Development of force displaying device using pneumatic parallel manipulator and application to palpation motion

&#60;P&#62;The goal of this study is to develop a mechanical system which display elastic characteristic like stiffness on the surface of human body aiming at applying to palpation simulator. Pneumatic parallel manipulator is employed as a driving mechanism, consequently, it brings capability of minute force displaying property owing to the air compressibility. Compliance control system without using force/moment sensor is constructed by introducing a disturbance observer and a compliance display scheme is proposed. The validity of the proposed scheme is verified experimentally. </p

Development of compliance displaying device using pneumatic parallel manipulator

The goal of this study is to develop a mechanical system that can display elastic characteristic of an object aiming at the application in the field of virtual reality. Pneumatic parallel manipulator is introduced as a driving mechanism, which, consequently, brings capability of minute force displaying property owing to the air compressibility. Compliance displaying scheme based on the contact force and contact point detection is proposed. The validity of the proposed scheme is verified experimentally. </p

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

Active link mechanisms for physical man-machine interaction

&lt;p&gt;In this paper, we propose a new type of haptic interface, named active link mechanism. This device realizes physical man-machine interaction (PMI) between machines and persons. Two prototypes were developed to demonstrate the potential of the active link mechanisms. Developed interface devices are an active tetrahedron and an active icosahedron. Nine-DOF micro spherical joints and pressure control pneumatic cylinders were developed to realize the active tetrahedron, while fifteen-DOF micro spherical joints and intelligent pneumatic cylinders were developed for the active icosahedron. The tetrahedron successfully realizes &quot;virtual touch&quot;; the operators feel actions, forces, and shapes of the virtual objects in PC and also move and deform them. Real time PMI is realized by building the developed devices into MSC.Visual-Nastran4D. MSC.VisuaI-Nastran4D is a mechanism analysis software, which can make motion analysis in real time. The active icosahedron also realized dynamic interaction with virtual objects in PC, showing the potential of the devices as a haptic interface.&lt;/p&gt;</p

Robotic simulators for tissue examination training with multimodal sensory feedback

Tissue examination by hand remains an essential technique in clinical practice. The effective application depends on skills in sensorimotor coordination, mainly involving haptic, visual, and auditory feedback. The skills clinicians have to learn can be as subtle as regulating finger pressure with breathing, choosing palpation action, monitoring involuntary facial and vocal expressions in response to palpation, and using pain expressions both as a source of information and as a constraint on physical examination. Patient simulators can provide a safe learning platform to novice physicians before trying real patients. This paper reviews state-of-the-art medical simulators for the training for the first time with a consideration of providing multimodal feedback to learn as many manual examination techniques as possible. The study summarizes current advances in tissue examination training devices simulating different medical conditions and providing different types of feedback modalities. Opportunities with the development of pain expression, tissue modeling, actuation, and sensing are also analyzed to support the future design of effective tissue examination simulators

Teleoperation of MRI-Compatible Robots with Hybrid Actuation and Haptic Feedback

Image guided surgery (IGS), which has been developing fast recently, benefits significantly from the superior accuracy of robots and magnetic resonance imaging (MRI) which is a great soft tissue imaging modality. Teleoperation is especially desired in the MRI because of the highly constrained space inside the closed-bore MRI and the lack of haptic feedback with the fully autonomous robotic systems. It also very well maintains the human in the loop that significantly enhances safety. This dissertation describes the development of teleoperation approaches and implementation on an example system for MRI with details of different key components. The dissertation firstly describes the general teleoperation architecture with modular software and hardware components. The MRI-compatible robot controller, driving technology as well as the robot navigation and control software are introduced. As a crucial step to determine the robot location inside the MRI, two methods of registration and tracking are discussed. The first method utilizes the existing Z shaped fiducial frame design but with a newly developed multi-image registration method which has higher accuracy with a smaller fiducial frame. The second method is a new fiducial design with a cylindrical shaped frame which is especially suitable for registration and tracking for needles. Alongside, a single-image based algorithm is developed to not only reach higher accuracy but also run faster. In addition, performance enhanced fiducial frame is also studied by integrating self-resonant coils. A surgical master-slave teleoperation system for the application of percutaneous interventional procedures under continuous MRI guidance is presented. The slave robot is a piezoelectric-actuated needle insertion robot with fiber optic force sensor integrated. The master robot is a pneumatic-driven haptic device which not only controls the position of the slave robot, but also renders the force associated with needle placement interventions to the surgeon. Both of master and slave robots mechanical design, kinematics, force sensing and feedback technologies are discussed. Force and position tracking results of the master-slave robot are demonstrated to validate the tracking performance of the integrated system. MRI compatibility is evaluated extensively. Teleoperated needle steering is also demonstrated under live MR imaging. A control system of a clinical grade MRI-compatible parallel 4-DOF surgical manipulator for minimally invasive in-bore prostate percutaneous interventions through the patient’s perineum is discussed in the end. The proposed manipulator takes advantage of four sliders actuated by piezoelectric motors and incremental rotary encoders, which are compatible with the MRI environment. Two generations of optical limit switches are designed to provide better safety features for real clinical use. The performance of both generations of the limit switch is tested. MRI guided accuracy and MRI-compatibility of whole robotic system is also evaluated. Two clinical prostate biopsy cases have been conducted with this assistive robot

Cable-driven parallel mechanisms for minimally invasive robotic surgery

Minimally invasive surgery (MIS) has revolutionised surgery by providing faster recovery times, less post-operative complications, improved cosmesis and reduced pain for the patient. Surgical robotics are used to further decrease the invasiveness of procedures, by using yet smaller and fewer incisions or using natural orifices as entry point. However, many robotic systems still suffer from technical challenges such as sufficient instrument dexterity and payloads, leading to limited adoption in clinical practice. Cable-driven parallel mechanisms (CDPMs) have unique properties, which can be used to overcome existing challenges in surgical robotics. These beneficial properties include high end-effector payloads, efficient force transmission and a large configurable instrument workspace. However, the use of CDPMs in MIS is largely unexplored. This research presents the first structured exploration of CDPMs for MIS and demonstrates the potential of this type of mechanism through the development of multiple prototypes: the ESD CYCLOPS, CDAQS, SIMPLE, neuroCYCLOPS and microCYCLOPS. One key challenge for MIS is the access method used to introduce CDPMs into the body. Three different access methods are presented by the prototypes. By focusing on the minimally invasive access method in which CDPMs are introduced into the body, the thesis provides a framework, which can be used by researchers, engineers and clinicians to identify future opportunities of CDPMs in MIS. Additionally, through user studies and pre-clinical studies, these prototypes demonstrate that this type of mechanism has several key advantages for surgical applications in which haptic feedback, safe automation or a high payload are required. These advantages, combined with the different access methods, demonstrate that CDPMs can have a key role in the advancement of MIS technology.Open Acces

Design, Development, and Evaluation of a Teleoperated Master-Slave Surgical System for Breast Biopsy under Continuous MRI Guidance

The goal of this project is to design and develop a teleoperated master-slave surgical system that can potentially assist the physician in performing breast biopsy with a magnetic resonance imaging (MRI) compatible robotic system. MRI provides superior soft-tissue contrast compared to other imaging modalities such as computed tomography or ultrasound and is used for both diagnostic and therapeutic procedures. The strong magnetic field and the limited space inside the MRI bore, however, restrict direct means of breast biopsy while performing real-time imaging. Therefore, current breast biopsy procedures employ a blind targeting approach based on magnetic resonance (MR) images obtained a priori. Due to possible patient involuntary motion or inaccurate insertion through the registration grid, such approach could lead to tool tip positioning errors thereby affecting diagnostic accuracy and leading to a long and painful process, if repeated procedures are required. Hence, it is desired to develop the aforementioned teleoperation system to take advantages of real-time MR imaging and avoid multiple biopsy needle insertions, improving the procedure accuracy as well as reducing the sampling errors. The design, implementation, and evaluation of the teleoperation system is presented in this dissertation. A MRI-compatible slave robot is implemented, which consists of a 1 degree of freedom (DOF) needle driver, a 3-DOF parallel mechanism, and a 2-DOF X-Y stage. This slave robot is actuated with pneumatic cylinders through long transmission lines except the 1-DOF needle driver is actuated with a piezo motor. Pneumatic actuation through long transmission lines is then investigated using proportional pressure valves and controllers based on sliding mode control are presented. A dedicated master robot is also developed, and the kinematic map between the master and the slave robot is established. The two robots are integrated into a teleoperation system and a graphical user interface is developed to provide visual feedback to the physician. MRI experiment shows that the slave robot is MRI-compatible, and the ex vivo test shows over 85%success rate in targeting with the MRI-compatible robotic system. The success in performing in vivo animal experiments further confirm the potential of further developing the proposed robotic system for clinical applications

Investigating the Feasibility of Using Focussed Airborne Ultrasound as Tactile Feedback in Medical Simulators

Novice medical practitioners commonly practice on live patients in real medical procedures. However, due to the inexperience of the practitioner, mistakes are likely which exposes the patient to undue risk. To improve the training of novices, medical simulators create a virtual patient providing a safe environment for the user to practice within. An important clinical skill is palpation, a physical examination technique. The practitioners use their hands to feel the body of the patient to make diagnosis. A virtual patient has a visual representation but as it is virtual, the patient is not physically present. Haptics technology provide additional benefits to the training session by stimulating the physical sense of touch. A novel technique has recently emerged for stimulating tactile sensation called acoustic radiation pressure from focussed airborne ultrasound. Acoustic radiation creates a focal point of concentrated acoustic pressure in a three-dimensional field producing a force in mid-air. Airborne ultrasound has several advantages over conventional technologies. It was also initially theorised that using airborne ultrasound to simulate palpation compared to a previous system called PalpSim which consists of a rubber tube filled with water permanently embedded in a block of silicone, will offer better controllability over the displayed sensation to simulate various tactile sensations. The thesis has investigated the feasibility of using focussed airborne ultrasound as tactile feedback in medical simulators. A tactile device called UltraSendo was completely custom built to simulate an arterial pulse and a thrill sensation. UltraSendo was integrated with an augmented reality simulator displaying a virtual patient for user interaction. The simulator was brought to Ysbyty Glan Clwyd hospital for user feedback. A wide range of user responses were gathered. The majority of responses felt the arterial pulse was not sufficiently realistic whilst there were higher ratings for the thrill sensation which is acceptably realistic. Positive feedback suggests that airborne ultrasound can indeed provide tactile feedback in a medical context and is better at simulating a thrill sensation compared to a pulse sensation