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

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

Measuring the impact of haptic feedback in collaborative robotic scenarios

[EN] In recent years, the interaction of a human operator with teleoperated robotic systems has been much improved. One of the factors influencing this improvement is the addition of force feedback to complement the visual feedback provided by traditional graphical user interfaces. However, the users of these systems performing tasks in isolated and safe environments are often inexperienced and occasional users. In addition, there is no common framework to assess the usability of these systems, due to the heterogeneity of applications and tasks, and therefore, there is a need for new usability assessment methods that are not domain specific. This study addresses this issue by proposing a measure of usability that includes five variables: user efficiency, user effectiveness, mental workload, perceived usefulness, and perceived ease of use. The empirical analysis shows that the integration of haptic feedback improves the usability of these systems for non-expert users, even though the differences are not statistically significant; further, the results suggest that mental workload is higher when haptic feedback is added. The analysis also reveals significant differences between participants depending on gender.SIPublicación en abierto financiada por el Consorcio de Bibliotecas Universitarias de Castilla y León (BUCLE), con cargo al Programa Operativo 2014ES16RFOP009 FEDER 2014-2020 DE CASTILLA Y LEÓN, Actuación:20007-CL - Apoyo Consorcio BUCL

Task Dynamics of Prior Training Influence Visual Force Estimation Ability During Teleoperation

The lack of haptic feedback in Robot-assisted Minimally Invasive Surgery (RMIS) is a potential barrier to safe tissue handling during surgery. Bayesian modeling theory suggests that surgeons with experience in open or laparoscopic surgery can develop priors of tissue stiffness that translate to better force estimation abilities during RMIS compared to surgeons with no experience. To test if prior haptic experience leads to improved force estimation ability in teleoperation, 33 participants were assigned to one of three training conditions: manual manipulation, teleoperation with force feedback, or teleoperation without force feedback, and learned to tension a silicone sample to a set of force values. They were then asked to perform the tension task, and a previously unencountered palpation task, to a different set of force values under teleoperation without force feedback. Compared to the teleoperation groups, the manual group had higher force error in the tension task outside the range of forces they had trained on, but showed better speed-accuracy functions in the palpation task at low force levels. This suggests that the dynamics of the training modality affect force estimation ability during teleoperation, with the prior haptic experience accessible if formed under the same dynamics as the task.Comment: 12 pages, 8 figure

Design of a wearable fingertip haptic device for remote palpation: Characterisation and interface with a virtual environment

© 2018 Tzemanaki, Al, Melhuish and Dogramadzi. This paper presents the development of a wearable Fingertip Haptic Device (FHD) that can provide cutaneous feedback via a Variable Compliance Platform (VCP). The FHD includes an inertial measurement unit, which tracks the motion of the user's finger while its haptic functionality relies on two parameters: pressure in the VCP and its linear displacement towards the fingertip. The combination of these two features results in various conditions of the FHD, which emulate the remote object or surface stiffness properties. Such a device can be used in tele-operation, including virtual reality applications, where rendering the level of stiffness of different physical or virtual materials could provide a more realistic haptic perception to the user. The FHD stiffness representation is characterised in terms of resulting pressure and force applied to the fingertip created through the relationship of the two functional parameters - pressure and displacement of the VCP. The FHD was tested in a series of user studies to assess its potential to create a user perception of the object's variable stiffness. The viability of the FHD as a haptic device has been further confirmed by interfacing the users with a virtual environment. The developed virtual environment task required the users to follow a virtual path, identify objects of different hardness on the path and navigate away from "no-go" zones. The task was performed with and without the use of the variable compliance on the FHD. The results showed improved performance with the presence of the variable compliance provided by the FHD in all assessed categories and particularly in the ability to identify correctly between objects of different hardness

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

Evaluation of sensor configurations for robotic surgical instruments

Designing surgical instruments for robotic-assisted minimally-invasive surgery (RAMIS) is challenging due to constraints on the number and type of sensors imposed by considerations such as space or the need for sterilization. A new method for evaluating the usability of virtual teleoperated surgical instruments based on virtual sensors is presented. This method uses virtual prototyping of the surgical instrument with a dual physical interaction, which allows testing of different sensor configurations in a real environment. Moreover, the proposed approach has been applied to the evaluation of prototypes of a two-finger grasper for lump detection by remote pinching. In this example, the usability of a set of five different sensor configurations, with a different number of force sensors, is evaluated in terms of quantitative and qualitative measures in clinical experiments with 23 volunteers. As a result, the smallest number of force sensors needed in the surgical instrument that ensures the usability of the device can be determined. The details of the experimental setup are also included

A Wave Variable Approach with Multiple Channel Architecture for Teleoperated System

© 2013 IEEE. Performance of teleoperation can be greatly influenced by time delay in the process of tele-manipulation with respect to accuracy and transparency. Wave variable is an effective algorithm to achieve a good stable capability. However, some traditional wave variable methods may decrease the performance of transparency and suffer the impacts of wave reflection. To deal with the problem of stability and transparency in teleoperation, in this paper, a novel wave variable method with four channel is presented to achieve stable tracking in position and force. In addition, the proposed method can achieve the distortion compensation and reduce the impacts of wave reflection. The simulation experimental results verified the tracking performance of the proposed method