Estimation of interaction forces in robotic surgery using a semi-supervised deep neural network model

Providing force feedback as a feature in current Robot-Assisted Minimally Invasive Surgery systems still remains a challenge. In recent years, Vision-Based Force Sensing (VBFS) has emerged as a promising approach to address this problem. Existing methods have been developed in a Supervised Learning (SL) setting. Nonetheless, most of the video sequences related to robotic surgery are not provided with ground-truth force data, which can be easily acquired in a controlled environment. A powerful approach to process unlabeled video sequences and find a compact representation for each video frame relies on using an Unsupervised Learning (UL) method. Afterward, a model trained in an SL setting can take advantage of the available ground-truth force data. In the present work, UL and SL techniques are used to investigate a model in a Semi-Supervised Learning (SSL) framework, consisting of an encoder network and a Long-Short Term Memory (LSTM) network. First, a Convolutional Auto-Encoder (CAE) is trained to learn a compact representation for each RGB frame in a video sequence. To facilitate the reconstruction of high and low frequencies found in images, this CAE is optimized using an adversarial framework and a L1-loss, respectively. Thereafter, the encoder network of the CAE is serially connected with an LSTM network and trained jointly to minimize the difference between ground-truth and estimated force data. Datasets addressing the force estimation task are scarce. Therefore, the experiments have been validated in a custom dataset. The results suggest that the proposed approach is promising.Peer ReviewedPostprint (author's final draft

Estimating and understanding motion : from diagnostic to robotic surgery

Estimating and understanding motion from an image sequence is a central topic in computer vision. The high interest in this topic is because we are living in a world where many events that occur in the environment are dynamic. This makes motion estimation and understanding a natural component and a key factor in a widespread of applications including object recognition , 3D shape reconstruction, autonomous navigation and medica! diagnosis. Particularly, we focus on the medical domain in which understanding the human body for clinical purposes requires retrieving the organs' complex motion patterns, which is in general a hard problem when using only image data. In this thesis, we cope with this problem by posing the question - How to achieve a realistic motion estimation to offer a better clinical understanding? We focus this thesis on answering this question by using a variational formulation as a basis to understand one of the most complex motions in the human's body, the heart motion, through three different applications: (i) cardiac motion estimation for diagnostic, (ii) force estimation and (iii) motion prediction, both for robotic surgery. Firstly, we focus on a central topic in cardiac imaging that is the estimation of the cardiac motion. The main aim is to offer objective and understandable measures to physicians for helping them in the diagnostic of cardiovascular diseases. We employ ultrafast ultrasound data and tools for imaging motion drawn from diverse areas such as low-rank analysis and variational deformation to perform a realistic cardiac motion estimation. The significance is that by taking low-rank data with carefully chosen penalization, synergies in this complex variational problem can be created. We demonstrate how our proposed solution deals with complex deformations through careful numerical experiments using realistic and simulated data. We then move from diagnostic to robotic surgeries where surgeons perform delicate procedures remotely through robotic manipulators without directly interacting with the patients. As a result, they lack force feedback, which is an important primary sense for increasing surgeon-patient transparency and avoiding injuries and high mental workload. To solve this problem, we follow the conservation principies of continuum mechanics in which it is clear that the change in shape of an elastic object is directly proportional to the force applied. Thus, we create a variational framework to acquire the deformation that the tissues undergo due to an applied force. Then, this information is used in a learning system to find the nonlinear relationship between the given data and the applied force. We carried out experiments with in-vivo and ex-vivo data and combined statistical, graphical and perceptual analyses to demonstrate the strength of our solution. Finally, we explore robotic cardiac surgery, which allows carrying out complex procedures including Off-Pump Coronary Artery Bypass Grafting (OPCABG). This procedure avoids the associated complications of using Cardiopulmonary Bypass (CPB) since the heart is not arrested while performing the surgery on a beating heart. Thus, surgeons have to deal with a dynamic target that compromisetheir dexterity and the surgery's precision. To compensate the heart motion, we propase a solution composed of three elements: an energy function to estimate the 3D heart motion, a specular highlight detection strategy and a prediction approach for increasing the robustness of the solution. We conduct evaluation of our solution using phantom and realistic datasets. We conclude the thesis by reporting our findings on these three applications and highlight the dependency between motion estimation and motion understanding at any dynamic event, particularly in clinical scenarios.L’estimació i comprensió del moviment dins d’una seqüència d’imatges és un tema central en la visió per ordinador, el que genera un gran interès perquè vivim en un entorn ple d’esdeveniments dinàmics. Per aquest motiu és considerat com un component natural i factor clau dins d’un ampli ventall d’aplicacions, el qual inclou el reconeixement d’objectes, la reconstrucció de formes tridimensionals, la navegació autònoma i el diagnòstic de malalties. En particular, ens situem en l’àmbit mèdic en el qual la comprensió del cos humà, amb finalitats clíniques, requereix l’obtenció de patrons complexos de moviment dels òrgans. Aquesta és, en general, una tasca difícil quan s’utilitzen només dades de tipus visual. En aquesta tesi afrontem el problema plantejant-nos la pregunta - Com es pot aconseguir una estimació realista del moviment amb l’objectiu d’oferir una millor comprensió clínica? La tesi se centra en la resposta mitjançant l’ús d’una formulació variacional com a base per entendre un dels moviments més complexos del cos humà, el del cor, a través de tres aplicacions: (i) estimació del moviment cardíac per al diagnòstic, (ii) estimació de forces i (iii) predicció del moviment, orientant-se les dues últimes en cirurgia robòtica. En primer lloc, ens centrem en un tema principal en la imatge cardíaca, que és l’estimació del moviment cardíac. L’objectiu principal és oferir als metges mesures objectives i comprensibles per ajudar-los en el diagnòstic de les malalties cardiovasculars. Fem servir dades d’ultrasons ultraràpids i eines per al moviment d’imatges procedents de diverses àrees, com ara l’anàlisi de baix rang i la deformació variacional, per fer una estimació realista del moviment cardíac. La importància rau en que, en prendre les dades de baix rang amb una penalització acurada, es poden crear sinergies en aquest problema variacional complex. Mitjançant acurats experiments numèrics, amb dades realístiques i simulades, hem demostrat com les nostres propostes solucionen deformacions complexes. Després passem del diagnòstic a la cirurgia robòtica, on els cirurgians realitzen procediments delicats remotament, a través de manipuladors robòtics, sense interactuar directament amb els pacients. Com a conseqüència, no tenen la percepció de la força com a resposta, que és un sentit primari important per augmentar la transparència entre el cirurgià i el pacient, per evitar lesions i per reduir la càrrega de treball mental. Resolem aquest problema seguint els principis de conservació de la mecànica del medi continu, en els quals està clar que el canvi en la forma d’un objecte elàstic és directament proporcional a la força aplicada. Per això hem creat un marc variacional que adquireix la deformació que pateixen els teixits per l’aplicació d’una força. Aquesta informació s’utilitza en un sistema d’aprenentatge, per trobar la relació no lineal entre les dades donades i la força aplicada. Hem dut a terme experiments amb dades in-vivo i ex-vivo i hem combinat l’anàlisi estadístic, gràfic i de percepció que demostren la robustesa de la nostra solució. Finalment, explorem la cirurgia cardíaca robòtica, la qual cosa permet realitzar procediments complexos, incloent la cirurgia coronària sense bomba (off-pump coronary artery bypass grafting o OPCAB). Aquest procediment evita les complicacions associades a l’ús de circulació extracorpòria (Cardiopulmonary Bypass o CPB), ja que el cor no s’atura mentre es realitza la cirurgia. Això comporta que els cirurgians han de tractar amb un objectiu dinàmic que compromet la seva destresa i la precisió de la cirurgia. Per compensar el moviment del cor, proposem una solució composta de tres elements: un funcional d’energia per estimar el moviment tridimensional del cor, una estratègia de detecció de les reflexions especulars i una aproximació basada en mètodes de predicció, per tal d’augmentar la robustesa de la solució. L’avaluació de la nostra solució s’ha dut a terme mitjançant conjunts de dades sintètiques i realistes. La tesi conclou informant dels nostres resultats en aquestes tres aplicacions i posant de relleu la dependència entre l’estimació i la comprensió del moviment en qualsevol esdeveniment dinàmic, especialment en escenaris clínics.Postprint (published version

Toward Force Estimation in Robot-Assisted Surgery using Deep Learning with Vision and Robot State

Knowledge of interaction forces during teleoperated robot-assisted surgery could be used to enable force feedback to human operators and evaluate tissue handling skill. However, direct force sensing at the end-effector is challenging because it requires biocompatible, sterilizable, and cost-effective sensors. Vision-based deep learning using convolutional neural networks is a promising approach for providing useful force estimates, though questions remain about generalization to new scenarios and real-time inference. We present a force estimation neural network that uses RGB images and robot state as inputs. Using a self-collected dataset, we compared the network to variants that included only a single input type, and evaluated how they generalized to new viewpoints, workspace positions, materials, and tools. We found that vision-based networks were sensitive to shifts in viewpoints, while state-only networks were robust to changes in workspace. The network with both state and vision inputs had the highest accuracy for an unseen tool, and was moderately robust to changes in viewpoints. Through feature removal studies, we found that using only position features produced better accuracy than using only force features as input. The network with both state and vision inputs outperformed a physics-based baseline model in accuracy. It showed comparable accuracy but faster computation times than a baseline recurrent neural network, making it better suited for real-time applications.Comment: 7 pages, 6 figures, submitted to ICRA 202

Supervised Deep Learning with Finite Element Synthetic Data for Force Estimation in Robotic-assisted Surgery

The prevalence of robot-assisted minimally invasive surgery on the liver has increased exponentially. Having accurate, real-time knowledge of force during robotic-assisted surgical procedures is vital for safe surgery. Many techniques have been proposed in the literature to tackle this concern, from deploying force sensors to physics-based modeling of the robot and, more recently, learning-based force prediction. For a high-fidelity force measurement, sensors should be integrated at the instrument's tip, close to the surgical site, which brings sterilization, biocompatibility, and MRI compatibility concerns. On the other hand, Dynamic robot modeling may be precise in a specific setting, but it suffers from the lack of generalization encountering unseen settings. Considering the drawbacks and deficits of mentioned methods, indirect force estimation via deflection measurement through imaging techniques is investigated as an alternative solution, generally done via machine learning methods. Almost all previous studies are either supervised learning, where data are labeled with ex-vivo ground truth, or unsupervised or semi-supervised learning, where outcomes are promising but not adequate. This study investigated indirect force prediction for the human liver through a developed deep autoencoder model as a supervised deep learning method trained via synthetic data generated by finite element (FE) simulation. This method took advantage of various patient-specific livers parameters and geometries extracted from CT images. The Hyperelastic modeling of the soft tissue is considered and assessed with various hyperelastic models. The uncertainty due to the surgical tool's occlusion is addressed in this model, and a novel state vector was proposed to improve the accuracy and generalisability of the prediction. In addition, the impact of the bounded region on the model's accuracy was evaluated. It was shown that the proposed method could predict the external force on an unseen tissue with different geometry and mechanical properties. The accuracy of force prediction considering tool occlusion noise diminishes by 4.2 percent, which is in an acceptable range. The accuracy of presented model for various scenarios ranges from 95 to 88 percent. Model's results have been evaluated by predicting the force encountering the surface deformation of an unseen liver geometry and constitutive model where the mean absolute error of prediction is 0.249 Newton

Gesture Recognition and Control for Semi-Autonomous Robotic Assistant Surgeons

The next stage for robotics development is to introduce autonomy and cooperation with human agents in tasks that require high levels of precision and/or that exert considerable physical strain. To guarantee the highest possible safety standards, the best approach is to devise a deterministic automaton that performs identically for each operation. Clearly, such approach inevitably fails to adapt itself to changing environments or different human companions. In a surgical scenario, the highest variability happens for the timing of different actions performed within the same phases. This thesis explores the solutions adopted in pursuing automation in robotic minimally-invasive surgeries (R-MIS) and presents a novel cognitive control architecture that uses a multi-modal neural network trained on a cooperative task performed by human surgeons and produces an action segmentation that provides the required timing for actions while maintaining full phase execution control via a deterministic Supervisory Controller and full execution safety by a velocity-constrained Model-Predictive Controller

Gesture Recognition in Robotic Surgery: a Review

OBJECTIVE: Surgical activity recognition is a fundamental step in computer-assisted interventions. This paper reviews the state-of-the-art in methods for automatic recognition of fine-grained gestures in robotic surgery focusing on recent data-driven approaches and outlines the open questions and future research directions. METHODS: An article search was performed on 5 bibliographic databases with combinations of the following search terms: robotic, robot-assisted, JIGSAWS, surgery, surgical, gesture, fine-grained, surgeme, action, trajectory, segmentation, recognition, parsing. Selected articles were classified based on the level of supervision required for training and divided into different groups representing major frameworks for time series analysis and data modelling. RESULTS: A total of 52 articles were reviewed. The research field is showing rapid expansion, with the majority of articles published in the last 4 years. Deep-learning-based temporal models with discriminative feature extraction and multi-modal data integration have demonstrated promising results on small surgical datasets. Currently, unsupervised methods perform significantly less well than the supervised approaches. CONCLUSION: The development of large and diverse open-source datasets of annotated demonstrations is essential for development and validation of robust solutions for surgical gesture recognition. While new strategies for discriminative feature extraction and knowledge transfer, or unsupervised and semi-supervised approaches, can mitigate the need for data and labels, they have not yet been demonstrated to achieve comparable performance. Important future research directions include detection and forecast of gesture-specific errors and anomalies. SIGNIFICANCE: This paper is a comprehensive and structured analysis of surgical gesture recognition methods aiming to summarize the status of this rapidly evolving field

A recurrent convolutional neural network approach for sensorless force estimation in robotic surgery

Providing force feedback as relevant information in current Robot-Assisted Minimally Invasive Surgery systems constitutes a technological challenge due to the constraints imposed by the surgical environment. In this context, force estimation techniques represent a potential solution, enabling to sense the interaction forces between the surgical instruments and soft-tissues. Specifically, if visual feedback is available for observing soft-tissues’ deformation, this feedback can be used to estimate the forces applied to these tissues. To this end, a force estimation model, based on Convolutional Neural Networks and Long-Short Term Memory networks, is proposed in this work. This model is designed to process both, the spatiotemporal information present in video sequences and the temporal structure of tool data (the surgical tool-tip trajectory and its grasping status). A series of analyses are carried out to reveal the advantages of the proposal and the challenges that remain for real applications. This research work focuses on two surgical task scenarios, referred to as pushing and pulling tissue. For these two scenarios, different input data modalities and their effect on the force estimation quality are investigated. These input data modalities are tool data, video sequences and a combination of both. The results suggest that the force estimation quality is better when both, the tool data and video sequences, are processed by the neural network model. Moreover, this study reveals the need for a loss function, designed to promote the modeling of smooth and sharp details found in force signals. Finally, the results show that the modeling of forces due to pulling tasks is more challenging than for the simplest pushing actions.Peer ReviewedPostprint (author's final draft