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

An Arm-Mounted Accelerometer and Gyro-Based 3D Control System

This thesis examines the performance of a wearable accelerometer/gyroscope-based system for capturing arm motions in 3D. Two experiments conforming to ISO 9241-9 specifications for non-keyboard input devices were performed. The first, modeled after the Fitts' law paradigm described in ISO 9241-9, utilized the wearable system to control a telemanipulator compared with joystick control and the user's arm. The throughputs were 5.54 bits/s, 0.74 bits/s and 0.80 bits/s, respectively. The second experiment utilized the wearable system to control a cursor in a 3D fish-tank virtual reality setup. The participants performed a 3D Fitts' law task with three selection methods: button clicks, dwell, and a twist gesture. Error rates were 6.82 %, 0.00% and 3.59 % respectively. Throughput ranged from 0.8 to 1.0 bits/s. The thesis includes detailed analyses on lag and other issues that present user interface challenges for systems that employ human-mounted sensor inputs to control a telemanipulator apparatus

A gaze-contingent framework for perceptually-enabled applications in healthcare

Patient safety and quality of care remain the focus of the smart operating room of the future. Some of the most influential factors with a detrimental effect are related to suboptimal communication among the staff, poor flow of information, staff workload and fatigue, ergonomics and sterility in the operating room. While technological developments constantly transform the operating room layout and the interaction between surgical staff and machinery, a vast array of opportunities arise for the design of systems and approaches, that can enhance patient safety and improve workflow and efficiency. The aim of this research is to develop a real-time gaze-contingent framework towards a "smart" operating suite, that will enhance operator's ergonomics by allowing perceptually-enabled, touchless and natural interaction with the environment. The main feature of the proposed framework is the ability to acquire and utilise the plethora of information provided by the human visual system to allow touchless interaction with medical devices in the operating room. In this thesis, a gaze-guided robotic scrub nurse, a gaze-controlled robotised flexible endoscope and a gaze-guided assistive robotic system are proposed. Firstly, the gaze-guided robotic scrub nurse is presented; surgical teams performed a simulated surgical task with the assistance of a robot scrub nurse, which complements the human scrub nurse in delivery of surgical instruments, following gaze selection by the surgeon. Then, the gaze-controlled robotised flexible endoscope is introduced; experienced endoscopists and novice users performed a simulated examination of the upper gastrointestinal tract using predominately their natural gaze. Finally, a gaze-guided assistive robotic system is presented, which aims to facilitate activities of daily living. The results of this work provide valuable insights into the feasibility of integrating the developed gaze-contingent framework into clinical practice without significant workflow disruptions.Open Acces

Impact of Ear Occlusion on In-Ear Sounds Generated by Intra-oral Behaviors

We conducted a case study with one volunteer and a recording setup to detect sounds induced by the actions: jaw clenching, tooth grinding, reading, eating, and drinking. The setup consisted of two in-ear microphones, where the left ear was semi-occluded with a commercially available earpiece and the right ear was occluded with a mouldable silicon ear piece. Investigations in the time and frequency domains demonstrated that for behaviors such as eating, tooth grinding, and reading, sounds could be recorded with both sensors. For jaw clenching, however, occluding the ear with a mouldable piece was necessary to enable its detection. This can be attributed to the fact that the mouldable ear piece sealed the ear canal and isolated it from the environment, resulting in a detectable change in pressure. In conclusion, our work suggests that detecting behaviors such as eating, grinding, reading with a semi-occluded ear is possible, whereas, behaviors such as clenching require the complete occlusion of the ear if the activity should be easily detectable. Nevertheless, the latter approach may limit real-world applicability because it hinders the hearing capabilities.</p

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

Soft Robot-Assisted Minimally Invasive Surgery and Interventions: Advances and Outlook

Since the emergence of soft robotics around two decades ago, research interest in the field has escalated at a pace. It is fuelled by the industry's appreciation of the wide range of soft materials available that can be used to create highly dexterous robots with adaptability characteristics far beyond that which can be achieved with rigid component devices. The ability, inherent in soft robots, to compliantly adapt to the environment, has significantly sparked interest from the surgical robotics community. This article provides an in-depth overview of recent progress and outlines the remaining challenges in the development of soft robotics for minimally invasive surgery