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

Design and control of components-based integrated servo pneumatic drives

On-off traditional pneumatic drives are most widely used in industry offering low-cost, simple but flexible mechanical operation and relatively high power to weight ratio. For a period of decade from mid 1980's to 1990's, some initiatives were made to develop servo pneumatic drives for most sophisticated applications, employing purpose-designed control valves for pneumatic drives and low friction cylinders. However, it is found that the high cost and complex installation have discouraged the manufacturer from applying servo pneumatic drives to industrial usage, making them less favourable in comparison to their electric counterpart. This research aims to develop low-cost servo pneumatic drives which are capable of point-to-point positioning tasks, suitable for applications requiring intermediate performance characteristics. In achieving this objective, a strategy that involves the use of traditional on-off valve, simple control algorithm and distributed field-bus control networks has been adopted, namely, the design and control of Components-based Integrated Pneumatic Drives (CIPDs). Firstly, a new pneumatic actuator servo motion control strategy has been developed. With the new motion control strategy, the processes of positioning a payload can be achieved by opening the control valve only once. Hence, lowspeed on-off pneumatic control valves can be employed in keeping the cost low, a key attraction for employing pneumatic drives. The new servo motion control strategy also provides a way of controlling the load motion speed mechanically. Meanwhile, a new PD-based three-state closed-loop control algorithm also has been developed for the new control scheme. This control algorithm provides a way of adapting traditional PID (Proportional Integral Derivative) control theories for regulating pneumatic drives. Moreover, a deceleration control strategy has been developed so that both high-speed and accurate positioning control can be realised with low cost pneumatic drives. Secondly, the effects of system parameters on the transient response are studied. In assisting the analysis, a second order model is developed to encapsulate the velocity response characteristics of pneumatic drives to a step input signal. Stability analyses for both open loop and closed-loop control have also been carried out for the CIPDs with the newly developed motion control strategy. Thirdly, a distributed control strategy employing Lon Works has been devised and implemented, offering desirable attributes, high re-configurability, low cost and easy in installation and maintenance, etc to keep with the traditional strength for using pneumatic drives. By applying this technology, the CIPDs become standard components in "real" and "virtual" design environments. A remote service strategy for CIPDs using TCP/IP communication protocol has also been developed. Subsequently a range of experimental verifications has been carried out in the research. The experimental study of high-speed motion control indicates that the deceleration control strategy developed in the research can be an effective method in improving the behaviour of high speed CIPDs. The verification of open loop system behaviour of CIPDs shows that the model derived is largely indicative of the likely behaviour for the system considered, and the steady state velocity can be estimated using the Velocity Gain Kv. The evaluation made on a pneumatically driven pick-and-place machine has also confirmed that the system setup, including wiring, tuning, and system reconfiguration can be achieved in relative ease. This pilot study reveals the potential for employing CIPDs in building highly flexible cost effective manufacturing machines. It can thus be concluded that this research has developed successfully a new dimension and knowledge in both theoretical and practical terms in building low-cost servo pneumatic drives, which are capable of point-to-point positioning through employing traditional on-off pneumatic valves and actuators and through their integration with distributed control technology (LonWorks) by adopting a component-based design paradigm

Medical Robotics for use in MRI Guided Endoscopy

Interventional Magnetic Resonance Imaging (MRI) is a developing field that aims to provide intra-operative MRI to a clinician to guide diagnostic or therapeutic medical procedures. MRI provides excellent soft tissue contrast at sub-millimetre resolution in both 2D and 3D without the need for ionizing radiation. Images can be acquired in near real-time for guidance purposes. Operating in the MR environment brings challenges due to the high static magnetic field, switching magnetic field gradients and RF excitation pulses. In addition high field closed bore scanners have spatial constraints that severely limit access to the patient. This thesis presents a system for MRI-guided Endoscopic Retrograde Cholangio-pancreatography (ERCP). This includes a remote actuation system that enables an MRI-compatible endoscope to be controlled whilst the patient is inside the MRI scanner, overcoming the spatial and procedural constraints imposed by the closed scanner bore. The modular system utilises non-magnetic ultrasonic motors and is designed for image-guided user-in-the-loop control. A novel miniature MRI compatible clutch has been incorporated into the design to reduce the need for multiple parallel motors. The actuation system is MRI compatible does not degrade the MR images below acceptable levels. User testing showed that the actuation system requires some degree of training but enables completion of a simulated ERCP procedure with no loss of performance. This was demonstrated using a tailored ERCP simulator and kinematic assessment tool, which was validated with users from a range of skill levels to ensure that it provides an objective measurement of endoscopic skill. Methods of tracking the endoscope in real-time using the MRI scanner are explored and presented here. Use of the MRI-guided ERCP system was shown to improve the operator’s ability to position the endoscope in an experimental environment compared with a standard fluoroscopic-guided system.Open Acces

Design, fabrication, and testing of micromachined silicone rubbermembrane valves

Technologies for fabricating silicone rubber membranes and integrating them with other processes on silicon wafers have been developed. Silicone rubber has been found to have exceptional mechanical properties including low modulus, high elongation, and good sealing. Thermopneumatically actuated, normally open, silicone rubber membrane valves with optimized components have been designed, fabricated, and tested. Suspended silicon nitride membrane heaters have been developed for low-power thermopneumatic actuation. Composite silicone rubber on Parylene valve membranes have been shown to have low permeability and modulus. Also, novel valve seats were designed to improve sealing in the presence of particles. The valves have been extensively characterized with respect to power consumption versus flow rate and transient response. Low power consumption, high flow rate, and high pressure have been demonstrated. For example, less than 40 mW is required to switch a 1-slpm nitrogen flow at 33 psi. Water requires dose to 100 mW due to the cooling effect of the liquid

Functionally-Graded Soft Robotic Actuators

The goal of this project is to design, analyze, and fabricate a pneumatically powered, functionally-graded soft robotic actuator made of a polymer embedded with nanoparticles, and later attach three of them to a hand-sized gripper assembly for object distribution. This was accomplished through finite element analysis, polymer-nanoparticle mix tensile testing, and construction of a mechanical arm controlled by a wearable gesture controller. Results show that the functionally-graded actuator produces 1.6 times the lateral force output and twice the displacement than the 15wt% control actuator

Space shuttle OMS helium regulator design and development

Analysis, design, fabrication and design verification testing was conducted on the technological feasiblity of the helium pressurization regulator for the space shuttle orbital maneuvering system application. A prototype regulator was fabricated which was a single-stage design featuring the most reliable and lowest cost concept. A tradeoff study on regulator concepts indicated that a single-stage regulator with a lever arm between the valve and the actuator section would offer significant weight savings. Damping concepts were tested to determine the amount of damping required to restrict actuator travel during vibration. Component design parameters such as spring rates, effective area, contamination cutting, and damping were determined by test prior to regulator final assembly. The unit was subjected to performance testing at widely ranging flow rates, temperatures, inlet pressures, and random vibration levels. A test plan for propellant compatibility and extended life tests is included

Use of McKibben muscle in a haptic interface

One of the most relevant issues in the development of a haptic interface is the choice of the actuators that are devoted to generating the reflection forces. This work has been particularly focused on the employment of the McKibben muscle to this aim. A prototype of one finger has been realized that is intended to be part of a haptic glove, and is based on an articulated mechanism driven by a McKibben muscle. A dynamic model of the finger has been created and validated; then, it has been used to define the control algorithm of the device. Experimental tests highlighted the static and dynamic effectiveness of the device and proved that a McKibben muscle can be appropriately used in such an application

Fiber-optic breath sensors: A comparison study

The paper presents a comparative study of three fiber optic sensors based on the fiber Bragg grating (FBG). The basic monitored parameter is the respiratory rate of the human body. Fiber-optic sensors are immune to electromagnetic interference (EMI). This fact singles them out as ideal for use in magnetic resonance environments (typically in MRI -magnetic resonance imaging) as a prediction of hyperventilation states in patients. These patient conditions arise as a result of the closed tunnel environment in MR scanners. The results (10 volunteers with written consent) were compared with the results using the conventional respiratory belt (RB) in a laboratory environment and processed using the objective Bland-Altman (B-A) method.Web of Science40635