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

Skill-based human-robot cooperation in tele-operated path tracking

This work proposes a shared-control tele-operation framework that adapts its cooperative properties to the estimated skill level of the operator. It is hypothesized that different aspects of an operatorâ\u80\u99s performance in executing a tele-operated path tracking task can be assessed through conventional machine learning methods using motion-based and task-related features. To identify performance measures that capture motor skills linked to the studied task, an experiment is conducted where users new to tele-operation, practice towards motor skill proficiency in 7 training sessions. A set of classifiers are then learned from the acquired data and selected features, which can generate a skill profile that comprises estimations of userâ\u80\u99s various competences. Skill profiles are exploited to modify the behavior of the assistive robotic system accordingly with the objective of enhancing user experience by preventing unnecessary restriction for skilled users. A second experiment is implemented in which novice and expert users execute the path tracking on different pathways while being assisted by the robot according to their estimated skill profiles. Results validate the skill estimation method and hint at feasibility of shared-control customization in tele-operated path tracking

Cooperative Object Manipulation with Force Tracking on the da Vinci Research Kit

The da Vinci Surgical System is one of the most established robot-assisted surgery device commended for its dexterity and ergonomics in minimally invasive surgery. Conversely, it inherits disadvantages which are lack of autonomy and haptic feedback. In order to address these issues, this work proposes an industry-inspired solution to the field of force control in medical robotics. This approach contributes to shared autonomy by developing a controller for cooperative object manipulation with force tracking utilizing available manipulators and force feedback. To achieve simultaneous position and force tracking of the object, master and slave manipulators were assigned then controlled with Cartesian position control and impedance control respectively. Because impedance control requires a model-based feedforward compensation, we identified the lumped base parameters of mass, inertias, and frictions of a three degree-of-freedom double four-bar linkage mechanism with least squares and weighted least squares regression methods. Additionally, semidefinite programming was used to constrain the parameters to a feasible physical solution in standard parameter space. Robust stick-slip static friction compensation was applied where linear Viscous and Coulomb friction was inadequate in modeling the prismatic third joint. The Robot Operating System based controller was tested in RViz to check the cooperative kinematics of up to three manipulators. Additionally, simulation with the dynamic engine Gazebo verified the cooperative controller applying a constant tension force on a massless spring-damper virtual object. With adequate model feedback linearization, the cooperative impedance controller tested on the da Vinci Research Kit yielded stable tension force tracking while simultaneously moving in Cartesian space. The maximum force tracking error was +/- 0.5 N for both a compliant and stiff manipulated object

Haptics-Enabled Teleoperation for Robotics-Assisted Minimally Invasive Surgery

The lack of force feedback (haptics) in robotic surgery can be considered to be a safety risk leading to accidental tissue damage and puncturing of blood vessels due to excessive forces being applied to tissue and vessels or causing inefficient control over the instruments because of insufficient applied force. This project focuses on providing a satisfactory solution for introducing haptic feedback in robotics-assisted minimally invasive surgical (RAMIS) systems. The research addresses several key issues associated with the incorporation of haptics in a master-slave (teleoperated) robotic environment for minimally invasive surgery (MIS). In this project, we designed a haptics-enabled dual-arm (two masters - two slaves) robotic MIS testbed to investigate and validate various single-arm as well as dual-arm teleoperation scenarios. The most important feature of this setup is the capability of providing haptic feedback in all 7 degrees of freedom (DOF) required for RAMIS (3 translations, 3 rotations and pinch motion of the laparoscopic tool). The setup also enables the evaluation of the effect of replacing haptic feedback by other sensory cues such as visual representation of haptic information (sensory substitution) and the hypothesis that surgical outcomes may be improved by substituting or augmenting haptic feedback by such sensory cues

Design, Development, and Evaluation of a Teleoperated Master-Slave Surgical System for Breast Biopsy under Continuous MRI Guidance

The goal of this project is to design and develop a teleoperated master-slave surgical system that can potentially assist the physician in performing breast biopsy with a magnetic resonance imaging (MRI) compatible robotic system. MRI provides superior soft-tissue contrast compared to other imaging modalities such as computed tomography or ultrasound and is used for both diagnostic and therapeutic procedures. The strong magnetic field and the limited space inside the MRI bore, however, restrict direct means of breast biopsy while performing real-time imaging. Therefore, current breast biopsy procedures employ a blind targeting approach based on magnetic resonance (MR) images obtained a priori. Due to possible patient involuntary motion or inaccurate insertion through the registration grid, such approach could lead to tool tip positioning errors thereby affecting diagnostic accuracy and leading to a long and painful process, if repeated procedures are required. Hence, it is desired to develop the aforementioned teleoperation system to take advantages of real-time MR imaging and avoid multiple biopsy needle insertions, improving the procedure accuracy as well as reducing the sampling errors. The design, implementation, and evaluation of the teleoperation system is presented in this dissertation. A MRI-compatible slave robot is implemented, which consists of a 1 degree of freedom (DOF) needle driver, a 3-DOF parallel mechanism, and a 2-DOF X-Y stage. This slave robot is actuated with pneumatic cylinders through long transmission lines except the 1-DOF needle driver is actuated with a piezo motor. Pneumatic actuation through long transmission lines is then investigated using proportional pressure valves and controllers based on sliding mode control are presented. A dedicated master robot is also developed, and the kinematic map between the master and the slave robot is established. The two robots are integrated into a teleoperation system and a graphical user interface is developed to provide visual feedback to the physician. MRI experiment shows that the slave robot is MRI-compatible, and the ex vivo test shows over 85%success rate in targeting with the MRI-compatible robotic system. The success in performing in vivo animal experiments further confirm the potential of further developing the proposed robotic system for clinical applications