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In situ 3D Bioprinting Robot Technology
(i) Assisting doctors in locating the focus and reducing 4. Robotic technology in in situ 3D
their surgical burden; (ii) realizing real time or remote bioprinting
control; and (iii) achieving high precision, minor trauma,
and less bleeding [37-39] . At present, there are many types At present, there are two approaches in the operation of
of neurosurgical robots in medical use. The Renaissance in situ 3D bioprinting: Handheld and robotic assistance.
® surgical robot system from Mazor Robotics features By handheld approach, the physicians operate handheld
high-precision positioning for minimally invasive devices to print directly. This approach is more flexible in
percutaneous spinal cord neurosurgery and provides 3D creating structures, more convenient in operation, and easier
images for intraoperative verification of brain implants. in terms of device sterilization. However, the application of
The “Leeyuan” surgical robot system, jointly developed this approach is only limited to repairing simple structures.
by Beijing University of Aeronautics and Astronautics, the On the other hand, robotic assistance approach combines
Naval General Hospital, and Tsinghua University, used robotic technology and computer-aided interventions
computed tomography/magnetic resonance imaging data with 3D bioprinting to print under the real-time control
as input data to guide the robot to complete the operation of physicians. Compared to the handheld approach, the
through stereo navigation and completed a minimally robotic assistance approach can build a more complex and
invasive brain surgery in 2003. The NeuroMate ® robot extensive structure and achieve better precision in repetitive
movements, making the printing process more accurate and
system developed and manufactured by Renishaw has faster. Robotic assistance approach in 3D bioprinting allows
been certified by the European Union CE. Through stereo
vision navigation configuration, the system can perform innovations in surgical procedures and treatment plans.
The team of Professor Xingsong Wang at Southeast
deep brain stimulation, transcranial magnetic stimulation, University, China, designed an in situ bioprinting device
and endoscopic surgery with sub-millimeter accuracy. based on a 6 degree-of-freedom robot. The robot has a
Pathfinder ®, developed by Prosurgics and certified by rapid tool center point (TCP) calibration system, which
the FDA for neurosurgery in 2004, is a robotic system can accurately calculate the TCP through the robot’s
that uses pre-operative medical images to help physicians kinematic model, distance constraints, and measurements
perform routine stereotactic brain surgery. In 2010, of the laser tracker. It helps improve the printing accuracy
British researchers upgraded the Pathfinder to achieve the to a printing surface error of <30 μm, and osteochondral
submillimeter positioning precision . Professor Garnett defects can be repaired in about 60 s. The researchers
[40]
Sutherland at the University of Calgary in Canada then used the robot to conduct experiments on the resin
developed the neuroArm surgery robot system, which can model in vitro to verify the printing accuracy and on
provide real-time, high-definition 3D image resources rabbits to assess the healing capabilities of cartilage.
and tactile feedback to assist surgeons in performing the Results showed that robot-assisted in situ 3D bioprinting
surgery. It enables surgeons to view real-time information can promote cartilage regeneration .
[6]
related to brain function, anatomy, and metabolism during Lipskas et al. developed a remote center of motion
the operation to avoid interruption . In 2016, iSYS1, (RCM) robotic system to treat focal cartilage defects in
[41]
a new micro-robot system for stereotactic intervention knee bone. They also designed an end effector that can
in neurosurgery, was released. Its positioning device handle three quick interchangeable end effectors for
is feasible and can be used for frameless stereotactic bone milling 3D printing and a contact probe. The robot
biopsy and the placement of shunts and catheters in is controlled using an Arduino Mega programmable
most conditions . The Remebot neurosurgical robot controller and custom firmware and utilizes a ladder
[42]
developed by the Department of Neurosurgery of the interpolation algorithm to generate paths. This method
306 Hospital of Chinese PLA and Beijing Bai Hui minimizes the risk of stent contamination in regenerative
th
Wei Kang Technology Co., Ltd. can realize frameless, medicine, omits the steps of extracorporeal stent
minimally invasive, higher positioning precision brain preparation, and reduces the risk of infection .
[47]
surgery. Compared with the existing treatment plans, Fortunato et al. developed a robotic bioprinting
the robot-assisted treatments can significantly reduce platform for fabricating 3D structures on complex
the probability of post-operative complications and surfaces. In this research, they built an experimental
improve the quality of life of patients [43,44] . The ROSA- platform based on the open-source bioprinting robot
Brain surgery robot assistant system by Zimmer Biomet platform IMAGObot, used LinuxCNC to control the
Co. in the United States adopts a 6 degree-of-freedom robot, and developed a path planning algorithm that can
robotic arm with sensing and dynamic tracking. It has a automatically project the printing pattern onto the surface
noticeable effect on deep brain stimulation and reactive of the printing site and calculate the angle of each joint
nerve stimulation system, and was approved by the FDA of the robotic arm to ensure the end effector is always
for neurosurgery in 2019 [45,46] . perpendicular to the surface . In another study, the
[48]
218 International Journal of Bioprinting (2022)–Volume 8, Issue 4