Vision-Based Autonomous Control in Robotic Surgery

Robotic Surgery has completely changed surgical procedures. Enhanced dexterity, ergonomics, motion scaling, and tremor filtering, are well-known advantages introduced with respect to classical laparoscopy. In the past decade, robotic plays a fundamental role in Minimally Invasive Surgery (MIS) in which the da Vinci robotic system (Intuitive Surgical Inc., Sunnyvale, CA) is the most widely used system for robot-assisted laparoscopic procedures. Robots also have great potentiality in Microsurgical applications, where human limits are crucial and surgical sub-millimetric gestures could have enormous benefits with motion scaling and tremor compensation. However, surgical robots still lack advanced assistive control methods that could notably support surgeon's activity and perform surgical tasks in autonomy for a high quality of intervention. In this scenario, images are the main feedback the surgeon can use to correctly operate in the surgical site. Therefore, in view of the increasing autonomy in surgical robotics, vision-based techniques play an important role and can arise by extending computer vision algorithms to surgical scenarios. Moreover, many surgical tasks could benefit from the application of advanced control techniques, allowing the surgeon to work under less stressful conditions and performing the surgical procedures with more accuracy and safety. The thesis starts from these topics, providing surgical robots the ability to perform complex tasks helping the surgeon to skillfully manipulate the robotic system to accomplish the above requirements. An increase in safety and a reduction in mental workload is achieved through the introduction of active constraints, that can prevent the surgical tool from crossing a forbidden region and similarly generate constrained motion to guide the surgeon on a specific path, or to accomplish robotic autonomous tasks. This leads to the development of a vision-based method for robot-aided dissection procedure allowing the control algorithm to autonomously adapt to environmental changes during the surgical intervention using stereo images elaboration. Computer vision is exploited to define a surgical tools collision avoidance method that uses Forbidden Region Virtual Fixtures by rendering a repulsive force to the surgeon. Advanced control techniques based on an optimization approach are developed, allowing multiple tasks execution with task definition encoded through Control Barrier Functions (CBFs) and enhancing haptic-guided teleoperation system during suturing procedures. The proposed methods are tested on a different robotic platform involving da Vinci Research Kit robot (dVRK) and a new microsurgical robotic platform. Finally, the integration of new sensors and instruments in surgical robots are considered, including a multi-functional tool for dexterous tissues manipulation and different visual sensing technologies

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 Asynchronous Simulation Framework for Multi-User Interactive Collaboration: Application to Robot-Assisted Surgery

The field of surgery is continually evolving as there is always room for improvement in the post-operative health of the patient as well as the comfort of the Operating Room (OR) team. While the success of surgery is contingent upon the skills of the surgeon and the OR team, the use of specialized robots has shown to improve surgery-related outcomes in some cases. These outcomes are currently measured using a wide variety of metrics that include patient pain and recovery, surgeon’s comfort, duration of the operation and the cost of the procedure. There is a need for additional research to better understand the optimal criteria for benchmarking surgical performance. Presently, surgeons are trained to perform robot-assisted surgeries using interactive simulators. However, in the absence of well-defined performance standards, these simulators focus primarily on the simulation of the operative scene and not the complexities associated with multiple inputs to a real-world surgical procedure. Because interactive simulators are typically designed for specific robots that perform a small number of tasks controlled by a single user, they are inflexible in terms of their portability to different robots and the inclusion of multiple operators (e.g., nurses, medical assistants). Additionally, while most simulators provide high-quality visuals, simplification techniques are often employed to avoid stability issues for physics computation, contact dynamics and multi-manual interaction. This study addresses the limitations of existing simulators by outlining various specifications required to develop techniques that mimic real-world interactions and collaboration. Moreover, this study focuses on the inclusion of distributed control, shared task allocation and assistive feedback -- through machine learning, secondary and tertiary operators -- alongside the primary human operator

Haptics in Robot-Assisted Surgery: Challenges and Benefits

Robotic surgery is transforming the current surgical practice, not only by improving the conventional surgical methods but also by introducing innovative robot-enhanced approaches that broaden the capabilities of clinicians. Being mainly of man-machine collaborative type, surgical robots are seen as media that transfer pre- and intra-operative information to the operator and reproduce his/her motion, with appropriate filtering, scaling, or limitation, to physically interact with the patient. The field, however, is far from maturity and, more critically, is still a subject of controversy in medical communities. Limited or absent haptic feedback is reputed to be among reasons that impede further spread of surgical robots. In this paper objectives and challenges of deploying haptic technologies in surgical robotics is discussed and a systematic review is performed on works that have studied the effects of providing haptic information to the users in major branches of robotic surgery. It has been tried to encompass both classical works and the state of the art approaches, aiming at delivering a comprehensive and balanced survey both for researchers starting their work in this field and for the experts

Human-Robot Team Interaction Through Wearable Haptics for Cooperative Manipulation

The interaction of robot teams and single human in teleoperation scenarios is beneficial in cooperative tasks, for example the manipulation of heavy and large objects in remote or dangerous environments. The main control challenge of the interaction is its asymmetry, arising because robot teams have a relatively high number of controllable degrees of freedom compared to the human operator. Therefore, we propose a control scheme that establishes the interaction on spaces of reduced dimensionality taking into account the low number of human command and feedback signals imposed by haptic devices. We evaluate the suitability of wearable haptic fingertip devices for multi-contact teleoperation in a user study. The results show that the proposed control approach is appropriate for human-robot team interaction and that the wearable haptic fingertip devices provide suitable assistance in cooperative manipulation tasks

The Shape of Damping: Optimizing Damping Coefficients to Improve Transparency on Bilateral Telemanipulation

This thesis presents a novel optimization-based passivity control algorithm for hapticenabled bilateral teleoperation systems involving multiple degrees of freedom. In particular, in the context of energy-bounding control, the contribution focuses on the implementation of a passivity layer for an existing time-domain scheme, ensuring optimal transparency of the interaction along subsets of the environment space which are preponderant for the given task, while preserving the energy bounds required for passivity. The involved optimization problem is convex and amenable to real-time implementation. The effectiveness of the proposed design is validated via an experiment performed on a virtual teleoperated environment. The interplay between transparency and stability is a critical aspect in haptic-enabled bilateral teleoperation control. While it is important to present the user with the true impedance of the environment, destabilizing factors such as time delays, stiff environments, and a relaxed grasp on the master device may compromise the stability and safety of the system. Passivity has been exploited as one of the the main tools for providing sufficient conditions for stable teleoperation in several controller design approaches, such as the scattering algorithm, timedomain passivity control, energy bounding algorithm, and passive set position modulation. In this work it is presented an innovative energy-based approach, which builds upon existing time-domain passivity controllers, improving and extending their effectiveness and functionality. The set of damping coefficients are prioritized in each degree of freedom, the resulting transparency presents a realistic force feedback in comparison to the other directions. Thus, the prioritization takes effect using a quadratic programming algorithm to find the optimal values for the damping. Finally, the energy tanks approach on passivity control is a solution used to ensure stability in a system for robotics bilateral manipulation. The bilateral telemanipulation must maintain the principle of passivity in all moments to preserve the system\u2019s stability. This work presents a brief introduction to haptic devices as a master component on the telemanipulation chain; the end effector in the slave side is a representation of an interactive object within an environment having a force sensor as feedback signal. The whole interface is designed into a cross-platform framework named ROS, where the user interacts with the system. Experimental results are presented

Telelocomotion—remotely operated legged robots

© 2020 by the authors. Li-censee MDPI, Basel, Switzerland. Teleoperated systems enable human control of robotic proxies and are particularly amenable to inaccessible environments unsuitable for autonomy. Examples include emergency response, underwater manipulation, and robot assisted minimally invasive surgery. However, teleoperation architectures have been predominantly employed in manipulation tasks, and are thus only useful when the robot is within reach of the task. This work introduces the idea of extending teleoperation to enable online human remote control of legged robots, or telelocomotion, to traverse challenging terrain. Traversing unpredictable terrain remains a challenge for autonomous legged locomotion, as demonstrated by robots commonly falling in high-profile robotics contests. Telelocomotion can reduce the risk of mission failure by leveraging the high-level understanding of human operators to command in real-time the gaits of legged robots. In this work, a haptic telelocomotion interface was developed. Two within-user studies validate the proof-of-concept interface: (i) The first compared basic interfaces with the haptic interface for control of a simulated hexapedal robot in various levels of traversal complexity; (ii) the second presents a physical implementation and investigated the efficacy of the proposed haptic virtual fixtures. Results are promising to the use of haptic feedback for telelocomotion for complex traversal tasks

Cutaneous Force Feedback as a Sensory Subtraction Technique in Haptics

A novel sensory substitution technique is presented. Kinesthetic and cutaneous force feedback are substituted by cutaneous feedback (CF) only, provided by two wearable devices able to apply forces to the index finger and the thumb, while holding a handle during a teleoperation task. The force pattern, fed back to the user while using the cutaneous devices, is similar, in terms of intensity and area of application, to the cutaneous force pattern applied to the finger pad while interacting with a haptic device providing both cutaneous and kinesthetic force feedback. The pattern generated using the cutaneous devices can be thought as a subtraction between the complete haptic feedback (HF) and the kinesthetic part of it. For this reason, we refer to this approach as sensory subtraction instead of sensory substitution. A needle insertion scenario is considered to validate the approach. The haptic device is connected to a virtual environment simulating a needle insertion task. Experiments show that the perception of inserting a needle using the cutaneous-only force feedback is nearly indistinguishable from the one felt by the user while using both cutaneous and kinesthetic feedback. As most of the sensory substitution approaches, the proposed sensory subtraction technique also has the advantage of not suffering from stability issues of teleoperation systems due, for instance, to communication delays. Moreover, experiments show that the sensory subtraction technique outperforms sensory substitution with more conventional visual feedback (VF)

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