TR&D Proposal TeleSurgical Robot Simulator

Proposal / Application
for
ICT-Related Development
and Research Grant
Development of a Tele-Surgical Training Robot and Simulator
DR. OSMAN HASAN

ASSISTANT PROFESSOR,
NUST SCHOOL OF ELECTRICAL ENGINEERING & COMPUTER SCIENCE,
(SEECS), SECTOR H-12, ISLAMABAD
DR. ASIF ZAFAR

MCPS, FCPS, MD, FRCS
PROFESSOR OF SURGERY,
RAWALPINDI MEDICAL COLLEGE,
PROJECT DIRECTOR, MINIMAL INVASIVE SURGERY & TELEMEDICINE & E-HEALTH TRAINING CENTER,
HOLY FAMILY HOSPITAL, RAWALPINDI
Application for ICT-Related Development and Research Grant Page I

Read carefully before filling the form.
1. Please do not alter the layout of the application form. Information

must be filled in the spaces provided, under set format.
2. Guidance notes in various fields should not be deleted.
3. Required information should be duly filled in the specified fields.
4. Required heads/fields which are not relevant to the project
should be marked N/A (Not Applicable) or left blank and should
not be deleted.
5. Specifications, justifications, purposes must be provided against
each item in the Budget file.
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Application for ICT-Related Development and Research Grant Page II

List of Abbreviations and Acronyms
EE External Evaluators
ICT Information and Communication Technologies
IPR Intellectual Property Rights
JPD Joint Project Director (Co-Director)
PD Project Director
PI Principal Investigator (Organization)
"Principal Investigator" means the person, company, partnership,
undertaking, concern, association of persons, body of individuals,
consortium or joint venture which receives funding from the
Company to execute a research and development project.”
R&D Research and Development
MIS Minimally Invasive Surgery
UI User Interface
UAV Unmanned Air Vehicle
UGV Unmanned Ground Vehicle
List of Abbreviations and Acronyms Used by PI/PD in the Proposal

(Please add abbreviations and acronyms in the table below, if any.)
Application for ICT-Related Development and Research Grant Page III

Application for ICT-Related Development and Research Grant
Guidelines and Forms
Introduction
National ICT R&D Fund was created in January 2007 by Ministry of IT with the vision to
transform Pakistan's economy into a knowledge-based economy by promoting efficient,
sustainable, and effective ICT (IT and Telecommunications) initiatives through synergic
development of industrial and academic resources. Collaborative efforts between
academia, research institutions, and industry are greatly encouraged to ensure that local
economy can reap the monetary benefits of investment in research. This organization
has significant funds available for proposals that are geared towards creating ICT related
technologies.
Research grants will be awarded for high-level and promising ICT-related development
and research projects by individuals or groups from academia and/or industry actively
involved in the development and research individually or collaboratively. These projects
should be based on either a universally known technology or a new technology
developed by the applicant and should be aimed at achieving economically viable
systems, products, or processes beneficial to the nation.
The grant will normally be provided for a period of up to two years – renewable every
year based on the performance. The grant will cover the honoraria of the project and co-
project directors, salaries of researchers, stipends for student research assistants, and
supporting staff. It will also cover travel(s) within and outside the country for project-
related activities and for project-related scientific conferences. The grant may be used to
purchase very specific unavoidable equipment kept to the bare minimum, consumable
materials, and other items needed for the project. The grant can also be used to cover
the training expenses of the personnel associated with the research project.
Submission Procedure
Duly filled applications in all respects along with any documents should be emailed to
helpdesk@ictrdf.org.pk. A hard copy should also be submitted by registered post or by
fax at our mailing address given below. On receipt of the applications the proposals will
be evaluated internally as well as externally as laid down in our policy documents. The
PD may need to revise the proposal in light of the evaluator‘s recommendations.
There is no deadline for submission of the application; however the application should
be submitted at least three months prior to commencing the project.
Joint Funding
The project proposal may be jointly funded by ICT R&D Fund and other funding
agencies/industry. The efforts to obtain joint funding will be at the discretion of the
Principal Investigator (PI) – Organization to which Project Director belongs. However any
such information must be provided to ICT R&D Fund. The funds released will be
provided to the PI.
Application for ICT-Related Development and Research Grant Page IV

Agreement
A written agreement will be made between National ICT R&D Fund and PI. The PI will
undertake to administer the grant according to the agreement and to provide laboratory
space, and other facilities necessary for the project. The equipment purchased with ICT
R&D Fund for the approved project will remain the property of ICT R&D Fund. The
laptops will be returned to ICT R&D Fund after completion of the project. The grantee is
required to submit a final narrative and financial report within one month of the
completion of the project. The IPR issues will be sorted according the policy in vogue.
For further information, please contact:
Solicitation and Evaluation Department,

National ICT R&D Fund,
6th Floor, HBL Towers,
Jinnah Avenue, Blue Area, Islamabad
Tel.: (+92-51) 921 5360 - 65
Fax: (+92-51) 921 5366
Website: www.ictrdf.org.pk
Application for ICT-Related Development and Research Grant Page V

Table of Contents
Description Page #
1. Project Identification ............................................................................................................... 1
A. Reference Number: ............................................................................................................. 1
B. Project Title:........................................................................................................................ 1
C. Project Director (PD): ......................................................................................................... 1
D. Organization (The Principal Investigator (PI)): .................................................................. 1
E. Other Organizations Involved in the Project: ..................................................................... 2
F. Key Words: ......................................................................................................................... 2
G. Research and Development Theme: ................................................................................... 3
H. Project Status: ..................................................................................................................... 3
I. Project Duration: ................................................................................................................. 3
J. Executive Summary: ........................................................................................................... 3
2. Scope, Introduction and Background of the Project ........................................................... 5
A. Scope of the Project: ........................................................................................................... 5
B. Introduction: ........................................................................................................................ 6
B1. Literature Review: ............................................................................................................ 11
B2. Current State of the Art: ................................................................................................... 21
C. Challenges: ........................................................................................................................ 21
D. Motivation and Need: ....................................................................................................... 22
3. Objectives of the Project ................................................................................................... 25
A. Specific Objectives Being Addressed by the Project:....................................................... 25
4. Research Approach ............................................................................................................... 27
A. Development / Research Methodology:............................................................................ 27
B. Project Team: .................................................................................................................... 45
C. Team Structure: ................................................................................................................. 46
D. Project Activities:.............................................................................................................. 48
E. Key Milestones and Deliverables: .................................................................................... 53
5. Benefits of the Project ........................................................................................................... 55
A. Direct Customers / Beneficiaries of the Project:............................................................... 55
B. Outputs Expected from the Project: .................................................................................. 55
C. Organizational / HRD Outcomes Expected: ..................................................................... 55
D. Technology Transfer / Diffusion Approach:..................................................................... 55
6. Risk Analysis ........................................................................................................................ 56
A. Risks of the Project: .......................................................................................................... 56
A1. Comments: ....................................................................................................................... 56
7. Contractual Matters ............................................................................................................... 57
A. Contractual Obligations under this Project: ...................................................................... 57
B. Ownership of Intellectual Property Rights: ...................................................................... 57
C. Competent Authority of the Principal Investigator (Organization). ................................. 57
8. Project Schedule / Milestone Chart....................................................................................... 58
9. Proposed Budget ................................................................................................................... 59
Bibliography ................................................................................................................................. 60
Annexure A – Curriculum Vitae ....................................................Error! Bookmark not defined.
Annexure B - Details of Hardware and Software Requirements……………………………….. 68
Annexure C - Details of Work Packages, Milestones and Deliverables ……………………….. 76
Application for ICT-Related Development and Research Grant Page VI

References …………………………………………………………………………………….... 74
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Application for ICT-Related Development and Research Grant Page VII

Application for ICT-Related Development and Research Grant
1. Project Identification
A. Reference Number:
(for office use only)
B. Project Title:
Development of a Tele-Surgical Training Robot and Simulator
C. Project Director (PD):
Name: Dr. Osman Hasan
Designation: Assistant Professor

NUST School of Electrical Engineering & Computer Science
Organization:
(SEECS)
Mobile # : Tel. # : 92-51-9085-2137
Email: osman.hasan@seecs.edu.pk
(A letter from the competent authority regarding project director’s time commitment for the proposed
research project must be provided.)
C1. Joint Project Director (JPD):
Name: Dr. Asif Zafar
Designation: Professor of Surgery, Rawalpindi Medical College

Project Director Minimal Invasive Surgery & Telemedicine & e-
Organization:
Health Training Center, Holy Family Hospital, Rawalpindi
+92-51-9290321 –
Mobile # : +92-300-5104404 Tel. # :
Ext 2132
Email: azmalik@hotmail.com
C2. Contact Person: (If different from PD.)
Name:
Designation:
Organization:
Mobile # : Tel. # :
Email:
D. Organization (The Principal Investigator (PI)):
Application for ICT-Related Development and Research Grant Page 1

(Please indicate the name, address, telephone and fax of the Organization acting as Principal
Investigator. The Project Director should also belong to this organization.)
NUST School of Electrical Engineering and Computer Science
Name:
(SEECS)
Address: Sector H#12, Islamabad
(Please attach certified
Registration #: copy)
(Please attach certified
National Tax #: copy)
Tel. # : +92-51-90852400 Fax # :
Website: www.seecs.edu.pk
E. Other Organizations Involved in the Project:

(Please identify all affiliated organizations collaborating in the project, and describe their
role/contribution to the project.)
E1. Industrial Organizations:

# Organization Name Role / Contribution
1.
2.
E2. Academic Organizations:

1. NUST School of Electrical Engineering & Research & Development
Computer Science
2. Holy Family Hospital Research & Testing
E3. Funding Organizations:

1. National ICT R&D Funding
2.
E4. Other Organizations:

1.
2.
F. Key Words:
(Please provide a maximum of 5 key words that describe the project. The key words will be
incorporated in our database.)

Robotics, Surgical Robot, Simulator, Tele-Surgical Robot, Telemedicine
G. Research and Development Theme:

(If the proposal belongs to a theme specified by NICT R&D Fund, please identify the Research
Theme.)
<type here>
H. Project Status:
(Please mark )
 New  Modification to previous Project
 Extension of existing project
H1. Project URL:

(The project URL should be provided. This URL should be hosted by the project executing
agency. Sufficient details such as executive summary, objectives are expected on the website.
Once the proposal is approved, the website should also provide final copy of the proposal and
deliverables/progress.)
I. Project Duration:
Expected Starting Date: December 2009
Planned Duration in months: 36 months
J. Executive Summary:
Surgical robots have gained popularity recently due to the introduction of robots that can
perform minimal invasive procedures as well as surgeries from remote locations. The
primary goal of this project is to develop a low cost Tele-surgical robot and simulator for
training of physicians. The basic requirement for such a project in Pakistan is to develop an
environment where robots can be utilized in the field of medicine to perform minimally
invasive surgeries. Surgical robots have become common in developed countries like USA
and parts of EU because of their efficiency, reliability and enabling quick recovery of patients.
Such robots are usually not easy to use in the beginning as they require extensive hands on
training before being used on actual human patients. Therefore training systems and
simulators are required that can provide the surgeons with enough expertise before any real
life surgical operation. In this project we focus on the development of a training system which
consists of a Surgical Training Robot and a Simulator. This training system will initially serve
the means to develop an environment where surgeons will become experienced with the use
of robots for surgeries. As skills are acquired in this field by surgeons through training in MIS
and by ICT experts through designing and developing robots and software in this field
eventually we will create human resource and support systems to perform minimal invasive
surgery procedures from remote locations in Pakistan.
Most training systems like ProMIS [6] available in the market cost thousands of dollars,

making it practically impossible for common use of such training systems in medical schools
and teaching hospitals. Therefore, the main objective of this project is to develop a cost
effective set of robots that can be initially for a period of several years used for training and
eventually deployed where the infrastructure for performing complex surgeries is limited to
hospitals in big cities only. These facilities for Tele-surgery will have to be augmented with
post operative care facilities. As the Tele-surgical training robot and simulator are put into
practice, they will train and produce experts in the area of robotic MIS procedures. In future,
this will allow them to utilize these skills to perform Tele-surgeries, where they would be
controlling surgical robots from a remote location and performing MIS procedures. In a few
years this will evolve into a system that will allow these trained surgeons to provide MIS
surgical facilities to remote areas of Pakistan, without any risk of safety, saving infrastructure
and development costs.
The proposed robot will be a combination of hardware and software systems, utilizing skills
and techniques in areas of robotics, image processing, computer game development and
control systems. The simulator will be developed using open source technology used in
game development, while the hardware of the training robot will be developed using parts
that are easily available off the shelf. This will be an integration of different technologies in
the area of robotics and software development. One of its advantages will be its user friendly
application software and it‘s easy to use hardware controls. Both these features shall help in
trainees getting used to the system more easily and in quick time rather than handling
difficult and hard to remember controls.
The simulator will run in two modes; Offline mode and online mode. In offline mode it will
only act as a simulator by displaying a virtual environment with 3-d images of organs and
operational procedures. Online mode will allow the user to control an actual robot while the
real imagery will be displayed from the robotic image acquisition device. Online mode could
be used with the robot in close proximity or at a remote location. Furthermore, the online
mode will allow the users to actually use the robotic arms on a mannequin (fake body) and
practice different procedures.
The surgical robot will provide the training skills for delicate control that is required to perform
surgical operations such as laparoscopy. The robotic arms will allow the surgeons to become
experts at performing surgeries and control robotic arms in areas where a human hand
cannot reach, thereby reducing the risks of post-op infection and slow recovery. It will also
provide far better results and advantages than the traditional methods as stated by chang
Moo kang et al [1]. In the future this robot could be deployed at most remote locations in
Pakistan, which means that every remote location would have the facility of complex surgical
operations performed by a trained and experienced surgeon. Since safety is one of the most
important issues, we plan to deploy this training system at the Telemedicine and E-health
training center Holy Family Hospital, Rawalpindi, where it will be tested and evaluated over a
certain period of time. Once it will be verified that the surgical robot is capable of training
surgeons for robotic MIS procedures, we will move on to the next phase, where we will
develop a fully functional Tele-Surgical robot capable of performing MIS procedures
controlled from a remote location.
A cost effective and locally developed Tele-surgical training robot can bring about a
revolution in the health care sector in not only Pakistan but most developing countries.
Currently the robot in use in most developed countries is the da Vinci Surgical Robot [2],
which costs about Rs. 160 million. This is the cost of a single robotic system. The extremely
high cost makes it almost impossible for developing countries to buy and implement this

technology in large numbers. The technology used by da Vinci is sophisticated and
expensive. We plan to develop a training robot using simpler technology as an initial step.
Once the initial phase is complete and tested, a more sophisticated robot can be developed
with features similar to that of the da Vinci Robot that can be actually used for MIS
operations. One of our main goals is to develop a training robot that is affordable by most
developing countries. For this purpose we plan to use open source software tools for
developing the simulator and the robot software; and we plan to develop an indigenously
built robot with inexpensive off the shelf parts that are commonly available.
The main value proposition of this proposal is that by creating synergy between knowledge
of expert surgeons, expert computer engineers and low cost hardware components created
for video gaming industry extremely valuable training systems for minimal invasive surgery
can be created in the short term. This expertise can be further nurtured to develop high
quality minimal invasive surgery systems in Pakistan at low cost and deploy these systems
throughout Pakistan. Thus creating an ecosystem that improves health care while generating
significant R&D activities, foster innovation, create job opportunities and lead to wealth
generation.
2. Scope, Introduction and Background of the Project

A. Scope of the Project:
Our goal for this project is to develop a training system comprising of a simulator and a
surgical robot. The main idea is to develop a training system that can be used by surgeons
for training of minimally invasive surgical procedures. There are two major objectives for this
project. First is to train doctors to perform minimally invasive procedures with the use of
robots and become experts in this area. Second is to test this robot and collect feedback as
a preamble for the development of a Tele-Surgical Robot that can be used by these
surgeons, in the future, to perform surgical operations from remote locations. Hence this
project is just the first of many phases that will continue to develop and improve on this
concept while improving efficiency, accuracy, safety and precision.
This project will bring in expertise of different fields and group them together for the
development and use of this project. Its development scope will include people in the field of
medicine, robotics, image processing and control systems. In Pakistan there are no facilities
available for the practitioners in the medicine filed to train themselves that involve the use of
robots for procedures like MIS. We intend to address this problem by developing a training
system that will allow the training as well as evaluation of surgeons on this system before
they can go on to perform robotic MIS procedure in the operating theatre. Furthermore, the
low cost of the system will allow for it to be used in most medicine schools and teaching
hospitals.
Currently similar robots for training MIS procedures are very expensive costing thousands of
dollars making them infeasible for countries like Pakistan. A low cost simulator and training
robot will allow the development of quality human resource and set the precedent for
development of robotics in the health sector in Pakistan, encouraging indigenous
development of training robots as well as robots in other fields.

B. Introduction:
In today‘s world robots have become common in many fields. Some examples of robots
being utilized in different fields are industrial robots, home cleaning (vacuum) robots, elderly
care robots, entertainment robots, military robots like UAVs and UGVs etc. Similarly for the
field of medicine there are surgical and health care robots. Surgical robots like da Vinci [2]
have improved the quality of healthcare by providing surgeons the ability to perform quick
and efficient MIS procedures. In this project, our aim is to enhance the quality of healthcare
in Pakistan by developing a Tele-surgical training robot and Simulator.
A Tele-Surgical robot enables a surgeon to perform surgeries or minimally invasive surgical

procedures by controlling a robot from a remote location. There are several techniques which
a surgeon must master before he can successfully use a robot for an MIS procedure. Firstly,
all the laparoscopic equipment that is used in an MIS operation is handled indirectly by the
surgeon. The surgeon uses controls that direct the movement of laparoscopic equipment
which is mounted or connected to three to four robotic arms. Secondly in a Tele-Surgical
robot the robotic arms are connected to the control application over a network link. Therefore
there is a certain time lag before the movements of the surgeon‘s controls are transferred to
the robotic arms. Other than these there are other factors as well. For example, indirect
control of laparoscopic equipment involves high risk and safety issues. Network and
electrical failure are some of the things that can go wrong. A surgeon might not be able to
master hand eye coordination, which is necessary in such procedures. Finally, a surgeon
might not have the necessary experience to perform a robotic MIS operation. This project
aims to solve all these problems by developing a training system which will allow the
surgeons to conduct practice runs and train themselves for all unforeseen and foreseen
circumstances during a robotic MIS procedure. Figure 2.1 illustrates the working of a Tele-
Surgical Robot.
Fig 2.1 Operation of Tele-Surgical Robotic System

The training system consists of two parts. A simulator and a surgical robot system. The
simulator will be used for undergoing training of different scenarios. These scenarios will
include performing different laparoscopic operations. The simulator will provide a virtual
environment where the trainer will guide a surgeon to control the robotic arms of the virtual
robot model within the simulator to perform certain operations. These operations could
include cutting or removing of cancerous parts or isolating a certain organ from cancerous
tissue. Once the development is undertaken several training operations will be added based
on input from expert surgeons in the field of laparoscopy.
The second part of the trainer will be a surgical robot system. This will be an actual robot
consisting of robotic arms with laparoscopic equipment attached to it as end-effectors. The
surgical robot trainer will give the trainee a ―real-world‖ experience of handling a surgical
robot. The trainee would use this trainer robot to perform the same procedures performed in
the simulator on a mannequin (fake body). Robotic arms will be inserted into the body of the
mannequin and artificial organs would be manipulated by the trainee using the robotic arms.
In this way, the training system will provide the trainee surgeon with two modes of learning.
One using a virtual environment and one using a real-world environment, hence improving
the level of expertise and adding to his experience of robot handling.
Robotic Surgery has several advantages over traditional methods. The following chart
compares the advantages of surgical robots over traditional methods [1].
A Tele-Surgical training robot and Simulator will help in producing surgeons with additional
skills of robotic surgery. The simulator could also be used to train surgeons for traditional
MIS laparoscopic procedures. A combination of different technologies for the development of
this project will bring together people from different backgrounds. People from the fields of
engineering and medicine will combine their skills to develop this training robot, which in turn
will allow both sets of people to attain skills in the fields of others. Hence this project will
create a synergy between different fields allowing people to enhance their horizons to many

fields and apply them to further create products that are unique and innovative.
The Concept
The concept of the proposed system is based on a two phase learning method. We will
develop a training system that will train surgeons using virtual reality and graphical methods
as well as using an actual robotic system capable of performing surgical procedures. A
simulator is used mostly when training on an actual system is not possible, or if it is possible
then only a limited number of times. A typical example for use of simulators is by the people
at NASA (National Astronautics and Space Agency) to train its astronauts for space flight.
Militaries also use simulators to train pilots for helicopters and airplanes, saving huge fuel
costs.
Our concept for the simulator is similar to that mentioned above. In our scenario, it is
impossible and unethical to train surgeons on patients. A simple mistake can be life
threatening. Therefore a simulator is necessary that can allow surgeons to train without the
fear of committing life threatening mistakes. Surgeon‘s can commit unlimited mistakes and
train for as long as required. A simulator in this case not only saves time and money but also
saves the surgeons from getting into potential life threatening situations.
Just as a pilot can never feel the actual physical features unless he flies a plane in reality,
similarly a surgeon can never be perfectly trained unless he controls a surgical robot
physically. Keeping this scenario in mind our training system also consists of a training robot
that will allow the trainee surgeons to train on mannequins and get a feel for the physical
control features of the robot. A combination of the two will train a surgeon for the best
possible circumstances in a real life operation.
The Technology
In the field of robotics there are no standards for hardware or software development. One of
the development environments for robotics is Microsoft Robotic Studio which requires a
license. In this project our main focus is to develop a robotic system with minimal costs,
making it cheap to purchase and deploy in large numbers. Therefore we will focus on open
source development tools and libraries to accomplish the different development stages of the
robotic system.
The technology that we will use in the development of this robot will be the key to its‘ low
cost. Using open source development tools and libraries along with cheap off the shelf
hardware and electronics we plan to develop a reliable and efficient robot that will be easily
reconfigurable for tasks other than serving as a Tele-surgical robot. There is no special kind
of hardware required for this project, except that the robotic arms will use off the shelf
laparoscopic equipment that is specially developed for Minimal Invasive Surgeries. In case
the application of the client is different than a surgical robot, then the laparoscopic robotic
arms would be replaced by those that are required. Hence what we would get is a highly re-
configurable remotely controlled robot that could be used for multiple purposes.
There are several stages of development of the many components in this proposed project.
The three main components are the Simulator, Haptic UI controls and the Training Robot.
We could have only developed a robot, but providing a simulator with it, gives many
advantages over other available systems. The simulator will allow a user to get trained
before attempting any real-life operation. It will also help in simulating errors, failures and any
unforeseen circumstances that the robot might encounter. Whereas the training robot will

allow the users to experience the real world feel of working with a surgical robot.
Technology for the Robot and Simulator

As we mentioned one of our main goals is to develop a low cost robot, for which we intend to
use open source libraries and software development tools. Let us mention a few of the open
source libraries that will be used the development of this robot.
 RoboIO Library
Roboard Library. This board will be used in the development of the Surgical
Robot System. It is provided with its own open source library for development
hence saving any software API costs. Most code for interfacing the board with
external hardware is handled using the available library therefore saving time for
developing interface drivers.
 OpenGL
An Open Graphics Library package with plenty of documentation and examples
available online.
 OpenCV
An Open source Computer Vision library providing functions such as image
loading, filters and many other computer vision methods.
 VXL
Another open source Visual ―something‖ library with a large number of image
processing, mathematical and matrix operations along with several other
functionalities provided. All open source and available for commercial
development without any licensing.
As far as the hardware is concerned, a custom robotic arm frame will be developed based on
Dynamixel‘s AX-12 actuator specially designed for high torque robotic arms. Even though we
don‘t need high torque, but these actuators also provide precision movement and
temperature feedback incase the motors become hot due to high load. For the grippers or
the end-effectors we will use commercially available laparoscopic equipment. The reason for
using off the shelf laparoscopic equipment is a very straight forward one as such equipment
is specially developed for MIS operations, and we would not need to develop any special
hardware as our motive is to perform MIS operations.
We will be using a custom designed embedded system as the heart of the robot, which will
be responsible for interfacing the robotic arms. The brains of the robot will be the Surgeon‘s
Console PC Application software, which will do all the calculations and any image processing
that might be required. We will also develop haptic (feeling feedback) user interface controls.
These custom developed controls will give the operator of the robot a feel for the control
movements and force applied.
The simulator will be developed using OpenGL using C++. The same input controls will be
used to control the virtual robotic arms in the simulator as the actual ones. The simulator will
be programmed to provide different training scenarios for the surgeons to train on. It will be a
tool used for training of surgeons for MIS procedures before trying their hands on an actual

subject using the robot.
Application Scenario
In this section we describe scenarios where this project is applicable. This scenario will show
how this project is useful in a number of fields and how it will create an impact on people
from different fields and backgrounds.
 The training robot and simulator being cost effective can be deployed at medical
colleges and teaching hospitals. It will allow the medical students to get familiar with
the latest in technology as well as get hands on training on simulators for future use.
 The simulator and robot can be modified and used for other purposes as well. For
example this training system could be used by engineering students as a case study
for research. They could modify it and use it for other purposes, like controlling a
robot remotely using this technology or for developing remote monitoring systems;
the possibilities are limitless.
 The same technology can be used to develop simulators for other systems as well
such as surgical robots for typical surgeries other than minimally invasive surgeries.
 Computer scientists can use image processing techniques to enhance the reality in
the simulator, by integrating real video with the simulation (augmented reality).
In this project we are only focusing on laparoscopic surgery training using MIS procedures.
At later stages we intend to extend the capabilities of this robot to perform other functions as
well. There are plenty of ideas and application scenarios that can be implemented on this
robot in not only the field of medicine but other fields as well.
Implications and advantages of this project
This project has far reaching implications and great advantages. Once successfully
implemented and tested, it can be commercially produced and deployed in most rural areas
of Pakistan. Some of the future implications and advantages of this project are
 Improving the lives of people by providing health care facility in their own localities
 Improving the health care facilities in rural and urban areas of Pakistan
 Training quality human resource in robotic MIS procedures
 Providing MIS procedures by expert surgeons in all remote areas of Pakistan
 Saving millions of rupees in infrastructure costs
 Earning foreign exchange for the national exchequer by exporting this product to
other countries
 Setting a trend for the development of robotics in the field of medicine for other
people to follow

 Developing a robot that can also be used in areas other than surgical operations, e.g.
remote handling of hazardous material
This project has tremendous potential to be a successful product in many fields. We intend to
start with this project and move on to develop other products based on this core technology.
Our motivation is for the use of robotics in every field possible, saving costs, lives and
helping the advancement of Pakistan in the engineering and academic sectors.
B1. Literature Review:

(Detailed summary of what all has been done internationally in the proposed area quoting
references and bibliography.)
The field of surgical robots is a relatively new field as compared to other robotic fields. Some
of the robots that are being used right now in countries like the US have only been
developed in the last 5 to 10 years. As a result this is a very new field with unlimited
potential. In this section we review some of the surgical robots that have been developed
and are being used in actual operations.
1.1 Existing Surgical Robotic Systems
I) da Vinci Surgical Robot
The da Vinci Surgical System developed by Intuitive Surg ical [2] is the most
advanced surgical system available. It consists of an ergonomically designed
surgeon‘s console, a patient-side cart with four interactive robotic arms, the high -
performance InSite ® Vision System and proprietary EndoWrist ® Instruments. In da
Vinci the surgeon‘s hand movements are scaled, filtered and seamlessly translated
into precise movements of the EndoWrist Instruments, which is a technology
developed by Intuitive Surgical.
Fig 2.2 The da Vinci Surgical Robot System
Components of the da Vinci Surgical System

 Surgeon Console

 Patient-side Cart
 EndoWrist Instruments
 Vision System
The da Vinci Surgical System is the only commercially available technology that
can provide the surgeon with the intuitive control, range of motion, fine t issue
manipulation capability and 3-D visualization characteristic of open surgery, while
simultaneously allowing the surgeon to work through tiny incisions typical of
minimally invasive surgery.
Fig 2.3. An example of one of robotic surgery‘s greatest benefits—―key hole‖ incisions, as
seen in this prostatectomy illustration. The smaller incision means faster healing, reduced
body trauma, infection risk and shorter hospital stays
II) Mako Surgical Robot System
Mako [3] developed the Robotic Arm Interactive Orthopedic System or RIO. RIO™
assists the surgeon in achieving natural knee kinematics and optimal results at a
level of precision previously unattainable with conventional instrumentation.
Some of the features that this system provides are
 Accurately plan implant size, orientation and alignment utilizing CT-derived 3-D
modeling
 Enabling the pre-resection capture of patient-specific kinematic tracking through full

flexion and extension
 Real-time intra-operative adjustments for correct knee kinematics and soft-tissue

balance
 Minimally invasive and bone sparing, with minimal tissue trauma for faster recovery

Fig 2.4. Mako Surgical System
Mako Surgical Robot System is different from da Vinci as it is limited to knee surgeries, but
the common points between MAKO and da Vinci are that both allow surgeons extra hands
and increase their efficiency at performing Minimally Invasive Surgeries. Minimally Invasive
Surgical operations are far more efficient in early patient recovery and reduce chances of
post operative infections as the body of the patient is not open during surgery. A robot further
facilitates the patient by allowing the surgeon to perform surgery within the body without
damaging any other areas and with better mobility.
III) NeuroArm
Fig 2.5. NeuroArm
NeuroArm has been developed by Garnette Sutherland [4], Professor of Neurosurgery,

University of Calgary and Calgary Health Region, and his group. It is a MRI-compatible

image-guided computer-assisted device specifically designed for neurosurgery. It performs
both microsurgery and biopsy-stereotaxy applications. The system includes a workstation, a
system control cabinet, and two remote manipulators mounted on a mobile base. For biopsy-
stereotaxy, either the left or right arm is transferred to an extension board that attaches to the
OR table and the procedure is able to be performed inside the MRI bore.
NeuroArm includes two MR compatible manipulators with end-effectors that interface with
microsurgical tools. It includes filters to eliminate unwanted tremors. End-effectors are
equipped with three-dimensional (3D) force-sensor, providing the sense of touch. The
surgeon seated at the workstation controls the robot using force feedback hand controllers.
The workstation recreates the sight and sensation of microsurgery by displaying the surgical
site and 3D MRI displays, with superimposed tools.
The system includes a workstation, a system control cabinet, and two remote slave-
manipulators on a moveable base platform. The anthropomorphic arms have 7 degrees of
freedom, are MR compatible and designed to hold a variety of surgical tools. The end
effector is designed to hold a variety of tools within a standardized interface, and allows for
two separate operator controlled manipulations: tool roll and tool actuation.
IV) RP-7 Robot

The InTouch [5] RP-7, where RP stands for Remote Presence, is a mobile robotic platform
that enables the physician to be remotely present. Through the integration of key
technologies, the Remote Presence Robotic System can remove time and distance barriers
and effectively extend the physician's reach to manage patient care. The Robot's panoramic
Virtually There visualization system, combined with the Holonomic Drive System, the
SenseArray System 360, and the easy-to-use control interface, affords physicians, patients
and hospital staff a safe and effective interactive experience.
Devices such as electronic stethoscopes, otoscopes and ultrasound can be connected to the
Expansion Bay of the Robot, to transmit medical data to the remote physician.

Fig 2.6. System Architecture of RP7
1.2 Existing Simulators
1.2.1 LapSim Simulator
LapSim surgical simulator is a Laparoscopic Surgical Simulator that has extensive training
scenarios for minimally invasive procedures. It provides basic and advanced training
techniques for keyhole surgery including suturing and anastomosis, cholecystectomy etc.
The simulator utilizes advanced 3D technology, including interactive live video, to provide the
student with a realistic virtual working environment. Practice sessions can vary in graphic
complexity as well as in the level of difficulty. Courses can easily be created or modified by
the teacher to fit a student´s specific needs, or the requirements of a training curriculum.
This simulator is available and is in use by Tele-medicine and E-health training center, Holy
Family Hospital Rawalpindi, for training of surgeons in minimally invasive procedures.
1.2.2 ProMIS Surgical Simulator
ProMIS is a surgical simulator developed by haptica [6] for training surgeons to perform
Minimally Invasive Surgeries. The simulator can be used with a physical mannequin to
actually perform a virtual operation. The simulator also allows for evaluation surgeons being
trained. Multiple simulators can be connected to compare their results of groups of students
at a time.

Fig 2.7. ProMIS Simulator
ProMIS uniquely enables users to interact with virtual and physical models in the same unit
while providing accurate, comprehensive feedback on performance. In validation studies, it
has been consistently shown to perform better than pure virtual reality simulators
1.2.3 Laparoscopy Virtual Reality System
Developed by immersion [16] this simulator has been developed for training in laparoscopic
and minimally invasive surgical procedures. The simulator has hardware that includes
standard laparoscopic instruments to be used with different training scenarios. Training
scenarios include essential skills like camera navigation, cutting, clipping, needle driving,
knot tying and general surgery skills like Cholecystectomy.

Fig 2.8 Laparoscopy VR Simulator
1.3 Available Open Source Software technology

In this section we list some of the development that has been undertaken in the field of open
source simulator development. We specifically list open source projects, as our project also
focuses on development using open source software technology. The advantage of the
available open source technology for our project is that, we can use this existing technology
by using code that is already available under general public license, and build on it to
develop our own surgical simulator.
1.3.1 SPRING Surgical Simulator
SPRING is a real-time surgical simulation system with soft-tissue modeling and multi-user,
multi-instrument, network haptic [17]. Spring can be used for training surgeons, building
surgery skills, surgical rehearsal etc. It is an extensible open source platform for developing
scenarios and simulations. SPRING is especially intended for training in minimal access
surgery in which indirect viewing and manipulation play key roles.
SPRING is written in highly portable standard C++, and can be compiled under Windows
2000 and XP, LINUX, and UNIX (SUN Solaris, SGI Irix, Macintosh OS X). SPRING's
architecture includes support for multi-platform and multiprocessor systems, automatically
sensing the number of available processors. Specific interfaces for 3-D digitizers, haptic
feedback systems, and other inputs are supported via interface servers, which connect to
specialized input/output devices. These servers then communicate with the SPRING
simulation program via TCP/IP messages send through local or wide-area networks. This
separation of interaction device and computation allows several important capabilities:
 use of interfaces that are not available on all computer systems,

 separation of CPU-intensive numerical interactions from I/O devices,
 coordination and cooperation of multiple users across the internet.
 Access to remote resources such as powerful processors

1.3.2 GiPSi (General Physical Simulation Interface)
GiPSi [18] is an open source/open architecture framework for developing organ level surgical
simulations. The goal of GiPSi is to provide an open architecture software development
framework to facilitate free exchange of models and algorithms, and development of
interoperable medical simulations, with special focus on the requirements of virtual
environment-based medical training simulations.
GiPSi is a general software development framework for developing organ level surgical
simulations, rather than a complete simulation engine. The framework consists of the
Simulation Object API, which also includes the object interfacing API, the Visualization API
and the Haptics API. The implemented Modeling Tools and Computational Tools form an
initial set of GiPSi compliant libraries to support development of GiPSi based simulations.
1.3.3 Irrlicht Engine
The Irrlicht Engine [19] is an open source high performance realtime 3D engine written and
usable in C++ and also available for .NET languages. It is completely cross-platform, using
D3D, OpenGL and its own software renderer, and has all of the state-of-the-art features
which can be found in commercial 3d engines. It can be used for developing 3D
environments necessary for game development or simulator development.
This engine has all the features available for developing a simulator package, which includes
a physics engine, rendering engine, collision detection and interaction with input devices like
mouse, keyboard and joysticks. Being open source this engine is ideal for developing
surgical simulators, by using existing code and extending it to suit our development
requirements.
1.4 Available Hardware technology
There are several hardware components that are required when developing a robot. These
may include motors, microprocessors, microcontrollers, sensors, power supplies etc. For the
fabrication of the robot, at an initial stage material like aluminum metal sheets can be used to
develop a prototype. Since this is a research based project, we want to use tools and
hardware that is very low cost and durable. In this section we list some of the available
technology that can be used for the development of our training robot.
1.4.1 Motors
There are several kinds of motors available that can be used for developing the surgical
robot system. Motors like servos, dc motors can be used to develop the robotic arms link
structures. Usually hobby servos are used by robotocists for developing custom robots. In
this project we want to focus on accuracy and low cost. Therefore we would like to use
servos that would provide high torque and are cost effective. Some of the types of motors
that are available are

 DC Motors (Brushed/ brushless)
 Servos
 Stepper Motors
1.4.2 Microcontrollers
Depending on the type and complexity of a robot, it can either be based on low end
microcontrollers or high end microprocessors. Some of the boards that are available and
being used for development are
i) AVR Microcontrollers
Atmel‘s [20] AVRs are RISC architecture microcontrollers with separate program and
data stored in different memory spaces. AVRs are generally categorized in three
groups. TinyAVR, megaAVR and XMEGA. These microcontrollers can support clock
speeds of up to 32Mhz. AVR microcontrollers are used for robotics development and
for developing real-time critical applications.
ii) PIC Microcontrollers
PIC microcontrollers are also very popular for development of real time applications
and embedded systems. They are popular with developers and hobbyists alike due to
their low cost, wide availability, large user base, extensive collection of application
notes, availability of low cost or free development tools, and serial programming (and
re-programming with flash memory) capability. They are not expensive and are very
useful when developing custom small and medium size electronic modules.
iii) 8051 Microcontrollers
8051 series of microcontrollers is also one of the most used series of microcontrollers.
It is also used extensively in embedded systems and robotics projects. It has been
replaced by AVR microcontrollers.
iv) Axon Microcontroller
Axon Microcontroller [13] runs an AVR microcontroller with 55 I/O ports and is
specially designed for robotic applications. It is mostly used by hobbyists and robotics
developers.
1.4.3 Microprocessor boards
Usually microprocessors are expensive and have more computing power than
microcontrollers. Therefore they are usually used when high processing power is required.
With clock speeds ranging from 200Mhz to 1.2 GHz microprocessor boards are very useful
for developing high end robots running real time operating systems.

i) Roboard
Just as there are boards for custom application development, there are boards also
available for robotics development. Roboard [12] is one such microprocessor based
development board that has been developed keeping in mind the needs of a robotics
project. All the development software is available open source. The board runs at
1Ghz and can run operating systems such as Linux or Windows.
ii) ARM Microprocessor
ARM microprocessors [21] are 32 bit RISC (Reduced Instruction Set Computer)
architecture processors. ARM processors are used extensively in consumer
electronics, including PDAs, mobile phones and other digital media and music
players, hand-held game consoles, calculators and computer peripherals such as
hard drives and routers.
iii) Rabbit Microprocessor
Rabbit microprocessors [22] have been specially designed and developed for
embedded system applications. They have open source development tools available
along with other modules that can be used to extend the capabilities of the board, like
WiFi or ZigBee modules.
1.5 Cost Benefit Analysis
In this section we review the costs of some of the commercial products available in this
domain. We also present a cost-benefit analysis of our system. The following is a breakdown
of the major costs involved for the development of the system. A complete breakdown is
available in section 9 (proposed budget).
Development / Maintenance Costs
Total Development cost of the system over a period of 3 years : Rs 40 million ~ $0.47 million
Maintenance Costs : 1.2 million per year @ 100,000 / month for 2 engineers
Existing Costs of the systems available commercially
daVinci Surgical Robotic System : 1.5 million dollars
LapSim Surgical Simulator : $40,000
Benefits:
 The robotic system being developed focuses on intelligent software technology for
control of the robotic system rather than developing expensive hardware, making it
cheap to develop at the same time not compromising on precision and accuracy.

 At the moment a 1.5 million dollar robot is unaffordable by any hospital in Pakistan. A
cheaper solution will allow these training robots to be deployed in large numbers.
 Once these training robots are deployed at rural and urban training centers, surgeons
can acquire robotic and laparoscopic surgical skills in their hometowns instead of
moving to urban areas. Once these surgeons are trained they can work in their own
rural areas, solving the problem of unavailability skilled doctors in rural areas.
 Patients would save traveling and living costs, since they would not require any
traveling to urban areas for laparoscopic surgical procedures.
 Commercialization of this technology will result in considerable earn of foreign

exchange for the country. Third world and developing countries that cannot afford
expensive surgical robotic systems will always be open to cost effective alternatives,
allowing us to capitalize on this huge market.
Conclusion
There are several robots available commercially but very few of them integrate the two most
necessary requirements, i.e. A robot with its own simulator. We intend to provide both with
our Surgical Robot System. Furthermore most surgical robots and commercial simulators
mentioned in this section cost thousands of dollars. We intend to develop a low cost system
that will not only be a great product for third world and poor countries but will also be a great
product commercially.
B2. Current State of the Art:

(Please describe the current state of the art specific to this research topic.)
In the previous section, the current state of the art in Surgical Robots has already been
mentioned. Most of these robots are very expensive and are out of the reach of people as
well as governments in the third world countries. This project is a combination of the current
state of the art technologies of ProMIS simulator and the da Vinci Surgical Robotic System.
The simulator will allow training of surgeons before they can actually use the robot, it will also
help in evaluation of their skills. The Tele-Surgical Robot will allow remote surgical
operations practically removing any infrastructure costs that are required to setup a location
for MIS operations using traditional methods.
C. Challenges:
(Please describe the challenges, specific to this research topic, currently being faced
internationally.)
There are several challenges that need to be met in order to develop a successful Surgical
Training Robot and a Simulator for use by people in the field of medicine. Some of them are
A robot and simulator system should
be safe and easy to use

have cheap maintenance and running costs

save cost for training of medical students
reduce training time for students
allow for training of many procedures, not only one
allow the students to train under different scenarios
evaluate the performance of students
D. Motivation and Need:

(Please describe the motivation and need for this work.)
Pakistan is a developing country, currently involved in tackling a large number of problems at
different levels. On one end is the fight against miscreants planning against Pakistan, and on
the other is the fight to improve the living standards of the people by providing quality
education, healthcare and jobs. Our motivation for this project stems from all these
challenges. A successful Tele-Surgical Training Robotic System is a great way for
engineering and medicine students to learn about the latest in technology and engineering.
With this project they will publish research papers in relevant conferences and journals
thereby gaining international exposure. It will improve the healthcare system in Pakistan by
training surgeons to perform robotic surgeries in the future. It will also create many jobs, as
being low cost, such a product has great potential for world markets.
The following statistics show how robotic surgery has improved over the traditional ways of
laparoscopic operations and the motivation for developing such a system. The data has been
taken from the Mt. Sinai School of Medicine, New York, USA [7]. It must be mentioned here
that Mt. Sinai School of Medicine uses robotic surgery.
Blood Loss Comparison
Laparoscopic and robotic surgeons make keyhole incisions, which are much smaller, much
less invasive and nearly bloodless. The equivalent of a few tablespoons of blood is lost
during robotic prostatectomies. When a large incision is made, blood loss is significant and
transfusions are sometimes required.

Fig. 2.8. Blood Loss Comparison
Complication Rates
Complication rates are far higher in open than robotic prostatectomies. Because far more
tissue is exposed during open surgery, infection rates are higher.
Fig. 2.9 Complication Rates

Time in OR
There‘s been a significant decrease in operating room time with the use of robotic
technology.
Fig. 2.10 Operation Room Time
Postoperative Stay
Robotic prostatectomy patients are released from the hospital after one day in nearly 100%
of cases.

Fig. 2.11 Length of Postoperative Stay
3. Objectives of the Project

A. Specific Objectives Being Addressed by the Project:
(Please describe the measurable objectives of the project and define the expected results. Use
results-oriented wording with verbs such as ‘to develop..’, ‘to implement..’, ‘to research..’, ‘to
determine..‘, ‘to identify..’ The objectives should not be statements and should not include
explanations and benefits. Fill only those objectives that are applicable to the proposed
project.)
A1. Research Objectives: (if any)
To develop a cost-effective Tele-surgical training robot and simulator that can be used to
train surgeons for robotic MIS procedures. Once developed and tested this will be
further researched and developed in the future for use and deployment in rural and
remote health centers or hospitals of Pakistan. In doing so we will be publishing
research papers in international conferences / journals highlighting our research.
The following is a list of research areas that we will focus on during the project
 Design Research of Robotic Manipulators

 Designing robotic arms around standard laparoscopic equipment
 Designing the base, robotic mechanical structure suitable for operation
theatre use and robotic arms suitable for use in hospitals
 Linking standard laparoscopic equipment with servo motors by transferring
torque using strings
 Design Research of Simulator Design
 Simulation and modeling of internal organs of a human body
 Simulation of blood flow inside the human body

 Soft tissue modeling
 Design Research of Haptic User Interface Controls
 Designing user interface controls that can provide feeling feedback to users
similar to actual laparoscopic surgical procedures
 Using input from haptic devices for generating real-time feedback
 Designing the mechanical structure of input controls that are similar to
industry standard laparoscopic equipment
A2. Academic Objectives: (if any)
To develop a simulator that can train medicine students to perform minimally invasive
surgeries using a robot. And to create a bridge between industry and academia by
involving engineering and medicine students to work on different aspects of the project.
This project is collaboration between Telemedicine and E-health Training Center, Holy
Family Hospital and NUST (National University of Sciences & Technology) School of
Electrical Engineering & Computer Science (SEECS). One of the objectives would be to
publish research papers in international conferences and journals giving the opportunity
for Pakistani students to gain international exposure in the area of robotics research and
development.
A3. Industrial Objectives: (if any)
To develop an indigenous low cost Tele-surgical training robot and simulator, affordable
by developing and poor countries for cost effective training; And promoting indigenous
development of robotics and bio-medical equipment.
A4. Human Resource Development Objectives: (if any)
As a result of this project we intend to setup a high-tech startup company that will
develop this product and commercialize it. We will also focus on developing other
projects based on the same technology. For example, we would develop robots in the
civilian sector as well as for military applications. We will utilize the engineering skills
that are available in Pakistan as well as the immense talent pool of human resources
available for utilization in every field.
A5. Other Objectives: (if any)

4. Research Approach
A. Development / Research Methodology:
(Please describe the technical details and justification of your development and research plan.
Identify specialized equipment, facilities and infrastructure which are required for the project and
their utilization plan.)
4.1. Introduction
The basic idea of the project is to promote quality healthcare by providing training for minimal
invasive surgical procedure to surgeons. This is possible by developing a training system
that includes a Simulator and a Surgical Robot System which are used for training of
surgeons for real world robotic MIS procedures. The initial phase of the project involves
developing a training system that can be used for minimal invasive procedures using robotic
control. In the future the capabilities of the system will be extended so that it becomes more
than a trainer and can be used in actual Tele-Surgical operations in rural and remote areas
of Pakistan.
Fig. 4.1 The overall working of a Tele-Surgical Robot System
Figure 4.1 depicts the two training phases of the system. A simulator which trains the users
in a virtual environment, while a robotic system that will train the users by performing
procedures on a mannequin by controlling movements of the robotic arms.
For the development of this project we will follow the methodology of research in design,
development and integration rather than developing everything from scratch. Our training
system will be mostly software controlled; therefore the core technology developed
indigenously will be the software and the mechanical design of the robot. The most important
area of the development would be design research. As every module of the system whether
mechanical or software would be designed from scratch, a lot of brainstorming and design
research is required, which will use major part of the time duration of this project.

Most of the electronic parts will be used off the shelf, but since we will focus on development
using a modular approach, any part that becomes unavailable over a period of time could be
easily replaced by a similar part. Moreover at the current stage we will use some embedded
development boards by purchasing them; but at later stages we would develop most of the
boards in Pakistan as well. Once the overall goal of the project is achieved by developing
and testing a Surgical Robot and Simulator Training system, we will move on to develop a
completely indigenously developed system with most modules made in Pakistan.
4.2 Development Methodology
We have divided the development of our project into three parallel phases of development.
Within each phase there are multiple stages. The three major phases are
1. Development of the Surgical Robot

2. Development of the Simulator
3. Development of the Haptic User Interface
All phases of development are crucial for the completion and success of the whole project;
therefore we have subdivided the three phases into multiple stages, each stage containing
several tasks. Please refer to annexure C for a detailed description of the development plan.
Simulator Surgical Robot Haptic User

Development Development Interface
Development
Planning, Analysis
and Design Year 1
Year 2
Development and
Integration
Testing &
Deployment Year 3
Fig. 4.2 Workflow of the Project

4.3. Research Methodology
As mentioned in section 4.1, a major part of this project is design research. We are focusing
on the development of a whole training system, which has not been developed by anyone in
the world. There are separate modules available by different companies, e.g LapSim by [23]
and daVinci by [2], but if we talk about a complete training system with a surgical robot along
with a training simulator which also includes Tele-operative control, then there is no system
like this available anywhere in the world. Furthermore, simulators that are available
commercially are only for training of MIS procedures. There are no training systems available
for training of surgeons for robotic surgery and Tele-robotic surgery. As mentioned in the
article [25], there is a great need for a training system that can not only provide training for
MIS procedures but also for robotic surgical procedures. We have divided our design
research into the following design problems and tasks
1. Design of the Robotic Arms

2. Design of control mechanism of manipulators (end-effectors)
3. Design of Haptic (feeling feedback) User Interface Controls
4. Design of simulator for training of MIS and robotic surgical procedures
1) Design of Robotics Arms
A lot of design research will be required to find the right design of the robotic arms.
Usually when a new product is designed, existing products can be researched and
improved upon. In our case this scenario is not possible, as most of the surgical
robots that are commercially available are very expensive, and their designs are
trade secrets of their respective companies. Therefore before considering the
development a lot of variables will have to be taken into the design research. For
example, the following factors would need to be considered in the design of the
robotic arms
 the best configuration of robotic arm that could be easily mounted over the
patient‘s bed,
 ease of movement and degrees of freedom of the robotic arms
 number of joints, directly effecting the degrees of freedom
 how to design the robotic arms around the design of existing laparoscopic
equipment
As we want the robotic arms to work with the industry standard laparoscopic
equipment, we would be using existing industry standard laparoscopic instruments
(refer to annexure B for pictures and details). This will save us from re-inventing the
wheel and make our robotic system compatible with existing industry standards.
2) Design of control mechanism of manipulators
As already mentioned, we will design our robotic arms around existing industry
standard laparoscopic equipment. For this reason we would require research in
developing an efficient and precise control mechanism for controlling the mechanism
of the manipulators. One of the major design problems for this is to transfer the

control torque of a motor to the end-effector, as motors cannot be mounted directly
on the laparoscopic equipment. One design that can be used is control by using
wires and gears. Many designs would need to be researched before the most
efficient design can be found and implemented.
3) Design of Haptic User Interface (UI) Controls
One of the major things that are missing from existing simulators and surgical robots
is haptic or feeling feedback. When surgeons use existing simulators they cannot get
any feedback from their input controls. This causes the surgeons to apply more or
less force when working with real laparoscopic instruments as beginners, which can
result in fatal life threatening situations.
The haptic user interface module of our training system will solve this problem by
providing the surgeon different kinds of force feedback, depending on the input force
that is applied by a surgeon. This will allow the surgeons to train for real life
laparoscopic surgery. To develop force feedback input controls is once again is a big
research design problem. Existing designs will need to be studied. One of the
designs that we would study and use as a guideline are the fore feedback control
joysticks that are available commercially. Different output signals can be generated
based on the different input signals generated by the surgeon‘s hand movements.
Every signal would be unique signifying a certain level of force that has been applied.
4) Simulator design for training of MIS and robotic surgical procedures
Another major part of design research would be the design and development of a
simulator. There are hundreds of factors that need to be considered in the design of
a simulator. A number of these factors would be researched by the surgical team,
while other factors relating to the actual performance of the simulator would be
studied by the developers. Some of these factors are
 How to model and simulate human internal body tissue

 How to simulate blood flow
 How to model and simulate the interactions of external instruments and
internal body organs
 How to display the view that is usually available form an endoscopic camera
in MIS procedures etc
4.4. System Architecture
The project will be developed using a modular architecture approach. This allows different
modules to be attached or detached to the system depending on the application area of the
robot and needs of the users. The following figure illustrates the modular architecture of the
system. The arrows show the interaction between different modules of the system.

Modular Architecture of the System
User Interface Software

Module Module
Network
Simulator Surgical Robot Training System Interface
Module
and Simulator Module
Mechanical H/W Control

Module Module
Fig. 4.3 Modular Architecture of the Surgical Robot System
As shown in figure 4.3, every module is independently responsible for its own function.
Although some modules are necessary but some can be removed. For example if some
users do not require the simulator then they can remove that module. Similarly if a wireless
link is required then the interface link can be changed to a wireless interface link.
4.5 Simulator Architecture
The simulator will allow the users to train using real scenarios by looking at a virtual
environment and controlling the robot within this environment to get a feel for, and gain real-
time experience of, working with the robot in real life. The robot controls within the virtual
environment should provide the user with the same feeling and feedback as the real
environment. This is crucial for the success of the system, as this simulator will be used to
teach the students to perform real laparoscopic and robotic operations on patients.
The development of the simulator has been divided into the following stages
1. Modeling of the environment using OpenGL [9]

2. Modeling of the internal human tissue and body organs using 3D studio Max
3. Developing the robot control application module in the simulator application package
4. Development of real-life scenarios for the training of medical students for laparoscopy
or other surgical operations
4.5.1 Software Methodology for development of the Simulator
a) Using the Agile Software Development methodology

For the development of the Simulator we will use the Agility Software Development
methodology. This method requires the building of a prototype application then taking it

through several development stages, each time improving it after acquiring feedback
from the customer or user. This method is more suited to our way of development as it is
used for quick development of the software and requires small teams working on
development and design.
Agile Software Methodology for the Simulator
Initial
Prototype
Continuous
Client
Development
Feedback
Cycle
Final Working
Application
Fig. 4.4 Software Methodology for the development of Simulator
b) Developing the virtual environment

The virtual environment will be developed using OpenGL, since using an Open source
library does not require any commercial license. Visual C++ will be used for the
programming of the environment, while controls and APIs will be developed to interface
the control hardware to be used with the virtual environment of the simulator. The
following diagram explains how the controlling hardware will interact with the simulator

Fig. 4.5 Basic Working of a Simulator
c) Development of the GUI and Controls
The graphical user interface of the simulator will allow easy interaction with the simulator.
Furthermore it will provide all the controls and the training tests that a user will be able to
load and practice on. For the reality effect of the simulator sensory feedback will be
generated on the user controls as in the real control of robot.
d) Controlling the robot in the virtual environment using Haptic UI controls
The robot will be controlled by the same haptic input controls in real-time and in the
simulator as well. This will help the user in getting used to handling the controls of the
robot. The robot control application will work in two modes; Offline and Online. Offline
will allow the user to use the same controls with the simulator while online mode will
allow him/her to use the controls to control the real surgical robot.
e) Interface driver between robot and control application

Once the simulator‘s environment will be developed code will need to be written to
connect the robot controlling hardware to the simulator. This will be done using a
standard USB port. The haptic user interface controls will be used to control the robot
directly as well as over a wireless link. These controls would also be used to interact with
the simulator and control the robot within the virtual environment.
4.6 Architecture of Surgical Robot System (SRS)

We divide the development of SRS consists of the following stages
Development of Software Components

Development of Mechanical (Hardware) Components
4.6.1 Software Components

The software architecture for the SRS has been divided into different layers depending
on the functionality of a particular part of the software.
Top Layer
Interface
Lower
Layer
Layer
Fig. 4.6 Layered Architecture
i) Top Layer
The top layer is the main application software layer. This is the most intelligent part of
the robot as all the complex calculations and processing is done at this level. Any
intelligence that is added to the robot is processed at the top layer. For example the
shaking of surgeons‘ hands is removed by applying filtering techniques at this layer. The
control application operates at the top layer being the brains of the robot.
Control Application Software

This is the main control application for robot command and control. It will be developed
using Microsoft‘s Visual Studio Development tools. The application will interact with the
control hardware or interface between the robot and the Control PC. The following figure
illustrates the role of each layer of the software for the SRS.
Fig. 4.7 Computational Complexity of the layered architecture

ii) Interface Layer
a. Hardware Interface between modules

The interface will be the driver that will connect the PC Control application to the robot
control hardware application. Using the modular approach for development, there will be
several modules developed separately. Each module will be able to communicate with
other modules. This communication is either wired or wireless. For wired communication
interface circuits will be developed that will create an interface between different
modules and allow communication.
b. Network Interface between Robot and Control Modules

The network interface will allow communication between different modules of the system
over a network link. The simulator will be connected to the surgical robot system by a
network link over a wired or wireless connection.
It will act as a communication interface between the application software and the
embedded software defining all the communication protocols and making sure of real-
time control of the robotic system by the user. The communication link used at the
hardware layer which will enable the communication of the robotic control application
with the robot from a remote location is discussed in section 4.8.
iii) Lower or Hardware Layer
Robotic Controller Driver (Embedded System)

The lower layer will be an embedded system that interacts with the PC control
application and the robot to control its hardware. It can be considered as a translating
device that translates the commands given by the user for the robot. The interface
between the embedded robot controller and the PC control application can be Wired or
Wireless depending on the clients‘ requirement and the design of the system. A wireless
interface increases the cost and complexity of the system whereas a wired system is
easier to implement and design, also being cheaper. To be programmed in C, the
hardware controller for the robotic arm will be developed using a microprocessor
development board, as detailed in the chapter 3.
4.6.2 Hardware Components
There are several hardware components that need to be integrated and developed for
the development of the robotic arms of the Surgical Robot.
i) Robotic Arms
Depending on the design of the robot we will design between 2 to 4 robotic arms. Two
of the arms shall be the surgeons left and right arms while the third one will carry the
endoscopic camera. The fourth arm will be an optional one allowing the surgeon with
more degrees of freedom to work with. The design of the robotic arms shall consist of
the following components:

 Joints with Actuators
Dynamixel [10] AX-12+ serially controlled actuators with high torque and accuracy
 End Effectors
Standard Surgical Instruments will be attached to the end effectors of the robotic
arms. Design of gripper hugely depends on the requirements of the client. It can
either be a grabber or a cutter. In the da Vinci robot there is a cutter or grabber that
is used for several functions. The following figures give examples of some of the
laparoscopic instruments that will be used as end effectors. [11]
Fig. 4.8 Surgical Instruments for end-effectors
 Sensory Feedback
The robotic arms and the gripper should consist of sensors that should supply the
user of the system with feedback. This feedback can be in the form of ―force
feedback‖ or any other kind of reading that should inform the user about the force
that is being applied at the end-effectors. We will design robotic arms by taking into
account the real-life experiences of surgeons doing laparoscopic surgical
procedures. The surgical team will provide their feedback and experience to the
haptic user interface development team in designing sensory feedback that will be
as close to the real feeling as possible.
 Power Supply System

Power supply for the robot and its motors has to be onboard the system. Power
supply for the Interface Application and the Robotic Controller Driver will be
designed to meet all the requirements of the system
 Mechanical Structure of Robotic Arm

The mechanical structure of the robotic arm shall be designed and developed
indigenously by our team. We will use light weight aluminum or plastic for the shell
of the robotic arm. The end-effectors shall be connected to the serially controlled

actuators through a wire and pulley system. Wire control is necessary as
laparoscopic instruments are very thin and are inserted through holes in a human
body. Therefore the force transferred from a motor to the end-effectors can only be
by a wire or a rigid string connected from the motor to the end-effectors.
The mechanical structure of the robotic arms will be based on the base, the elbow
design and the arm of the robot. The end-effector or manipulator would be
connected to the end of the robotic arm. The number of links or joints that are
required would be decided during the design research of the robotic arm. This would
also affect the degrees of freedom of the robotic arm.
ii) Surgeon‘s Console for Interaction with the Robot
A standard PC will be used for the console that will be used by a surgeon to interact
with the robot as well as the simulator of the Surgical Robot System. The console will
be developed with an ergonomic design so that it can be used by the surgeon with
comfort and for long times. An LCD monitor will be encased in a cubicle type
mechanical structure that will allow the surgeon to access all controls of the system
in an easy and ergonomic way.
iii) Haptic Input Controls
As described previously, haptic controls will be developed that will provide users with
feeling feedback. This feedback can be in the form of different types of signals
generated by the controls. For example if the surgeon or user tries to move the input
controls too fast, then the controls will resist that motion by generating force opposite
to the direction of the movement by the user. In other cases when a surgeon applies
too much force then the feedback will generate a long pulse of motion in the controls
indicating that too much force is being applied by the user, and if the user uses the
input controls delicately then a small intensity force will be generated by the feedback
system. Therefore once the surgeon becomes used to these input controls, he will
know at once if he is using the controls with perfect control or if he is committing
mistakes and applying undue force.
As an example of the hardware components we can consider the following illustration

of a typical surgical system.
Fig. 4.9 A typical Surgical Robot System [2]

4.7 Haptic User Interface
One of the most important parts of the system will be the input controls. In our survey of
existing simulators, the LapSim [23] surgical simulator is the most widely used simulator for
MIS training procedures. One of its‘ major drawbacks is lack of feedback in its input controls.
We intend to address this problem by developing haptic input controls that allow the user to
feel the force that is being exerted by the laparoscopic instruments on the human tissue or
body organs.
A surgeon will be controlling the robot and the simulator by these input controls. Therefore it
is necessary that these controls are easy to handle, ergonomic in design so that they can be
used for long hours at a time, are accurate in their movements and rugged so that they have
a long lifetime. An example of input controls of the lapsim [23] simulator is given in the
following figure.
Fig. 4.10 Input controls of LapSim Surgical Simulator [23]
Throughout this project we shall focus on modular approach of development. This means
that every module that we develop can be added and removed from the system without
needing to modify anything. For the same purpose we have targeted our design of the haptic
input controls to be compatible with the existing LapSim surgical simulation software.
4.7.1 Developing Interface Software
The Haptic UI controls will be intelligent controls with a sophisticated embedded

software working in the background. This embedded software will be the primary
interface between the Haptic controls and other modules of the system. The
mechatronics team responsible for the mechanical design of the UI controls will also be
responsible for developing the interface software of the input controls.
4.7.2 Developing the Input Controls Hardware
In this phase of development customized input controls would be developed for use by
the surgeons. These controls will be designed after studying the controls of the da Vinci
Surgical robot and other robots that are available commercially.

We will make efforts to make the input controls compatible with most commercially
available simulators. As most of these simulators have input control hardware that is
interfaced through a USB port, we will make an effort to make these controls
compatible with these software and use USB port for interfacing.
4.7.3 Interfacing the end-effectors
In minimal access surgery also known as keyhole surgery, industry standard

equipment is used the world over, which makes the surgeons used to this kind of
equipment. Figure 4.8 lists some of the industry standard equipment that is used by
surgeons. We will interface this equipment with our robotic arms of the surgical robot.
This will allow the robotic arms to be safe while operation, at the same time giving the
users a feel for real life equipment. Since our purpose is to develop a training system, it
is necessary that our robot is compatible with industry standard laparoscopy
equipment.
4.8 Telecommunication Link
One of the objectives of this project is to provide quality healthcare to the masses in
Pakistan. This is done by providing MIS facilities to people at all rural and urban locations in
Pakistan. The telecom link is necessary to provide this facility in the Tele-Surgical Robot. We
will use existing telecom infrastructure available in Pakistan for this purpose. Some of the
telecom links that can be used for this purpose are
 PTCL‘s EVO wireless connection [8]

 PTCL‘s DSL service available in a number of cities in Pakistan [24]
 Other Edge connections available by different telecom companies
The network interface module will control the communication protocol while using one of the
above links at the hardware layer for data delivery. There are other options available for
enabling the telecom link between our robot and its control application. Holy Family
Hospital‘s Telemedicine & eHealth training center has already facilities available for
connecting remote locations over WiMax and satellite links. We will use those
communication links for testing the remote operation of our robot.
4.9. System Requirements
This section identifies the different software, hardware and infrastructure requirements that
are needed for the implementation of this project.
4.9.1 Hardware requirements
Requirements for Surgical Robot System
 Roboard [12]
 The heart of the robot, this multiprocessor will control all the movements of the
robotic arms of the surgical robot. It will also be responsible for all sensory
feedback from the robot. The board can be used to run a Linux kernel as well as

any real time and other operating systems. This will be used in the embedded
robot controller at its core.
 Axon Microcontroller [13]

 The hardware interface of the servo motors in the robotic arm to the roboard
microprocessor will be controlled using the Axon microcontroller. This runs an
AVR microcontroller with 55 I/O ports and is specially designed for robotic
applications. Using an Axon with the Roboard microprocessor allows for greater
extensibility.
 Dynamixel series Robot Actuator [10]

 In order to get accurate and precise movements of the end effectors of the
robotic arms, we will design the robotic arms using Dynamixel‘s AX-12. The
Dynamixel series robot actuator is a smart, modular actuator that incorporates a
gear reducer, a precision DC motor and a control circuitry with networking
functionality, all in a single package. Despite its compact size, it can produce
high torque and is made with high quality materials to provide the necessary
strength and structural resilience to withstand large external forces. It also has
the ability to detect and act upon internal conditions such as changes in internal
temperature or supply voltage
4.9.2 Requirements for the Telecommunication link
A fast internet link can be used for telecommunication between the base station where
the surgeon is stationed and the remote location where the robot is being used. Recently
high speed internet has been made available in Pakistan due to the expansion of
telecommunication sector in Pakistan. We plan to utilize the CDMA 2000 technology
being offered by several network service providers including PTCL‘s Wireless broadband
on the go technology with 3 Mbps of network speeds [8]. In the initial stages the system
will be tested without using the telecom link; in the final stages a telecom link will be used
to perform remote minimally invasive surgical operations. As mentioned, WiMax and
satellite links will be available at Holy Family Hospital‘s Telemedicine & eHealth training
center for testing the remote operation of our robot.
4.9.3 Software requirements
 Open Source Development Tools

 Integrated Development Environment and compilers for C and C++
 OpenGL Library
 Open Graphics Library, will be used for development of the simulator
 OpenCV Library [14]
 Used for image processing
 AutoCad
 For designing the mechanical structure of the robot
4.10 Testing and Evaluation Requirements
The testing of the simulator and the surgical robotic system will be evaluated by the students
of Rawalpindi medical college, under the supervision of Professor Dr. Asif Zafar who is the
project director of Telemedicine & E-health Training Center, Holy Family Hospital,

Rawalpindi and a Professor at the Rawalpindi Medical College [15].
4.10.1 Test plan for Simulator
Initial level Testing

Since we are using the agile software development methodology, the testing of the simulator
system shall be carried out under multiple cycles. The first prototype will be tested by users
and feedback generated will be used to improve on the prototype, developing into a better
and complete application fulfilling all requirements.
Mid-level Testing
Once the final version of the simulator has been developed it will again be tested by users
and feedback will be used to further improve on the final version.
Final Testing
Final testing of the Simulator will be done once the development of the whole project
including the Surgical Robot System (SRS) is complete. The Simulator will be used in
conjunction with the Surgical Robot System for final phase of testing.
4.10.2 Test plan for Surgical Robot System
The testing for the Surgical Robot System is a very important requirement. The robot will
need to be tested extensively before any training can be carried out using this robot. We
have developed a comprehensive test plan for the testing and quality control of the Surgical
Robot System.
1. Testing of Hardware and Electronics

The electronics and the embedded system of the robot will be tested under different
conditions. Some of the testing criteria are described below
i. Testing of electronics by varying voltage in the power supply

ii. Testing the electronics under varying temperatures
iii. Testing the electronics and the embedded software for long hours of
operation
2. Operational Testing of the Robotic Arms

Once the electronics and the embedded system have been extensively tested, the
operation of the robotic arms and the end-effectors will be tested extensively. For this
purpose we will perform operational testing on a mannequin with similar skin material
as humans for the operation of the surgical instruments of the end-effectors. Several
surgeons will be invited to test the operation of the system. Their feedback will be
used to improve on the overall operational experience of the training Surgical Robot
System. The surgical team will play a crucial role in testing and evaluating the
performance of the robotic arms and the end-effectors.
3. Application Software Testing

The robot control application will go through a quality control process during the
development phase. For this purpose a team of quality control professionals will also
be constituted for this project, which will not only test the operation of the robot
control application but will also be responsible for the testing of the embedded

system of the robot controller. All the data generated will be used to improve on the
next versions of the application that are developed in the future.
4. Reliability Testing
The Surgical Robot Training System is a mission critical device. It requires extensive
reliability testing. For this purpose several use cases will be developed for testing the
robot control application in conjunction with the embedded robot controller. Failure
scenarios will be created and tested on the software application and hardware of the
robot.
5. Network Testing
The system will be tested over wired and wireless links for performance and
efficiency. Any time lag that occurs due to network operation would be reduced to the
minimum possible value. The testing will be carried out using different
telecommunication technologies that are available in Pakistan and the best one will
be chosen for actual operation of the system.
4.10.3 Evaluation and Test plan for local and remote locations
The final phase for the development of the system will be testing and evaluation at
Telemedicine and E-health Training Center, Holy Family Hospital, Rawalpindi, under the
supervision of the Joint Project Director. There will be three phases of testing for the system
1. Test Phase -1
Testing of the Controls of the robot by surgeons performing typical MIS operations on
the ProMIS simulator Mannequin. This testing will be carried out with the Surgeon
console and Surgical Robot System in close proximity and wired link.
2. Test Phase - 2
Second phase of testing will involve the same test procedures performed over a
wireless link within the same building. A high speed LAN or WAN link will be utilized
for this purpose. The video feedback quality and the time to delay of movement from
controls to robot will be noted down, and will be improved upon, based on the
feedback from this test and evaluation phase.
3. Test Phase – 3
For the final phase of testing the Surgical Robot System will be installed at a remote
location and tests will be performed to evaluate the video quality and the time delay
or lag between transmission of control signals to movement of robotic arms will be
evaluated. These tests will be conducted over either a WiMax link or a VSat link to be
provided by the Telemedicine and E-health Training Center, Holy family Hospital.
4.11 System Interface and Flow Description
The proposed Surgical Robot Training System and Simulator will have different interfaces.
The following section explains the data flow of the robot control application and the Surgical
Robot System along with the Simulator; and also the different interfaces of the system.

4.11.1 System Interfaces
The system will have two major interfaces for the users.
Interface with the Simulator

Input interface to the simulator will be using robot input controls. It will be the same input
interface for the Simulator as well as the Surgical Robot System.
Interface with the Surgical Robot System

The interface with the Surgical Robot System will also be using the robot input controls.
These controls will interface with the Robot Control Application which in turn will use the
interface driver layer to connect with the Surgical Robot System.
4.11.2 Data Flow of the System
The flowchart in this section is self explanatory. It shows the flow of data of the whole
system. User interacts with the robot using a group of Robot controls attached to the robot
control application. These are also the same controls used to interact with the simulator
program. The Robot Control Application is the main heart of the whole system. It makes all
the decision of how, when and to whom the different input and output signals to deliver and
in what form. For example the trembling motion of a surgeon‘s hands will be filtered out by
the robot control application before sending the movement signals to the interface device.
Any accidental sudden movement by the surgeon shall also be filtered out. An intelligent
safety mechanism within the application software will make sure that no untoward movement
happens while the robot is working on a patient. Alarms will be generated if such a
movement occurs and every movement will be logged so that the surgeon can view all the
movements made by the robotic arms during an operation. An evaluation of the surgeon‘s
activity will also be possible based on the log data generated.

Haptic UI
Simulator Application Robot Controls Sensory Feedback (Video & other

sensors)
Sensory Feedback
Robot Control
Output in Virtual Application
Environment
Interface link to Robot
Embedded Robot
Controller
Movement of
Robotic Arms
Fig. 4.10 Data Flow of the System
4.12 Utilization Plan
The robotic system once developed will go through an extensive test phase at Holy Family
Hospital, Rawalpindi. As the Telemedicine training center at this hospital has the
infrastructure available for connecting remote locations over satellite and high speed
broadband networks, the remote control of the system and its feedback will be monitored
and tested. Once this phase is complete, the system will move onto the utilization phase.
The following are the different utilization phases for the robotic training system
Phase-1: Utilization at Holy Family Hospital for training of surgeons in laparoscopic and
robotic surgery

Phase-2: Deployment at remote locations already connected with Holy Family Hospital for
remote training of surgeons and control of robotic training system
Phase-3: Testing of the system in the operation theater at Holy Family Hospital with an
expert surgeon at hand at all times to monitor the performance of the system, in case
anything goes wrong.
Phase-4: Commercialization of the technology with improved safety and health regulations in
order for the robotic system to be deployed at remote locations for actual surgery.
4.13 Maintenance Plan
A dedicated team of engineers will be trained and hired by NUST for providing maintenance
and support services to the users of the system. The completion of this project will result in a
prototype being developed and tested for further improvement and commercialization of the
technology.
Furthermore, as part of our plan to commercialize this technology we intend to start a

technology start-up company that will work on refining this technology and improving the
overall concept for marketing the product locally and internationally. This company will also
be responsible for providing technical support and training to users of the robotic training
system, making it sustainable over a period of time.
B. Project Team:
(Please attach the curriculum vitae (CV) of PD and JPD(s). Also attach the CVs of key research/
development personnel if available. Please follow the format included in Annexure A.
The numbers in the table below must tally with the HR Cost sheet in the Budget file.)
Title / Position Number

Project Coordinator 1
Team Leads
3
(Software / Mechatronics / Surgical)
Professional Researchers / Developers
1
(Surgical Team)
Post Graduate Trainees
2
(Surgical Team)
2
(Software Design Team)
Researchers / Development Assistants
(Grad / Undergrad students) 2+1
(Software Design Team)
2
(Mechatronics Team)
Researcher / Development Assistants
2+1
(Grad / Undergrad students)

(Mechatronics Team)
Support Staff
Contract Staff (please specify)
Others (please specify)
Add more rows if required
C. Team Structure:
(Please define the team structure (organogram) and role/key responsibilities of each member. If
in collaboration with another partner, the division of manpower at various locations of partners
be provided.)
PD JPD
Project Coordinator
Team Lead (Software) Team Lead Team Lead (Surgical)

(Mechatronics)
Simulator Application Network Module Haptic UI Design Team (1) Robotic Manipulators Professional Researcher (1)
Team (1) Development Team (1) Team (1)
Title/Position Role/Key Minimum Expertise / Minimum

(of each member) Responsibilities Qualification Background Experience
Required Required Required
(years)
Project Coordinator (1) Coordination between MS Electrical 3
Software, Mechatronics Engineering and
and Surgical Teams Computer Science
Overall design of the
Simulator, Robot
Control Application,
Embedded Robot
Controller and
Management of
engineering and
technical side of the
project
Team Lead (Software Software Design for BS/MS Computer Science/ 4

Design) (1) Simulator and Robot Expertise in
Control App software
management and
development using
Windows / Linux
Architecture
Team Lead Mechanical and Robotic BS/MS Electronics/ 4
(Mechatronics) (1) Design Mechatronics,
Experience in
development of
embedded
applications and
robotic design
Team Lead (Surgical Developing Scenarios MBBS, FCPS Extensive 5
Team) (1) and providing support in experience of
the developing of the Laparoscopic and
Location, Holy Family Simulator. Testing of Robotic Surgery
Hospital Simulator and Robot and usage of
Surgical Simulators
Professional Assisting the Team lead MBBS, FCPS Experience of 4
Researcher (Surgical in studying existing Laparoscopic and
Team) (1) designs. Working with Robotic Surgery
the software and and usage of
mechatronics teams in Surgical Simulators
testing and evaluation
of the system.
Post Graduate Trainees Assisting in the 1
(2) development of the
Training Simulator and
Location, Holy Family Emulator, Testing and
Hospital evaluating the design
and interface of the
training system
Sr. Software Engineers Design and BS/MS Computer Science, 4
(2) Development of with experience of
Simulator and Network OpenGL and
Module OpenCV libraries,
Visual C++/.Net
Linux/Windows
Undergraduate Research and literature Undergraduat Computer Science, 0
Trainees (2) study. Developing small e students C/C++
modules for the system
Graduate Trainees (1) Assisting in Design and MS students Computer Science, 0
Development of expertise in C/C++,
Simulator Application Java, OpenGL
Sr. Mechatronics Design of Robotic BS / MS Expertise in design 4
Engineers (2) Manipulators and end- of robotic and
effectors along with control systems
Interface and
Embedded Software
Undergraduate Assist in Design of BS Students Some experience 0
Trainees (2) Robotic Arm and in mechanical
Surgeon design of robots

Console ,Embedded
Software and haptic UI
design
Graduate Trainees (1) Assisting the team in BS Mechanical Design 0
design of robotic arms
and mechanical
Structures
D. Project Activities:
(Please list and describe the main project activities, including those associated with the transfer
of the research results to customers/beneficiaries. The timing and duration of research activities
are to be shown in the Gantt chart in Section 8.)
Work Package1
Team Mobilization (3 months)
Activities
The first phase of project will involve hiring of team members and mobilization of
teams. All teams will be divided into sub-teams by their team leads and assigned tasks
to perform. Workload will be distributed among these teams. The first phase will also
include procurement of development tools and hardware required initially like PCs,
Servers, printers etc.
Deliverables
The deliverable for the first work phase will be the hiring report, team structure and task
assignment report
Work Package 2
Literature Study and Utilization Plan(3 months)
Activities
This activity will include an extensive survey of existing technology by the three teams.
Each Team will survey existing technology; identifying key elements that can be used
in the design of this project and make a comparison of all technologies studied.
Simulator team will study existing open source simulators and open source graphics
libraries that can be used in simulator development. Network Interface team will survey
what technological infrastructure is available in Pakistan that can be used for tele-
oepration of the project. It will further study which libraries are required for socket and
network programming of the module. The detailed utilization plan of the project will be
developed. This will include the implementation details of different phases of the
utilization plan described in section 4.12. During this stage an initial tentative design
document will also be prepared which will details the design of the whole system. This
document will be updated and revised as the project progresses through the different
stages of implementation.
Deliverables
Literature Review document of each team

Detailed Utilization Plan
Tentative Design Document of the System
Work Package 3
Analysis (3 months)
Activities
In the second phase, analysis will be carried out by the three development teams of
Software, Mechatronics and Surgical. The mechatronics team is further divided into
Robotic Manipulator Development Team and Haptic User Interface Development
Team. Similarly Software team is further divided into Simulator development team and
Network Interface development team. An SRS document will be generated by each
team describing the software requirements of simulator application, network interface
module, robotic manipulators, haptic UI controls.
Deliverables
SRS document by each development team will be delivered.
Work Package 4
Design (3 months)
Activities
Work package 3 will be the most crucial phase as this will be the design phase of the
project. All teams will conduct research on the design of their respective modules. The
simulator will create the initial design of the Simulator, while the Haptic UI team will
design the user interface hardware and software and the Robotic Manipulators team
will complete the design of the architecture of surgical robot and robotic arms. At the
end of 12 months a comprehensive design document of the whole system will also be
produced which will include the design specifications for the different modules of the
system.
Deliverables
A design document will be delivered by each team on the initial design of each module.
A comprehensive and detailed design document of the whole system will also be
delivered.
Work Package 5
Development Stage 1 (3 months)
This is the second most crucial phase after the design phase. This is will transform the
design of each module into a reality. Each module will be developed through several
cycles in this work package. Each team will work in parallel ensuring the completion of
the initial phase of development of each module. The development stage is divided into
3 stages. Each stage is of 3 months. After completion of every stage a document or

demonstration will be delivered depending on the stage of development.
Activities
Simulator Development
The simulator core development will be done at this stage. The physics engine will be
coded along with the environment of the simulator. The first step is developing the main
core i.e the engine of the simulator. This will be done using OpenGL library. This
activity requires significant development and coding.
Network Interface Development

The network interface module will also be developed at this stage by the network
interface team. This software module will be developed as a separate module, so that it
can be integrated later in the simulator and the robot manipulator control application.
Haptic UI hardware development

The first prototype of the User Interface hardware will be fabricated and its embedded
software controller developed at this stage.
Robotic Manipulators Development

The mechanical design of the robotic manipulators will be fabricated and motors will be
mounted on the joints. This robotic arm will have basic control movements at this stage.
Deliverables
Prototypes of the haptic User Interface hardware and surgical robot manipulators and
physics engine of the simulator application will be the deliverables of this phase.
Work Package 6
Activities
Soft tissue modeling along with development and modeling of internal body organs will
be done at this stage. Blood flow will be designed and integrated with the physics
engine of the simulator.

Interface software will be written for the interface module, that will allow the input

controls to be used with simulator application as well as robotic manipulators.

The mechanical design of the end-effectors will be fabricated and integrated with the
robotic manipulators. The main embedded robotic arm manipulation software will be
written. A network interface module will be developed for the robotic manipulators to be
controlled over a network link.
Deliverables
Development Reports, Simulator Demo (secondary phase), prototypes of haptic UI
controls and Surgical Robot end-effectors
Work Package 7
Activities
The GUI and front end application will be designed. Haptic UI controls will be interfaced
with the simulator application. Since the simulator application runs in two modes; online
mode and offline mode. In online mode it actually behaves as a robotic control
application, while in offline mode it behaves as a simulator application. Therefore it is
necessary that the haptic UI controls are integrated with both modes of the application.
The network interface module will be integrated with the simulator application and
tested for connectivity as well.

Haptic UI controls will be interfaced with the Simulator application and tested.

Software will be developed for the control of robotic manipulators and end-effectors.
The software will also be refined and tuned for the delicate and fine movements of the
end-effectors. This input for refinement shall be provided by the surgical team.
Deliverables
Development Reports, Demonstration of Simulator (third phase), Haptic UI controls and
Surgical Robot manipulators and end-effectors movement.
Work Package 8
Internal Modular Integration (3 months)

Activities
All the internal modules developed separately will be integrated at this stage.
Simulator Application
The application will be integrated with the physics engine module, soft tissue simulation
module, GUI module and network interface module.
Robotic Manipulators
The robotic arms and end-effectors will be interfaced with the main embedded robotic
control application. Robotic manipulators will also be connected with the main simulator
application.
Deliverables
Working individual modules of the system will be demonstrated. These demos will
include Simulator Application and Haptic UI controls with Robotic Manipulators.
Work Package 9
Integration of System Modules (3 months)
Activities
This is another crucial and important phase of the project. Once all the modules have
been developed and tested independently they will be integrated to form the whole
training system. All the problems that occur in the integration phase will be addressed
with the system going through another phase of iterations.
Deliverables
An development report will be generated which will describe all the features that the
system is able to perform. An evaluation report will also be delivered by the surgical
team which will test all the crucial features of the system.
Work Package 10
Integration Testing (3 months)
Activities
In this work package extensive testing will be carried out to evaluate the performance
of the simulator as well as the surgical robot system, in conjunction with the haptic UI
controls. Integration testing requires all modules to be tested to be working together
without any bugs and errors, therefore all the bugs will be removed in this phase. All
the development teams will be involved in this phase along with the surgical team.
Deliverables
An evaluation report will be delivered that will contain the integration test and
evaluation analysis.

Work Package 11
Network Testing (3 months)
Activities
Once the whole system has been thoroughly tested and evaluated, the next phase will
be to re-evaluate all the capabilities of the system over a network link. The system will
be deployed at a remote location and controlled by surgeons of Holy Family Hospital
using a network link. Any issues related to the network will be solved at this stage.
Deliverables
An evaluation report will be delivered that will list the performance comparison of the
system over a wired link versus a wireless link.
A complete demonstration will also be delivered displaying the overall application of the
system under Tele-operation.
Work Package 12
Deployment (3 months)
Activities
The final phase will include final level of testing, deployment, tutorials, user manuals
and release of all documentation.
Deliverables
Tutorials, videos, user manuals of the system.
E. Key Milestones and Deliverables:

(Please list and describe the principal milestones and associated deliverables of the project. A
key milestone is reached when a significant phase in the project is concluded, e.g. selection and
simulation of algorithms, completion of architectural design and design documents,
commissioning of equipment, completion of test, etc.) The timing of milestones is also to be
shown in the Gantt chart in Section 8. Quarterly deliverables are preferred.
The information given in this table will be the basis of monitoring and release of funds by the
National ICT R&D Fund.
No. Elapsed time Milestone Deliverables

from start (in
months) of
the project
1. 3 Team Mobilization  Hiring Report

 Team Structure and Task
Assignment Document
2. 6 Literature Survey  Literature Survey document of
each development team
 Detailed Utilization Plan
 Tentative Design Document of
the system
3. 9 Analysis Complete  Software Requirement
Specification (SRS) document
of each development team
4. 12 Design Stage Complete  Design documents by each
development team
 Detailed Design Document of
the System
5. 15 Prototype Development (1st  Development Reports (Stage

Stage) 1) for Simulator Application
 Prototype 1.0 of Haptic UI
Controls
 Prototype 1.0 of mechanical
structure of Robotic
Manipulators
6. 18 Prototype Development (2nd  Development Report (Stage 2)

Stage) of Simulator Application
 Prototype 2.0 of Haptic UI
Controls
 Prototype 1.0 of Surgical
Robotic end-effectors
7. 21 Modular Development complete  Demonstrations of Simulator

(3rd Stage) Application,
 Haptic UI controls
 Robotic Manipulators
Movement
8. 24 Completion of Modular  Demonstration of individual
Integration modules of the system
9. 27 System Integration Complete  Integration report and
demonstration of the system
with all modules integrated

10. 30 Integration Testing Complete  Evaluation Report
11. 33 Network Testing Complete  Network performance
evaluation report and
demonstration
12. 36 Deployment and Documentation  Project introduction and
Release orientation seminar / workshop
(Please add more rows if required.)
5. Benefits of the Project

A. Direct Customers / Beneficiaries of the Project:
(Please identify clearly the potential customers/beneficiaries of the research results and provide
details of their relevance, e.g. size, economic contribution, etc.)
The direct beneficiary of this project is the Telemedicine and E-Health Training Center,
Holy Family Hospital, Rawalpindi. Initially the project is being developed for them but
this project has tremendous commercial potential for markets in Asia, Africa and
Europe as well.
B. Outputs Expected from the Project:

The output expected from the project is a low-cost simulator and surgical training robot
for training of medical staff in Minimal Invasive Procedures. One of the outcomes of this
project will be to create a team from different fields and make them experts in using ICT
for developing new products in the field of medicine and robotics.
We will also involve experts in the field of industrial management to advise us regarding
the commercialization of this technology, once a working prototype is complete. We
have already identified people from the industry that can help us in this process. Some
industry linkages are available between the industry, SEECS and Holy Family
Hospital‘s eHealth and Tele-medicine Training Center, that can be exploited and used
for this purpose.
C. Organizational / HRD Outcomes Expected:
<type here>
D. Technology Transfer / Diffusion Approach:

(Please describe how the outputs of the project will be transferred to the direct
beneficiaries/customers. Please also state if the project outputs are sustainable, i.e. if they can
be utilized without further external assistance.)
The robot will be deployed at the Telemedicine and E-health Training Center, Holy
Family Hospital, Rawalpindi. In order for the successful deployment and use of this
technology video tutorials will be developed, training seminars conducted and user
manuals and web-help will be made available on the project website. Technical support

will be provided to the users. This project once completed can be commercially
marketed as it has great potential. One of the biggest advantages of this project will be
its low cost development and hence over all low market price. Similar systems cost
thousands of dollars, whereas this system will be very cheap to buy, deploy, maintain
and use. It has the potential to sustain itself in the long run.
During the development of this project we will exploit are links with the industry and
take advice on how to commercial this technology once the first working prototype after
36 months is complete. For this purpose we have already identified groups working in
the high tech industry in the US, that are willing to help and guide us in this regard. For
this purpose we will employ the services of persons with proven experience of bringing
prototypes to the level of marketable products.
6. Risk Analysis
A. Risks of the Project:
(Please describe the factors that may cause delays in, or prevent implementation of, the project
as proposed above; estimate the degree of risk.)
(Please mark  where applicable) Low Medium High
 Technical risk   
 Timing risk   
 Budget risk   
A1. Comments:
The technical risk is low in this project, since most of the design has been considered
after careful brainstorming sessions. Since we are using a modular architecture for the
system, even at some stage if a particular module is not available or has a problem it
can be easily replaced. Off the shelf parts make this project simpler to design and
integrate and with our expertise, the overall technical risk is low.
The timing risk is medium since we have a target of 36 months for completion. In case
of electronics development certain areas take more time to develop than certain others.
Therefore there can be unexpected delays. Furthermore, a lot of design research and
brainstorming is required for the mechanical design of the system; hence it is essential
that enough time is given to the design of each module.
Budget is always a risk. With many of the modules being purchased from outside
Pakistan, most of them are priced in US dollars. If the price of dollar fluctuates too
much, than there can be a problem with the equipment costs, although care has been
taken to foresee beforehand any such circumstances and avoid them.

7. Contractual Matters
A. Contractual Obligations under this Project:
(Please indicate any contractual obligations with third parties that will be entered into for this
project.)
<type here>
B. Ownership of Intellectual Property Rights:
All newly developed intellectual property rights arising out of or capable of legal
recognition with respect to the projects implemented by the National ICT R&D Fund
(The ―Company‖) shall vest with the Company.
The Company may assign or license its rights in the said intellectual property to any
person on such terms as it may deem appropriate.
C. Competent Authority of the Principal Investigator (Organization).

(Documentary proof of the Competent Authority as being the authorized signatory for the PI is
mandatory for approval of the Project Proposal. Please attach copy of the proof.)
Name: Dr Arshad Ali

Designation: Director General
Email: arshad.ali@seecs.edu.pk
Date: Signature
& stamp:

8. Project Schedule / Milestone Chart
(Project schedule using MS-Project (or similar tools) with all tasks, deliverables, milestones, cost estimates, payment schedules clearly
indicated are preferred.)

9. Proposed Budget
Please use the embedded Excel Worksheet for providing budget details.
Double click the icon to open the worksheet.
C:\Documents and
Settings\Sohail\Desktop\Proposed Budget-TR&D.xls

Bibliography

Annexure B – Details of hardware and software requirements
This section contains the details of some of the hardware requirements for the project. The
equipment identified and the prices quoted are for reference only. Actual equipment and
prices might be different from those identified. The approximate cost is included with the
description of each module to be purchased.
1. Roboard Microprocessor
Roboard Microprocessor Board $300
 Why is it required?
The Roboard is a dedicated development SBC (Single Board Computer) that is
required for controlling all the mechanical devices of the robot. The actuators for the
robotic arm, the feedback from the robotic arm and all the sensors will be interfaced
with this board. This board will run the embedded control application of the robot.
 What is the approximate cost?

The actual cost of the board is $300. Shipping charges amount to $75 and with tax the
total approximate cost of the board comes to about $400.

2. Axon Microcontroller
Axon Microcontroller Board $100
The Axon mircrocontroller provides more than 55 I/O (input/output) ports for interfacing
different motors including servos and sensors. This will allow the Roboard to interface
with all the motors and sensors, providing a protection layer to the Roboard, therefore
in case of any hardware failure the brain of the robot would still be able to function
while this cheap controller will be easily replaceable.

The actual cost of the board is $100. Shipping charges amount to $75 and with tax the
total approximate cost of the board comes to about $200.
3. Dynamixel Robot Actuator
Dynamixel Actuator $44
The robot will consist of three to four robotic arms. Each robotic arm will have several
degrees of freedom (several axes movements). Each axis will require its own motor.
We have chosen Dynamixel‘s Robot Actuator since it provides sensory feedback for
every actuator, which means that at any given time, if any axis of the robotic arm is not

functioning then evasive action can be taken by the robot and warn the surgeon of any
potential danger during operations.

The actual cost of the actuator is $44. Shipping charges amount to $70 and with tax
the total approximate cost of the board comes to about $130. In total about 10 to 16 of
these motors will be required in total. For 16 of these actuators the shipping cost would
be about $100, therefore total cost will be $850.
4. Surgeon Console
LCD Monitor with PC
A PC will be required to run the main control application of the robot. This will also be
used to run the Simulator. It will be interfaced with the input controls and the hardware
interface driver of the Surgical Robot.

A usual PC with enough computing power for the current project would approximately
cost about Rs 40,000.
5. End-effectors
Laparoscopic Instruments
The end-effectors or the grippers of the robotic arms will be designed to fit laparoscopic
instruments that are available in the market. This will allow for near perfect control for
the surgeons as they will already be used to these equipments.

The cost for the industry standard laparoscopic equipment has been added in the
budget hardware requirements

References
1. The first Korean Experience of Telemanipulative Robot-Assisted Laparoscopic

Cholecystectomy Using the da Vinci System, Chang Moo Kang, Hoon Sang Chi,
Woo Jin Hyeung, Kyung Sik Kim, Jin Sub Choi, Woo Jung Lee & Byung Ro Kim,
Yonsei Medical Journal, Vol 48. No.3, pp 540-545, 2007
2. Intuitive Surgical
www.intuitivesurgical.com
3. Mako Surgical
www.makosurgical.com
4. NeuroArm
www.neuroarm.org
5. InTouch Health
www.intouchhealth.com
6. ProMIS
www.haptica.com
7. Mt. Sinai School of Medicine, New York
http://www.roboticoncology.com/data/
8. PTCL Wireless Broadband
http://ptcl.com.pk/contentb.php?NID=199
9. OpenGL
www.opengl.org
10. Dynamixel Actuators
www.robotis.com
11. Laparoscopic Instruments for End-effectors
http://www.stryker.com/enus/products/Endoscopy/Laparoscopy/Laparoscopes/in
dex.htm
12. Roboard
www.roboard.com/RB-100.htm
13. Axon Microcontroller
http://www.societyofrobots.com/axon/
14. OpenCV (Computer Vision Library)
http://opencv.willowgarage.com/wiki/
15. Pakistan‘s Telemedicine Project
www.telemedicine.pk
16. Laparoscopy Virtual Reality System
http://www.immersion.com
17. SPRING: A General Framework for Collaborative, Real-time Surgical Simulation,
Kevin Montgomery, Cynthia Bruyns, Joel Brown, Stephen Sorkin, Frederic
Mazzella, Guillame Thonier, Arnaud Tellier, Benjamin Lermin, Aneel Menon,
Medicine Meets Virtual Reality (MMVR), Pages 23-26, 2002
18. GiPSi: An Open Source/Open Architecture Software Development Framework
for Surgical Simulation, M. C. Cavusoglu, T. G. Goktekin, F. Tendick, and S. S.
Sastry. In Proceedings of Medicine Meets Virtual Reality XII (MMVR 2004),
Newport Beach, CA, January 14-17, 2004, pp.46-48.
19. Irrlicht Engine

http://irrlicht.sourceforge.net/
20. AVR Microcontroller
http://www.atmel.com/products/AVR/
21. ARM Microprocessor
www.arm.com/products/CPUs/
22. Rabbit Microprocessor
http://www.rabbit.com
23. LapSim Simulator
http://www.surgical-science.com
24. PTCL DSL Service
http://www.ptcl.com.pk/contentb.php?NID=167
25. DAWN Article on Robotic Surgery
http://www.dawn.com/wps/wcm/connect/dawn-content-library/dawn/news/sci-
tech/14-medical-societies-push-standards-for-robotic-surgery-zj-03

Annexure C – Details of Work Packages, Milestones, Deliverables
Year 1: Analysis and Design
Year 2: Development
Year 3: Testing & Deployment
WP1 Work Package 1 (HR, Equipment and Initial Design Study) 3 months
- Mobilization of Team (Hiring and Team Selection)

- Selection and procurement of initial development tools and hardware
MS 1 : Hiring / Team Mobilization Complete
D1 : Hiring Report / Project commencement report
WP2 Work Package 2 (Literature Study and Utilization Plan) 3 months
- Literature Review (Simulator Team)

 Studying available open source simulators and libraries
- Literature Review (Haptic UI Team)
 Surveying designs for haptic user interfaces for Input controls
- Literature Review (Surgical Robot Team)
 Studying existing surgical robot designs
- Utilization Plan Study
 Developing a detailed utilization plan for the utilization of the developed technology
- Developing a tentative design of the system
MS 2 : Literature Survey Complete
D2.1 : Literature Review Document of each team
D2.2 : Detailed Utilization Plan
D2.2 : Tentative Design Document of the System
WP3 Work Package 3 (Analysis) 3 months
- Software Requirement Specification Document (Simulator and Surgical Teams)

 SRS for Simulator
 SRS for GUI and Network Module
 Will be developed by Surgical and Simulator Design Teams
- Software Requirement Specification Document (Haptic UI Team)
 SRS for input controls, will include requirements for core software module of input
controls and interface module for interfacing with other parts of the system
 Will be developed by haptic controls and surgical teams
- Software Requirement Specification Document for Surgical Robot (Surgical Robot
Team)
 SRS for Real Time OS running on the main control board of the robot. This will also
include FPGA requirements for development as well.
 This document will include the design of software that is required for the robotic
manipulators
 Will be developed by Manipulator design team in collaboration with all other teams
MS 3 : Analysis Complete
D3 : SRS Documents of each team
WP4 Work Package 4 (Design) 3 months
- Software Design Document (Simulator Development Team)

 Overall design and architecture of simulator will be included in the design
document. It will also include details of all modules to be developed in the
simulator
 A separate design document will be developed by the network module development
team. This will list the design of the network communication model of the system
- Mechanical Design Document (Haptic UI Team)
 Design of the input controls will be included in this document. It will also include
design of interface circuitry required for interfacing with other parts of the system
(simulator and robotic manipulators)
- Mechanical Design Document (Surgical Robot Team)

 Overall mechanical design of the robotic manipulators will be included in this
document. CAD diagrams of the structure will be included as well as identification
of parts will be done that will be used in the development
MS 4 : Initial Design Complete
D4.1 : Design documents of each team
D4.2 : Detailed Design Document of the System
WP5 Work Package 5 (Development Stage 1) 3 months
- Simulator Development
 Physics Engine Development (Core Design)
 Network Interface module development
- Haptic UI hardware development
 Prototype 1.0 User Interface Hardware with embedded control software
- Robotic Manipulators development
 The robotic arms will be fabricated and the first prototype will be developed. This
hardware will have basic control movements.
MS 5 : Prototype Development Complete
D5 : Development Reports, Simulation Software (Initial Phase), Prototypes of Haptic
UI Controls and Surgical Robotic Arms
 Soft Tissue Modeling will be done to simulate the internal body organs and blood
flow.
- Haptic UI hardware
 Interface module will be developed that will allow the input controls to be used with
the simulator application as well as the robotic manipulators.
- Robotic Manipulators development
 The end-effectors will be developed and integrated with the robotic arms.
 Network interface module to be integrated with embedded control software of
robotic manipulators
D6 : Development Reports, Simulation Software (Secondary Phase), Prototypes of
Haptic UI Controls and Surgical Robotic End-Effectors
 Front End Application Design and haptic input control interface module
development
 Integration and testing of network interface module with front end application
- Haptic UI hardware
 Haptic User Interface controls will be integrated with simulator application and
tested
- Robotic Manipulators
 Software for control of robotic arms and end-effectors will be written for controlling
the fine movements of the end-effectors
 The movements of the end-effectors will be refined based on input from surgical
design team
D7 : Development Reports and Demonstrations of Simulator Application, Haptic UI
controls and Robotic Manipulators movement
WP8 Work Package 8 (Internal Modular Integration) 3 months
- Simulator Application
 Integration of physics engine module, soft tissue simulation module, GUI module
and network interface module
- Robotic Manipulators

 Integration of different robotic arms with the main embedded software robot
controller application
 Integration of network software module with embedded software robot controller
application
MS 8 : Completion of Modular Integration
D8 : Demonstration of Individual Modules of the System (Simulator Application and
Haptic UI Controls with Robotic Manipulator Control)
WP9 Work Package 9 (Integration of System Modules) 3 months
- Integration of Modules
 Integration of Simulator Application with Haptic Interface Module
 Integration of Robotic Manipulators with Haptic Interface Module
 Integration of Simulator Application with Robotic Manipulators
MS 9 : Integration Complete
D9 : Integration Report and Demonstration of the system with all modules
integrated
WP10 Work Package 10 (Integration Testing) 3 months
- Integration Testing of Modules

 Integration testing of Simulator Application with haptic interface module
 Integration testing of Robot Control Application with haptic interface module
 Integration testing of Simulator Application with offline and online control (with
Robotic Manipulators)
MS 10 : Integration Testing Complete
D10 : Integration Test Report
WP11 Work Package 11 (Network Testing) 3 months
- Network Testing of all modules

 Testing of Robotic Manipulators over a network
 Testing of Haptic Controls over a network link
 Testing of Robotic Manipulators Control over wired and wireless links
MS 11 : Network Testing Complete
D11 : Network Test and Evaluation Report and Demonstration at Holy Family
Hospital
WP12 Work Package 12 (Deployment and Documentation Release) 3 months
- Final Testing and Deployment

- Training Sessions and Workshops
MS 12 : Deployment and Documentation Release
D12 : Workshop and Introductory Seminar

TR&amp;D Proposal TeleSurgical Robot Simulator

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Proposal / Application

Development of a Tele-Surgical Training Robot and Simulator

DR. OSMAN HASAN

DR. ASIF ZAFAR

Application for ICT-Related Development and Research Grant Page I

1. Please do not alter the layout of the application form. Information

Application for ICT-Related Development and Research Grant Page II

List of Abbreviations and Acronyms Used by PI/PD in the Proposal

Application for ICT-Related Development and Research Grant Page III

Application for ICT-Related Development and Research Grant Page IV

For further information, please contact:

Solicitation and Evaluation Department,

Application for ICT-Related Development and Research Grant Page V

Application for ICT-Related Development and Research Grant Page VI

Application for ICT-Related Development and Research Grant Page VII

C. Project Director (PD):

Name: Dr. Osman Hasan

Designation: Assistant Professor

C1. Joint Project Director (JPD):

Name: Dr. Asif Zafar

Designation: Professor of Surgery, Rawalpindi Medical College

C2. Contact Person: (If different from PD.)

D. Organization (The Principal Investigator (PI)):

Application for ICT-Related Development and Research Grant Page 1

E. Other Organizations Involved in the Project:

E1. Industrial Organizations:

E2. Academic Organizations:

E3. Funding Organizations:

E4. Other Organizations:

Application for ICT-Related Development and Research Grant Page 2

G. Research and Development Theme:

H1. Project URL:

Application for ICT-Related Development and Research Grant Page 3

Application for ICT-Related Development and Research Grant Page 4

2. Scope, Introduction and Background of the Project

Application for ICT-Related Development and Research Grant Page 5

A Tele-Surgical robot enables a surgeon to perform surgeries or minimally invasive surgical

Fig 2.1 Operation of Tele-Surgical Robotic System

Application for ICT-Related Development and Research Grant Page 6

Application for ICT-Related Development and Research Grant Page 7

Application for ICT-Related Development and Research Grant Page 8

Technology for the Robot and Simulator

Application for ICT-Related Development and Research Grant Page 9

Implications and advantages of this project

Application for ICT-Related Development and Research Grant Page 10

B1. Literature Review:

1.1 Existing Surgical Robotic Systems

I) da Vinci Surgical Robot

Fig 2.2 The da Vinci Surgical Robot System

Components of the da Vinci Surgical System

Application for ICT-Related Development and Research Grant Page 11

II) Mako Surgical Robot System

Some of the features that this system provides are

 Enabling the pre-resection capture of patient-specific kinematic tracking through full

 Real-time intra-operative adjustments for correct knee kinematics and soft-tissue

Application for ICT-Related Development and Research Grant Page 12

Fig 2.5. NeuroArm

NeuroArm has been developed by Garnette Sutherland [4], Professor of Neurosurgery,

Application for ICT-Related Development and Research Grant Page 13

IV) RP-7 Robot

Application for ICT-Related Development and Research Grant Page 14

1.2 Existing Simulators

1.2.1 LapSim Simulator

TR&D Proposal TeleSurgical Robot Simulator

TR&D Proposal TeleSurgical Robot Simulator