【正文】 附件 2：外文原文 State of the Art in Surgical Robotics: Clinical Applications and Technology Challenges Abstract While it has been over 15 years since the first recorded use of a robot for a surgical procedure, the field of medical robotics is still an emerging one that has not yet reached a critical mass. While robots have the potential to improve the precision and capabilities of physicians, the number of robots in clinical use is still very small. In this review article, we begin with a short historical review of medical robotics, followed by an overview of clinical applications where robots have been applied. The clinical applications are then discussed, which include neurosurgery, orthopedics, urology, maxillofacial surgery, radiosurgery, opthamology, and cardiac surgery. We conclude with a listing of technology challenges and research areas, including system architecture, software design, mechanical design, imaging patible systems, user interface, and safety issues. Key Words Medical robotics, review article, technology challenges, neurosurgery, orthopedics, urology, maxillofacial surgery, radiosurgery, opthamology, and cardiac surgery Introduction Medical robotics has tremendous potential for improving the precision and capabilities of physicians to perform surgical procedures. However, we are just at the beginning of the application of robotics to medicine, and many questions remain open regarding effectiveness, safety, and cost. While there are several mercial panies selling medical robots, the total installed number is extremely small, and the market will most likely continue to grow slowly. Unlike the area of factory robotics, which grew rapidly during the 1970s and 1980s, medical robotics has not yet reached a critical mass. However, it is believed the benefits of medical robotics will bee increasingly clear and this will lead to a continued rise in their use in medicine. According to the Robotic Institute of America, a robot is a reprogrammable, multifunctional manipulator designed to move materials, parts, tools, or other specialized devices through various programmed motions for the performance of a variety of tasks. While the term “robot” may conjure up images of R2D2 from the movie “Star Wars”, in this paper we will stay with the definition above. These robots consist of nearly rigid links that are connected with joints that allow relative motion from one link to another [1]. Attached to the end of the links is the robot hand, usually referred to as the endeffector. The robot is controlled by a puter system that is used to move the endeffector to any desired point and orientation within its workspace. This review article highlights the state of the art of medical robotics across several clinical areas. In this review, we will focus on robots that play an active role during a surgical intervention. These systems are not meant to replace the physician, but rather to augment the capabilities of the physician. There are other categories of medical robotics, such as robotics for rehabilitation or miniature robots that might be placed inside the body, but these will not be discussed here. This review is not intended to be prehensive, but rather to give an overview of the field, with a focus on key historical developments and on current work. Several other medical robotics review articles with a focus on surgical procedures have also been written. Davies [2] describes the history of surgical robotics and gives one classification for the types of robot systems studied by researchers. Taylor [3] discusses several taxonomies for surgical robotics and presents a different classification. Troccaz [4] gives a historical review and describes passive, semiactive, and active robotic systems. Howe [5] overviews applications in imagebased procedures, orthopedic surgery, and neurosurgery, among others. Specialized reviews also exist, such as the article by Caddedu on urology robotics [6]. The paper is anized as follows. Section 2 gives a brief historical review, followed by a table of clinical applications in Section 3. Each of these clinical applications is then described. Section 4 presents technology challenges and research areas. Conclusions are given in Section 5. Historical Review Medical robotics is a relatively young field, with the first recorded medical application of a robot occurring in 1985 [7]. In this case, the robot was a simple positioning device to orient a needle for biopsy of the brain. A 52yearold man was put on a CT scanner table, the target was identified on the CT images, and the robot was used to orient a guide tube through which a needle was inserted. Unfortunately, the robot used was a PUMA 560 industrial robot, and safety issues concerning the operation of the robot in close proximity to people prevented this work from continuing [2]. Shortly thereafter, research groups in Europe, Asia, and the United States began investigating medical applications of robotics. In Europe, a group at Imperial College in London under the direction of Davies began developing a robot for prostate applications [8]. At Grenoble