Surgical Applications of Compliant Mechanisms:A Review

Current surgical devices are mostly rigid and are made of stiff materials, even though their predominant use is on soft and wet tissues. With the emergence of compliant mechanisms (CMs), surgical tools can be designed to be flexible and made using soft materials. CMs offer many advantages such as monolithic fabrication, high precision, no wear, no friction, and no need for lubrication. It is therefore beneficial to consolidate the developments in this field and point to challenges ahead. With this objective, in this article, we review the application of CMs to surgical interventions. The scope of the review covers five aspects that are important in the development of surgical devices: (i) conceptual design and synthesis, (ii) analysis, (iii) materials, (iv) maim facturing, and (v) actuation. Furthermore, the surgical applications of CMs are assessed by classification into five major groups, namely, (i) grasping and cutting, (ii) reachability and steerability, (iii) transmission, (iv) sensing, and (v) implants and deployable devices. The scope and prospects of surgical devices using CMs are also discussed

Towards retrieving force feedback in robotic-assisted surgery: a supervised neuro-recurrent-vision approach

Robotic-assisted minimally invasive surgeries have gained a lot of popularity over conventional procedures as they offer many benefits to both surgeons and patients. Nonetheless, they still suffer from some limitations that affect their outcome. One of them is the lack of force feedback which restricts the surgeon's sense of touch and might reduce precision during a procedure. To overcome this limitation, we propose a novel force estimation approach that combines a vision based solution with supervised learning to estimate the applied force and provide the surgeon with a suitable representation of it. The proposed solution starts with extracting the geometry of motion of the heart's surface by minimizing an energy functional to recover its 3D deformable structure. A deep network, based on a LSTM-RNN architecture, is then used to learn the relationship between the extracted visual-geometric information and the applied force, and to find accurate mapping between the two. Our proposed force estimation solution avoids the drawbacks usually associated with force sensing devices, such as biocompatibility and integration issues. We evaluate our approach on phantom and realistic tissues in which we report an average root-mean square error of 0.02 N.Peer ReviewedPostprint (author's final draft

Activity profiling for minimally invasive surgery

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Cherry-Picking with Reinforcement Learning : Robust Dynamic Grasping in Unstable Conditions

Grasping small objects surrounded by unstable or non-rigid material plays a crucial role in applications such as surgery, harvesting, construction, disaster recovery, and assisted feeding. This task is especially difficult when fine manipulation is required in the presence of sensor noise and perception errors; errors inevitably trigger dynamic motion, which is challenging to model precisely. Circumventing the difficulty to build accurate models for contacts and dynamics, data-driven methods like reinforcement learning (RL) can optimize task performance via trial and error, reducing the need for accurate models of contacts and dynamics. Applying RL methods to real robots, however, has been hindered by factors such as prohibitively high sample complexity or the high training infrastructure cost for providing resets on hardware. This work presents CherryBot, an RL system that uses chopsticks for fine manipulation that surpasses human reactiveness for some dynamic grasping tasks. By integrating imprecise simulators, suboptimal demonstrations and external state estimation, we study how to make a real-world robot learning system sample efficient and general while reducing the human effort required for supervision. Our system shows continual improvement through 30 minutes of real-world interaction: through reactive retry, it achieves an almost 100% success rate on the demanding task of using chopsticks to grasp small objects swinging in the air. We demonstrate the reactiveness, robustness and generalizability of CherryBot to varying object shapes and dynamics (e.g., external disturbances like wind and human perturbations). Videos are available at https://goodcherrybot.github.io/

Fast and Reliable Autonomous Surgical Debridement with Cable-Driven Robots Using a Two-Phase Calibration Procedure

Automating precision subtasks such as debridement (removing dead or diseased tissue fragments) with Robotic Surgical Assistants (RSAs) such as the da Vinci Research Kit (dVRK) is challenging due to inherent non-linearities in cable-driven systems. We propose and evaluate a novel two-phase coarse-to-fine calibration method. In Phase I (coarse), we place a red calibration marker on the end effector and let it randomly move through a set of open-loop trajectories to obtain a large sample set of camera pixels and internal robot end-effector configurations. This coarse data is then used to train a Deep Neural Network (DNN) to learn the coarse transformation bias. In Phase II (fine), the bias from Phase I is applied to move the end-effector toward a small set of specific target points on a printed sheet. For each target, a human operator manually adjusts the end-effector position by direct contact (not through teleoperation) and the residual compensation bias is recorded. This fine data is then used to train a Random Forest (RF) to learn the fine transformation bias. Subsequent experiments suggest that without calibration, position errors average 4.55mm. Phase I can reduce average error to 2.14mm and the combination of Phase I and Phase II can reduces average error to 1.08mm. We apply these results to debridement of raisins and pumpkin seeds as fragment phantoms. Using an endoscopic stereo camera with standard edge detection, experiments with 120 trials achieved average success rates of 94.5%, exceeding prior results with much larger fragments (89.4%) and achieving a speedup of 2.1x, decreasing time per fragment from 15.8 seconds to 7.3 seconds. Source code, data, and videos are available at https://sites.google.com/view/calib-icra/.Comment: Code, data, and videos are available at https://sites.google.com/view/calib-icra/. Final version for ICRA 201

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