Haptic communication to support biopsy procedures learning in virtual environments

International audienceIn interventional radiology, physicians require high haptic sensitivity and fine motor skills development because of the limited real-time visual feedback of the surgical site. The transfer of this type of surgical skill to novices is a challenging issue. This paper presents a study on the design of a biopsy procedure learning system. Our methodology, based on a task-centered design approach, aims to bring out new design rules for virtual learning environments. A new collaborative haptic training paradigm is introduced to support human-haptic interaction in a virtual environment. The interaction paradigm supports haptic communication between two distant users to teach a surgical skill. In order to evaluate this paradigm, a user experiment was conducted. Sixty volunteer medical students participated in the study to assess the influence of the teaching method on their performance in a biopsy procedure task. The results show that to transfer the skills, the combination of haptic communication with verbal and visual communications improves the novices' performance compared to conventional teaching methods. Furthermore, the results show that, depending on the teaching method, participants developed different needle insertion profiles. We conclude that our interaction paradigm facilitates expert-novice haptic communication and improves skills transfer; and new skills acquisition depends on the availability of different communication channels between experts and novices. Our findings indicate that the traditional fellowship methods in surgery should evolve to an off-patient collaborative environment that will continue to support visual and verbal communication, but also haptic communication, in order to achieve a better and more complete skills training

Haptic communication to support biopsy procedures learning in virtual environments

International audienceIn interventional radiology, physicians require high haptic sensitivity and fine motor skills development because of the limited real-time visual feedback of the surgical site. The transfer of this type of surgical skill to novices is a challenging issue. This paper presents a study on the design of a biopsy procedure learning system. Our methodology, based on a task-centered design approach, aims to bring out new design rules for virtual learning environments. A new collaborative haptic training paradigm is introduced to support human-haptic interaction in a virtual environment. The interaction paradigm supports haptic communication between two distant users to teach a surgical skill. In order to evaluate this paradigm, a user experiment was conducted. Sixty volunteer medical students participated in the study to assess the influence of the teaching method on their performance in a biopsy procedure task. The results show that to transfer the skills, the combination of haptic communication with verbal and visual communications improves the novices' performance compared to conventional teaching methods. Furthermore, the results show that, depending on the teaching method, participants developed different needle insertion profiles. We conclude that our interaction paradigm facilitates expert-novice haptic communication and improves skills transfer; and new skills acquisition depends on the availability of different communication channels between experts and novices. Our findings indicate that the traditional fellowship methods in surgery should evolve to an off-patient collaborative environment that will continue to support visual and verbal communication, but also haptic communication, in order to achieve a better and more complete skills training

Robot-Assisted Minimally Invasive Surgery-Surgical Robotics in the Data Age

Telesurgical robotics, as a technical solution for robot-assisted minimally invasive surgery (RAMIS), has become the first domain within medicosurgical robotics that achieved a true global clinical adoption. Its relative success (still at a low single-digit percentile total market penetration) roots in the particular human-in-the-loop control, in which the trained surgeon is always kept responsible for the clinical outcome achieved by the robot-actuated invasive tools. Nowadays, this paradigm is challenged by the need for improved surgical performance, traceability, and safety reaching beyond the human capabilities. Partially due to the technical complexity and the financial burden, the adoption of telesurgical robotics has not reached its full potential, by far. Apart from the absolutely market-dominating da Vinci surgical system, there are already 60+ emerging RAMIS robot types, out of which 15 have already achieved some form of regulatory clearance. This article aims to connect the technological advancement with the principles of commercialization, particularly looking at engineering components that are under development and have the potential to bring significant advantages to the clinical practice. Current RAMIS robots often do not exceed the functionalities deriving from their mechatronics, due to the lack of data-driven assistance and smart human–machine collaboration. Computer assistance is gradually gaining more significance within emerging RAMIS systems. Enhanced manipulation capabilities, refined sensors, advanced vision, task-level automation, smart safety features, and data integration mark together the inception of a new era in telesurgical robotics, infiltrated by machine learning (ML) and artificial intelligence (AI) solutions. Observing other domains, it is definite that a key requirement of a robust AI is the good quality data, derived from proper data acquisition and sharing to allow building solutions in real time based on ML. Emerging RAMIS technologies are reviewed both in a historical and a future perspective

Medical Robotics

The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently “medical roboticists” or not

An Energy-Based Approach for n-dof Passive Dual-user Haptic Training Systems

International audienceThis paper introduces a dual-user training system whose design is based on an energetic approach. This kind of system is useful for supervised hands-on training where a trainer interacts with a trainee through two haptic devices, in order to practice on a manual task performed on a virtual or teleoperated robot (for example for an MIS task in a surgical context). This paper details the proof of stability of an Energy Shared Control (ESC) architecture we previously introduced for one degree of freedom (d.o.f.) devices. An extension to multiple degrees of freedom is proposed, along with an enhanced version of the Adaptive Authority Adjustment (AAA) function. Experiments are carried out with 3 d.o.f. haptic devices in free motion as well as in contact contexts in order to show the relevance of this architecture

Output-Feedback Shared-Control for Fully Actuated Linear Mechanical Systems

This paper presents an output feedback shared-control algorithm for fully-actuated, linear, mechanical systems. The feasible configurations of the system are described by a group of linear inequalities which characterize a convex admissible set. The properties of the shared-control algorithm are established with a Lyapunov-like analysis. Simple numerical examples demonstrate the effectiveness of the strategy

ROBOTIC TELESURGERY: AN INVESTIGATION OF UTILITY, HUMAN ADAPTATION, AND PERFORMANCE

Robotic surgery is a powerful, new method for performing minimally invasive surgery (MIS). The method allows complex procedures through incisions which are 10 mm or less. Robotic surgery has grown rapidly because small MIS incisions result in rapid patient recovery compared to conventional methods. Although surgical robots have the potential of long distance control, insufficient data is available to determine whether long distance robotic surgery, or telesurgery, is practical. Telesurgery could provide multiple benefits, including dissemination of expertise, widespread patient care, cost savings, and improved community care. We describe a series of experiments to investigate telesurgery using a one of a kind telesurgery platform and ground- and satellite-based Internet networks. The networks provided the redundancy and quality of service that would be required for human surgery. Tolerances for performing surgical tasks over a long distance were unknown. We show that operators using the platform can complete dry lab manoeuvres with communication latencies up to 500 ms, with no appreciable increase in error rates. Such latency would be equivalent to a North American transcontinental distance, implying a wide range of telesurgical capability. The characteristics of ground- and satellite-based Internet networks for telesurgery were unavailable. We demonstrate that emulated surgery in animals can be effectively performed using either ground or satellite. The networks can reliably support surgery, and satellite-based surgery can be performed even though latency exceeds 500 ms. Further, satellite bandwidth should be above 5 Mb/s for telesurgery applications. Satellite networks could be used either for back up or primarily where a community does not have ground-based equipment. iii Methods of training operators for telesurgery had not been explored. We demonstrate two methods of training for telesurgery. Operators doing dry lab surgical manoeuvres performed equally well either with sequentially increasing latency or with full latency only, suggesting that both methods of training may be effective. Telesurgery can become a practical method of treatment. Within a few years, more widespread platforms and telecommunications may exist to launch everyday telesurgery procedures

Output-feedback shared-control for fully actuated linear mechanical systems

This paper presents an output feedback shared-control algorithm for fully-actuated, linear, mechanical systems. The feasible configurations of the system are described by a group of linear inequalities which characterize a convex admissible set. The properties of the shared-control algorithm are established with a Lyapunov-like analysis. Simple numerical examples demonstrate the effectiveness of the strategy