A robotic surgical nurse for handling surgical instruments in the operating room

While surgeon–scrub nurse collaboration provides a fast, straightforward and inexpensive method of delivering surgical instruments to the surgeon; it often results in ‘‘mistakes’’ (e.g. missing information, ambiguity of instructions and delays). It has been shown that these errors can have a negative impact on the outcome of the surgery. These errors could potentially be reduced or eliminated by introducing robotics into the operating room. A robotic scrub nurse has the potential to reduce errors in the OR by automating the passing of surgical instruments which allows personnel to focus on more complicated tasks such as maintaining a sterile environment, preparing required surgical supplies and monitoring the state of the patient. This allows a possible reduction of errors due to communication failures. These failures can lead to wastage of resources, procedural errors, delays, distraction and inefficiency. A real-time robotic scrub nurse dedicated to passing surgical instruments to the surgeon by speech and/or gesture is presented. An advantage of gesture interaction is that it is not affected by ambient noise and does not require surgeon re-training since hand signals are used by surgeons to request surgical instruments as part of standard OR procedure.

A robotic scrub nurse capable of handling and passing surgical instruments, called Gestonurse, was tested during a mock surgical procedure at the Large Animal Hospital at Purdue University. This robot uses real-time hand tracking and recognition based on fingertip detection and gesture inference. In an in situ experiment, the robot passed the surgical instruments to the main surgeon effectively and safely, without interfering with his focus of attention. In addition to allowing natural interaction with the surgeon, Gestonurse provided the following features: (a) ease of use—the robotic system allowed the main surgeon to use his hands which are the surgeon’s standard working tool, (b) natural interaction—nonverbal commands issued through hand signals are fast and intuitive, therefore the robot should interact quickly and still be reliable (currently, Gestonurse can process images in real-time, can recognize speech commands, and handle the surgical instruments to the main surgeon within 4 s), (c) an unencumbered interface—the proposed robotic system does not require the surgeon to wear markers nor to attach microphones, and (d) reliability— The results showed that fingertips were detected and gestures recognized with 99% and 97% accuracy on average, respectively. Also the robot can pick instruments when they are as close as 25 mm from each other.








  • "Gestonurse: A Multimodal Robotic Scrub Nurse", Mithun George Jacob, Yu-Ting Li, Juan P. Wachs, 7th ACM/IEEE International Conference on Human-Robot Interaction (HRI), March 5-8, 2012 (to appear)
  • "Does a robotic scrub nurse improve economy of movements?", Juan P. Wachs, Mithun George Jacob, Yu-Ting Li, A. George Akingba, Proceedings of the SPIE Vol. 8316, 8316E(2012) Oral Presentation
  • "Gestonurse: a robotic surgical nurse for handling surgical instruments in the operating room", Mithun George Jacob, Yu-Ting Li, Juan P. Wachs, Journal of Robotic Surgery (27 Nov 2011), Pgs. 1-11
  • "A Gesture Driven Robotic Scrub Nurse", Mithun George Jacob, Yu-Ting Li, Juan P. Wachs, In Proceedings of the 2011 IEEE International Conference on Systems, Man, and Cybernetics , ISBN: 978-1-4577-0651-6; pp. 2039-2044. Oral Presentation PDF



Juan P. Wachs
jpwachs (at) purdue (dot) edu | Juan Wachs website
Yu-Ting Li
yutingli (at) purdue (dot) edu
Mithun George Jacob
mithunjacob (at) purdue (dot) edu

© 2012 Juan Wachs

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