Optical coherence tomography-based consensus definition for lamellar macular hole.

BackgroundA consensus on an optical coherence tomography definition of lamellar macular hole (LMH) and similar conditions is needed.MethodsThe panel reviewed relevant peer-reviewed literature to reach an accord on LMH definition and to differentiate LMH from other similar conditions.ResultsThe panel reached a consensus on the definition of three clinical entities: LMH, epiretinal membrane (ERM) foveoschisis and macular pseudohole (MPH). LMH definition is based on three mandatory criteria and three optional anatomical features. The three mandatory criteria are the presence of irregular foveal contour, the presence of a foveal cavity with undermined edges and the apparent loss of foveal tissue. Optional anatomical features include the presence of epiretinal proliferation, the presence of a central foveal bump and the disruption of the ellipsoid zone. ERM foveoschisis definition is based on two mandatory criteria: the presence of ERM and the presence of schisis at the level of Henle's fibre layer. Three optional anatomical features can also be present: the presence of microcystoid spaces in the inner nuclear layer (INL), an increase of retinal thickness and the presence of retinal wrinkling. MPH definition is based on three mandatory criteria and two optional anatomical features. Mandatory criteria include the presence of a foveal sparing ERM, the presence of a steepened foveal profile and an increased central retinal thickness. Optional anatomical features are the presence of microcystoid spaces in the INL and a normal retinal thickness.ConclusionsThe use of the proposed definitions may provide uniform language for clinicians and future research

Assistance strategies for robotized laparoscopy

Robotizing laparoscopic surgery not only allows achieving better accuracy to operate when a scale factor is applied between master and slave or thanks to the use of tools with 3 DoF, which cannot be used in conventional manual surgery, but also due to additional informatic support. Relying on computer assistance different strategies that facilitate the task of the surgeon can be incorporated, either in the form of autonomous navigation or cooperative guidance, providing sensory or visual feedback, or introducing certain limitations of movements. This paper describes different ways of assistance aimed at improving the work capacity of the surgeon and achieving more safety for the patient, and the results obtained with the prototype developed at UPC.Peer ReviewedPostprint (author's final draft

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

Evaluation of haptic guidance virtual fixtures and 3D visualization methods in telemanipulation—a user study

© 2019, The Author(s). This work presents a user-study evaluation of various visual and haptic feedback modes on a real telemanipulation platform. Of particular interest is the potential for haptic guidance virtual fixtures and 3D-mapping techniques to enhance efficiency and awareness in a simple teleoperated valve turn task. An RGB-Depth camera is used to gather real-time color and geometric data of the remote scene, and the operator is presented with either a monocular color video stream, a 3D-mapping voxel representation of the remote scene, or the ability to place a haptic guidance virtual fixture to help complete the telemanipulation task. The efficacy of the feedback modes is then explored experimentally through a user study, and the different modes are compared on the basis of objective and subjective metrics. Despite the simplistic task and numerous evaluation metrics, results show that the haptic virtual fixture resulted in significantly better collision avoidance compared to 3D visualization alone. Anticipated performance enhancements were also observed moving from 2D to 3D visualization. Remaining comparisons lead to exploratory inferences that inform future direction for focused and statistically significant studies

Improvement of the sensory and autonomous capability of robots through olfaction: the IRO Project

Proyecto de Excelencia Junta de Andalucía TEP2012-530Olfaction is a valuable source of information about the environment that has not been su ciently exploited in mobile robotics yet. Certainly, odor information can contribute to other sensing modalities, e.g. vision, to successfully accomplish high-level robot activities, such as task planning or execution in human environments. This paper describes the developments carried out in the scope of the IRO project, which aims at making progress in this direction by investigating mechanisms that exploit odor information (usually coming in the form of the type of volatile and its concentration) in problems like object recognition and scene-activity understanding. A distinctive aspect of this research is the special attention paid to the role of semantics within the robot perception and decisionmaking processes. The results of the IRO project have improved the robot capabilities in terms of efciency, autonomy and usefulness.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tec

Robotic Ultrasound Imaging: State-of-the-Art and Future Perspectives

Ultrasound (US) is one of the most widely used modalities for clinical intervention and diagnosis due to the merits of providing non-invasive, radiation-free, and real-time images. However, free-hand US examinations are highly operator-dependent. Robotic US System (RUSS) aims at overcoming this shortcoming by offering reproducibility, while also aiming at improving dexterity, and intelligent anatomy and disease-aware imaging. In addition to enhancing diagnostic outcomes, RUSS also holds the potential to provide medical interventions for populations suffering from the shortage of experienced sonographers. In this paper, we categorize RUSS as teleoperated or autonomous. Regarding teleoperated RUSS, we summarize their technical developments, and clinical evaluations, respectively. This survey then focuses on the review of recent work on autonomous robotic US imaging. We demonstrate that machine learning and artificial intelligence present the key techniques, which enable intelligent patient and process-specific, motion and deformation-aware robotic image acquisition. We also show that the research on artificial intelligence for autonomous RUSS has directed the research community toward understanding and modeling expert sonographers' semantic reasoning and action. Here, we call this process, the recovery of the "language of sonography". This side result of research on autonomous robotic US acquisitions could be considered as valuable and essential as the progress made in the robotic US examination itself. This article will provide both engineers and clinicians with a comprehensive understanding of RUSS by surveying underlying techniques.Comment: Accepted by Medical Image Analysi

Aerial-Ground collaborative sensing: Third-Person view for teleoperation

Rapid deployment and operation are key requirements in time critical application, such as Search and Rescue (SaR). Efficiently teleoperated ground robots can support first-responders in such situations. However, first-person view teleoperation is sub-optimal in difficult terrains, while a third-person perspective can drastically increase teleoperation performance. Here, we propose a Micro Aerial Vehicle (MAV)-based system that can autonomously provide third-person perspective to ground robots. While our approach is based on local visual servoing, it further leverages the global localization of several ground robots to seamlessly transfer between these ground robots in GPS-denied environments. Therewith one MAV can support multiple ground robots on a demand basis. Furthermore, our system enables different visual detection regimes, and enhanced operability, and return-home functionality. We evaluate our system in real-world SaR scenarios.Comment: Accepted for publication in 2018 IEEE International Symposium on Safety, Security and Rescue Robotics (SSRR