaging methods | Apart from camera systems other imaging methods can be further exploited for visualization and guidance (e.g., US, CT, MRI) |
9 | Information fusing | Fusing intra-operative images with 3D patient-specific models constructed from pre-operative information enhances perception. Also, merging intra-operative information acquired from different imaging modalities (e.g., MRI and ultrasound) may improve visualization |
10 | Telecommunication networks | Long-distance telerobotics demand reliable transmission of huge amounts of data with acceptable delay. Latest technologies need to be embraced |
11 | Video compression technologies | Compression technologies will facilitate the transfer of large quantities of information |
12 | Network security enhancements | Wireless networks’ security vulnerability remains a major concern for the exploitation of (long-distance) telerobotics in telemedicine |
13 | Moral and legal issues | Transmission of information over communication networks raises issues regarding the protection of patient’s privacy and needs to be regulated. Legal regulation regarding application of medical telerobotics is also needed to prevent unauthorized service providers |
14 | Liability issues | Liability and responsibility for complications during a telerobotic procedure is among delicate issues to be formally addressed |
15 | Development of robotic comanipulation systems | Robotic comanipulation systems with required dexterity are needed while satisfying safety requirements |
16 | Robot control | The establishment of stable/robust control systems despite the long-distance data transmission involved presents engineering challenges |
17 | Auxiliary control functions | Implementation of auxiliary control functions will provide enhancements to long-distance telerobotics and reduce burden on the operating physician. Particularly important will be the biomotion compensation |
18 | Physicians training | The availability of trained physicians will require medical schools to acquire telerobotic technologies and introduce them in their educational programs. Development of training simulators will also play an important role in that respect |
19 | Telementoring and collaborative surgery | The telementoring capabilities of telerobotics can be further exploited to train and support physicians. Experienced physicians can play the preceptor’s role to other physicians without having to relocate |
20 | Collaborative research approach | Shared efforts between universities and companies will foster the development of new commercializable technologies |