Prevalence of haptic feedback in robot-mediated surgery : a systematic review of literature

© 2017 Springer-Verlag. This is a post-peer-review, pre-copyedit version of an article published in Journal of Robotic Surgery. The final authenticated version is available online at: https://doi.org/10.1007/s11701-017-0763-4With the successful uptake and inclusion of robotic systems in minimally invasive surgery and with the increasing application of robotic surgery (RS) in numerous surgical specialities worldwide, there is now a need to develop and enhance the technology further. One such improvement is the implementation and amalgamation of haptic feedback technology into RS which will permit the operating surgeon on the console to receive haptic information on the type of tissue being operated on. The main advantage of using this is to allow the operating surgeon to feel and control the amount of force applied to different tissues during surgery thus minimising the risk of tissue damage due to both the direct and indirect effects of excessive tissue force or tension being applied during RS. We performed a two-rater systematic review to identify the latest developments and potential avenues of improving technology in the application and implementation of haptic feedback technology to the operating surgeon on the console during RS. This review provides a summary of technological enhancements in RS, considering different stages of work, from proof of concept to cadaver tissue testing, surgery in animals, and finally real implementation in surgical practice. We identify that at the time of this review, while there is a unanimous agreement regarding need for haptic and tactile feedback, there are no solutions or products available that address this need. There is a scope and need for new developments in haptic augmentation for robot-mediated surgery with the aim of improving patient care and robotic surgical technology further.Peer reviewe

A mechatronic leg replica to benchmark human-exoskeleton physical interactions

: Evaluating human-exoskeleton interaction typically requires experiments with human subjects, which raises safety issues and entails time-consuming testing procedures. This paper presents a mechatronic replica of a human leg, which was designed to quantify physical interaction dynamics between exoskeletons and human limbs without the need for human testing. In the first part of this work, we present the mechanical, electronic, sensory system and software solutions integrated in our leg replica prototype. In the second part, we used the leg replica to test its interaction with two types of commercially available wearable devices, i.e. an active full leg exoskeleton and a passive knee orthosis. We ran basic test examples to demonstrate the functioning and benchmarking potential of the leg replica to assess the effects of joint misalignments on force transmission. The integrated force sensors embedded in the leg replica detected higher interaction forces in the misaligned scenario in comparison to the aligned one, in both active and passive modalities. The small standard deviation of force measurements across cycles demonstrates the potential of the leg replica as a standard test method for reproducible studies of human-exoskeleton physical interaction

Gait Dynamic Stability Analysis with Wearable Assistive Robots

abstract: Lower-limb wearable assistive robots could alter the users gait kinematics by inputting external power, which can be interpreted as mechanical perturbation to subject normal gait. The change in kinematics may affect the dynamic stability. This work attempts to understand the effects of different physical assistance from these robots on the gait dynamic stability. A knee exoskeleton and ankle assistive device (Robotic Shoe) are developed and used to provide walking assistance. The knee exoskeleton provides personalized knee joint assistive torque during the stance phase. The robotic shoe is a light-weighted mechanism that can store the potential energy at heel strike and release it by using an active locking mechanism at the terminal stance phase to provide push-up ankle torque and assist the toe-off. Lower-limb Kinematic time series data are collected for subjects wearing these devices in the passive and active mode. The changes of kinematics with and without these devices on lower-limb motion are first studied. Orbital stability, as one of the commonly used measure to quantify gait stability through calculating Floquet Multipliers (FM), is employed to asses the effects of these wearable devices on gait stability. It is shown that wearing the passive knee exoskeleton causes less orbitally stable gait for users, while the knee joint active assistance improves the orbital stability compared to passive mode. The robotic shoe only affects the targeted joint (right ankle) kinematics, and wearing the passive mechanism significantly increases the ankle joint FM values, which indicates less walking orbital stability. More analysis is done on a mechanically perturbed walking public data set, to show that orbital stability can quantify the effects of external mechanical perturbation on gait dynamic stability. This method can further be used as a control design tool to ensure gait stability for users of lower-limb assistive devices.Dissertation/ThesisMasters Thesis Mechanical Engineering 201

Biomechanical mechanisms underlying exosuit-induced improvements in walking economy after stroke

Stroke-induced hemiparetic gait is characteristically asymmetric and metabolically expensive. Weakness and impaired control of the paretic ankle contribute to reduced forward propulsion and ground clearance—walking subtasks critical for safe and efficient locomotion. Targeted gait interventions that improve paretic ankle function after stroke are therefore warranted. We have developed textile-based, soft wearable robots that transmit mechanical power generated by off-board or body-worn actuators to the paretic ankle using Bowden cables (soft exosuits) and have demonstrated the exosuits can overcome deficits in paretic limb forward propulsion and ground clearance, ultimately reducing the metabolic cost of hemiparetic walking. This study elucidates the biomechanical mechanisms underlying exosuit-induced reductions in metabolic power. We evaluated the relationships between exosuit-induced changes in the body center of mass (COM) power generated by each limb, individual joint powers, and metabolic power. Compared to walking with an exosuit unpowered, exosuit assistance produced more symmetrical COM power generation during the critical period of the step-to-step transition (22.4±6.4% more symmetric). Changes in individual limb COM power were related to changes in paretic (R2= 0.83, P= 0.004) and nonparetic (R2= 0.73, P= 0.014) ankle power. Interestingly, despite the exosuit providing direct assistance to only the paretic limb, changes in metabolic power were related to changes in nonparetic limb COM power (R2= 0.80, P= 0.007), not paretic limb COM power (P> 0.05). These findings provide a fundamental understanding of how individuals poststroke interact with an exosuit to reduce the metabolic cost of hemiparetic walking.Accepted manuscript2019-03-0

A demonstration and comparative analysis of haptic performance using a Gough-Stewart platform as a wearable haptic feedback device

In many hazardous work environments, contact tasks ranging from manufacturing to disassembly to emergency response are performed by industrial manipulators. Due to the hazardous and complex nature of these environments, teleoperation is often employed. When such is the case, the operator is left to interpret a large amount of data during task completion due to the complexity of modern robotic systems and the possible complexity of the tasks. This information is usually processed visually but can lead to sensory overload. To mitigate this, the information processing can also be distributed through other modes of sensory such as auditory or haptic. The University of Texas at Austin's TeMoto hands-free interface reduces the burden on the operator of commanding remote systems by enabling the use of gestural and verbal commands to complete a range of tasks, but the removal of a mechanical interactive device from the operator interface complicates the inclusion of haptic feedback. In this work, a standalone Gough-Stewart platform previously configured as a wearable haptic feedback device for the Nuclear and Applied Robotics Group at the University of Texas at Austin provides real-time haptic feedback to the unconstrained hand(s) of the operator. In doing so, this haptic interface can be employed with the intent of enhancing situational awareness and minimizing operator stress by imparting forces and torques to the user based on those imparted on the end-effector of the industrial manipulator. While multiple technical issues and human factor issues must be addressed, this effort focuses on integrating the system and evaluating its performance for various industrial manipulator designs and sensor modalities. After testing various digital signal processing techniques, functionality was demonstrated among one series-elastic and two rigid industrial manipulators, each with different force/torque data acquisition characteristics and a comparative analysis in haptic performance was performed. Furthermore, it was demonstrated with the TeMoto hands-free teleoperation system. Overall, the demonstrations and experiments performed in this work prove the system to be a viable, hardware agnostic means of haptic feedback and a strong basis for future effortsMechanical Engineerin

Enabling Human-Robot Collaboration via Holistic Human Perception and Partner-Aware Control

As robotic technology advances, the barriers to the coexistence of humans and robots are slowly coming down. Application domains like elderly care, collaborative manufacturing, collaborative manipulation, etc., are considered the need of the hour, and progress in robotics holds the potential to address many societal challenges. The future socio-technical systems constitute of blended workforce with a symbiotic relationship between human and robot partners working collaboratively. This thesis attempts to address some of the research challenges in enabling human-robot collaboration. In particular, the challenge of a holistic perception of a human partner to continuously communicate his intentions and needs in real-time to a robot partner is crucial for the successful realization of a collaborative task. Towards that end, we present a holistic human perception framework for real-time monitoring of whole-body human motion and dynamics. On the other hand, the challenge of leveraging assistance from a human partner will lead to improved human-robot collaboration. In this direction, we attempt at methodically defining what constitutes assistance from a human partner and propose partner-aware robot control strategies to endow robots with the capacity to meaningfully engage in a collaborative task

The sensor-based biomechanical risk assessment at the base of the need for revising of standards for human ergonomics

Due to the epochal changes introduced by “Industry 4.0”, it is getting harder to apply the varying approaches for biomechanical risk assessment of manual handling tasks used to prevent work-related musculoskeletal disorders (WMDs) considered within the International Standards for ergonomics. In fact, the innovative human–robot collaboration (HRC) systems are widening the number of work motor tasks that cannot be assessed. On the other hand, new sensor-based tools for biomechanical risk assessment could be used for both quantitative “direct instrumental evaluations” and “rating of standard methods”, allowing certain improvements over traditional methods. In this light, this Letter aims at detecting the need for revising the standards for human ergonomics and biomechanical risk assessment by analyzing the WMDs prevalence and incidence; additionally, the strengths and weaknesses of traditional methods listed within the International Standards for manual handling activities and the next challenges needed for their revision are considered. As a representative example, the discussion is referred to the lifting of heavy loads where the revision should include the use of sensor-based tools for biomechanical risk assessment during lifting performed with the use of exoskeletons, by more than one person (team lifting) and when the traditional methods cannot be applied. The wearability of sensing and feedback sensors in addition to human augmentation technologies allows for increasing workers’ awareness about possible risks and enhance the effectiveness and safety during the execution of in many manual handling activities