Ever imagine doing surgery on a beating heart?  HMRI and University of Newcastle (UoN) researcher, Dr Lingbo Cheng has been developing a sophisticated way to conduct beating heart surgery with telerobotic control systems.

The manual use of tools during beating heart surgery could not only lead to human operator fatigue and exhaustion but also increases the risk of tool-tissue collision and tissue injury.

In an alternate to risky arrested heart operations – where the heart stops beating – a HMRI and University of Newcastle researcher has been developing a sophisticated way to conduct beating heart surgery with telerobotic control systems.

It can compensate for the beating heart motion and essentially create a “stationary heart” for surgeons to operate on.

“My research endeavours to push the boundaries of control and automation for medical robots, with a focal point on teleoperation haptics, non-linear control and medical imaging,” member of HMRI’s Surgical and Perioperative Care Research Program, Dr Lingbo Cheng said.

“The ultimate goal is to empower medical professionals with advanced tools to amplify their skills, improve patient care and drive the evolution of medical robots into a new era of efficacy.”

Dr Cheng has also designed multi-user surgical robots to provide guidance in surgical training and to provide feedback to all operators, trainers, and trainees during beating heart surgery.

Meanwhile with visualisation one of the major challenges in some robotic surgeries, because a surgeon’s vision is narrowed by a patient’s small opening, Augmented Reality (AR) guided technology has emerged as a solution.

AR-guided assistance can give surgeon’s a better view of the patient’s anatomy providing real-time visual guidance which can allow for better spatial understanding and precision in complex procedures.

Despite current challenges in applying AR in robotic surgeries and the potential disruptions in a surgeon’s workflow due to having to shift between an AR display and the patient, Dr Cheng’s research is set to break through these barriers.

One notable project Dr. Cheng has researched is AR-guided robot-assisted fibula osteotomies in mandible reconstruction surgery.

This procedure involves using a segment of the leg’s fibula bone, along with soft tissue from the calf and the fibular vascular pedicle, to reconstruct the mandible, also known as the jawbone.

The fibula bone segment must be shaped to match the piece of the mandible that was removed, with the main difficulty shaping the straight bone into a curved piece.

To improve accuracy, Dr. Cheng has developed an innovative robotic assistant that incorporates 3D AR visualisation, which can reduce a surgeon’s hand tremor and provide guidance.

Also, in response to the pandemic, Dr. Cheng collaborated with Tactile Robotics Ltd in Canada in 2019 to develop a compact and portable teaching and learning platform for dental schools.

This platform facilitates remote teaching and learning in dentistry and complements traditional methods, allowing for real-time orientation between instructors and students connecting to the cloud for performance metrics and enabling use anywhere.

Currently both the beating heart telerobotic system and the AR-guided robotic systems are being used at the University of Alberta in Canada as experimental prototypes.

Dr Cheng’s long-term goal is to establish a top-notch telerobotic laboratory here in the Hunter and to integrate robotic systems into operating rooms, pioneering clinical robotic beating heart surgeries to assist clinicians and surgeons globally.

“For robotic beating-heart surgery, it is one of the most cutting-edge problems, because it remains as an unsolved problem around the world,” Dr Cheng explained.

“It is extremely challenging, and there are only a few researchers studying this topic with one of our competitors in Harvard University.

“I have used unique and innovative methodologies and successfully shown how this could work for simple heart motions, however further refinements and rigorous testing are necessary before using the robot in operating rooms.

“I also plan to conduct both invitro and in vivo experiments to design experiments involving animals and cadavers to assess the effectiveness of my system.

“I plan to collaborate with industry partners to commercialise my robotic system promoting their widespread application in the medical field.”