sCAM: An Untethered Insertable Laparoscopic Surgical Camera Robot

Fully insertable robotic imaging devices represent a promising future of minimally invasive laparoscopic vision. Emerging research efforts in this field have resulted in several proof-of-concept prototypes. One common drawback of these designs derives from their clumsy tethering wires which not only cause operational interference but also reduce camera mobility. Meanwhile, these insertable laparoscopic cameras are manipulated without any pose information or haptic feedback, which results in open loop motion control and raises concerns about surgical safety caused by inappropriate use of force.This dissertation proposes, implements, and validates an untethered insertable laparoscopic surgical camera (sCAM) robot. Contributions presented in this work include: (1) feasibility of an untethered fully insertable laparoscopic surgical camera, (2) camera-tissue interaction characterization and force sensing, (3) pose estimation, visualization, and feedback with sCAM, and (4) robotic-assisted closed-loop laparoscopic camera control. Borrowing the principle of spherical motors, camera anchoring and actuation are achieved through transabdominal magnetic coupling in a stator-rotor manner. To avoid the tethering wires, laparoscopic vision and control communication are realized with dedicated wireless links based on onboard power. A non-invasive indirect approach is proposed to provide real-time camera-tissue interaction force measurement, which, assisted by camera-tissue interaction modeling, predicts stress distribution over the tissue surface. Meanwhile, the camera pose is remotely estimated and visualized using complementary filtering based on onboard motion sensing. Facilitated by the force measurement and pose estimation, robotic-assisted closed-loop control has been realized in a double-loop control scheme with shared autonomy between surgeons and the robotic controller.The sCAM has brought robotic laparoscopic imaging one step further toward less invasiveness and more dexterity. Initial ex vivo test results have verified functions of the implemented sCAM design and the proposed force measurement and pose estimation approaches, demonstrating the technical feasibility of a tetherless insertable laparoscopic camera. Robotic-assisted control has shown its potential to free surgeons from low-level intricate camera manipulation workload and improve precision and intuitiveness in laparoscopic imaging

Development of A Soft Robotic Approach for An Intra-abdominal Wireless Laparoscopic Camera

In Single-Incision Laparoscopic Surgery (SILS), the Magnetic Anchoring and Guidance System (MAGS) arises as a promising technique to provide larger workspaces and field of vision for the laparoscopes, relief space for other instruments, and require fewer incisions. Inspired by MAGS, many concept designs related to fully insertable magnetically driven laparoscopes are developed and tested on the transabdominal operation. However, ignoring the tissue interaction and insertion procedure, most of the designs adopt rigid structures, which not only damage the patients\u27 tissue with excess stress concentration and sliding motion but also require complicated operation for the insertion. Meanwhile, lacking state tracking of the insertable camera including pose and contact force, the camera systems operate in open-loop control. This provides mediocre locomotion precision and limited robustness to uncertainties in the environment. This dissertation proposes, develops, and validates a soft robotic approach for an intra-abdominal wireless laparoscopic camera. Contributions presented in this work include (1) feasibility of a soft intra-abdominal laparoscopic camera with friendly tissue interaction and convenient insertion, (2) six degrees of freedom (DOF) real-time localization, (3) Closed-loop control for a robotic-assisted laparoscopic system and (4) untethering solution for wireless communication and high-quality video transmission. Embedding magnet pairs into the camera and external actuator, the camera can be steered and anchored along the abdominal wall through transabdominal magnetic coupling. To avoid the tissue rapture by the sliding motion and dry friction, a wheel structure is applied to achieve rolling motion. Borrowing the ideas from soft robotic research, the main body of the camera implements silicone material, which grants it the bendability to passively attach along the curved abdominal wall and the deformability for easier insertion. The six-DOF pose is estimated in real-time with internal multi-sensor fusion and Newton-Raphson iteration. Combining the pose tracking and force-torque sensor measurement, an interaction model between the deformable camera and tissue is established to evaluate the interaction force over the tissue surface. Moreover, the proposed laparoscopic system is integrated with a multi-DOF manipulator into a robotic-assisted surgical system, where a closed-loop control is realized based on a feedback controller and online optimization. Finally, the wireless control and video streaming are accomplished with Bluetooth Low Energy (BLE) and Analog Video (AV) transmission. Experimental assessments have been implemented to evaluate the performance of the laparoscopic system

Development of An In Vivo Robotic Camera for Dexterous Manipulation and Clear Imaging

Minimally invasive surgeriy (MIS) techniques are becoming more popular as replacements for traditional open surgeries. These methods benefit patients with lowering blood loss and post-operative pain, reducing recovery period and hospital stay time, decreasing surgical area scarring and cosmetic issues, and lessening the treatment costs, hence greater patient satisfaction would be earned. Manipulating surgical instruments from outside of abdomen and performing surgery needs precise hand-eye coordination which is provided by insertable cameras. The traditional MIS insertable cameras suffer from port complexity and reduced manipulation dexterity, which leads to defection in Hand-eye coordination and surgical flow. Fully insertable robotic camera systems emerged as a promising solution in MIS. Implementing robotic camera systems faces multiple challenges in fixation, manipulation, orientation control, tool-tissue interaction, in vivo illumination and clear imaging.In this dissertation a novel actuation and control mechanism is developed and validated for an insertable laparoscopic camera. This design uses permanent magnets and coils as force/torque generators in an external control unit to manipulate an in vivo camera capsule. The motorless design of this capsule reduces the, wight, size and power consumption of the driven unit. In order to guarantee the smooth motion of the camera inside the abdominal cavity, an interaction force control method was proposed and validated.Optimizing the system\u27s design, through minimizing the control unit size and power consumption and extending maneuverability of insertable camera, was achieved by a novel transformable design, which uses a single permanent magnet in the control unit. The camera robot uses a permanent magnet as fixation and translation unit, and two embedded motor for tilt motion actuation, as well as illumination actuation. Transformable design provides superior imaging quality through an optimized illumination unit and a cleaning module. The illumination module uses freeform optical lenses to control light beams from the LEDs to achieve optimized illumination over surgical zone. The cleaning module prevents lens contamination through a pump actuated debris prevention system, while mechanically wipes the lens in case of contamination. The performance of transformable design and its modules have been assessed experimentally

Smart Camera Robotic Assistant for Laparoscopic Surgery

The cognitive architecture also includes learning mechanisms to adapt the behavior of the robot to the different ways of working of surgeons, and to improve the robot behavior through experience, in a similar way as a human assistant would do. The theoretical concepts of this dissertation have been validated both through in-vitro experimentation in the labs of medical robotics of the University of Malaga and through in-vivo experimentation with pigs in the IACE Center (Instituto Andaluz de Cirugía Experimental), performed by expert surgeons.In the last decades, laparoscopic surgery has become a daily practice in operating rooms worldwide, which evolution is tending towards less invasive techniques. In this scenario, robotics has found a wide field of application, from slave robotic systems that replicate the movements of the surgeon to autonomous robots able to assist the surgeon in certain maneuvers or to perform autonomous surgical tasks. However, these systems require the direct supervision of the surgeon, and its capacity of making decisions and adapting to dynamic environments is very limited. This PhD dissertation presents the design and implementation of a smart camera robotic assistant to collaborate with the surgeon in a real surgical environment. First, it presents the design of a novel camera robotic assistant able to augment the capacities of current vision systems. This robotic assistant is based on an intra-abdominal camera robot, which is completely inserted into the patient’s abdomen and it can be freely moved along the abdominal cavity by means of magnetic interaction with an external magnet. To provide the camera with the autonomy of motion, the external magnet is coupled to the end effector of a robotic arm, which controls the shift of the camera robot along the abdominal wall. This way, the robotic assistant proposed in this dissertation has six degrees of freedom, which allow providing a wider field of view compared to the traditional vision systems, and also to have different perspectives of the operating area. On the other hand, the intelligence of the system is based on a cognitive architecture specially designed for autonomous collaboration with the surgeon in real surgical environments. The proposed architecture simulates the behavior of a human assistant, with a natural and intuitive human-robot interface for the communication between the robot and the surgeon

Design of a Flexible Control Platform and Miniature in vivo Robots for Laparo-Endoscopic Single-Site Surgeries

Minimally-invasive laparoscopic procedures have proven efficacy for a wide range of surgical procedures as well as benefits such as reducing scarring, infection, recovery time, and post-operative pain. While the procedures have many advantages, there are significant shortcomings such as limited instrument motion and reduced dexterity. In recent years, robotic surgical technology has overcome some of these limitations and has become an effective tool for many types of surgeries. These robotic platforms typically have an increased workspace, greater dexterity, improved ergonomics, and finer control than traditional laparoscopic methods. This thesis presents the designs of both a four degree-of-freedom (DOF) and 5-DOF miniature in vivo surgical robot as well as a software architecture for development and control of such robots. The proposed surgical platform consists of a two-armed robotic prototype, distributed motor control modules, custom robot control software, and remote surgeon console. A plug-in architecture in the control software provides the user a wide range of user input devices and control algorithms, including a numerical inverse kinematics solver, to allow intuitive control and rapid development of future robot prototypes. A variety of experiments performed by a surgeon at the University of Nebraska Medical Center were used to evaluate the performance of the robotic platform. Adviser: Shane Farrito

Anthropomorphic surgical system for soft tissue robot-assisted surgery

Over the past century, abdominal surgery has seen a rapid transition from open procedures to less invasive methods such as laparoscopy and robot-assisted minimally invasive surgery (R-A MIS). These procedures have significantly decreased blood loss, postoperative morbidity and length of hospital stay in comparison with open surgery. R-A MIS has offered refined accuracy and more ergonomic instruments for surgeons, further minimising trauma to the patient.This thesis aims to investigate, design and prototype a novel system for R-A MIS that will provide more natural and intuitive manipulation of soft tissues and, at the same time, increase the surgeon's dexterity. The thesis reviews related work on surgical systems and discusses the requirements for designing surgical instrumentation. From the background research conducted in this thesis, it is clear that training surgeons in MIS procedures is becoming increasingly long and arduous. Furthermore, most available systems adopt a design similar to conventional laparoscopic instruments or focus on different techniques with debatable benefits. The system proposed in this thesis not only aims to reduce the training time for surgeons but also to improve the ergonomics of the procedure.In order to achieve this, a survey was conducted among surgeons, regarding their opinions on surgical training, surgical systems, how satisfied they are with them and how easy they are to use. A concept for MIS robotic instrumentation was then developed and a series of focus group meetings with surgeons were run to discuss it. The proposed system, named microAngelo, is an anthropomorphic master-slave system that comprises a three-digit miniature hand that can be controlled using the master, a three-digit sensory exoskeleton. While multi-fingered robotic hands have been developed for decades, none have been used for surgical operations. As the system has a human centred design, its relation to the human hand is discussed. Prototypes of both the master and the slave have been developed and their design and mechanisms is demonstrated. The accuracy and repeatability of the master as well as the accuracy and force capabilities of the slave are tested and discussed

A flexible access platform for robot-assisted minimally invasive surgery

Advances in Minimally Invasive Surgery (MIS) are driven by the clinical demand to reduce the invasiveness of surgical procedures so patients undergo less trauma and experience faster recoveries. These well documented benefits of MIS have been achieved through parallel advances in the technology and instrumentation used during procedures. The new and evolving field of Flexible Access Surgery (FAS), where surgeons access the operative site through a single incision or a natural orifice incision, is being promoted as the next potential step in the evolution of surgery. In order to achieve similar levels of success and adoption as MIS, technology again has its role to play in developing new instruments to solve the unmet clinical challenges of FAS. As procedures become less invasive, these instruments should not just address the challenges presented by the complex access routes of FAS, but should also build on the recent advances in pre- and intraoperative imaging techniques to provide surgeons with new diagnostic and interventional decision making capabilities. The main focus of this thesis is the development and applications of a flexible robotic device that is capable of providing controlled flexibility along curved pathways inside the body. The principal component of the device is its modular mechatronic joint design which utilises an embedded micromotor-tendon actuation scheme to provide independently addressable degrees of freedom and three internal working channels. Connecting multiple modules together allows a seven degree-of-freedom (DoF) flexible access platform to be constructed. The platform is intended for use as a research test-bed to explore engineering and surgical challenges of FAS. Navigation of the platform is realised using a handheld controller optimised for functionality and ergonomics, or in a "hands-free" manner via a gaze contingent control framework. Under this framework, the operator's gaze fixation point is used as feedback to close the servo control loop. The feasibility and potential of integrating multi-spectral imaging capabilities into flexible robotic devices is also demonstrated. A force adaptive servoing mechanism is developed to simplify the deployment, and improve the consistency of probe-based optical imaging techniques by automatically controlling the contact force between the probe tip and target tissue. The thesis concludes with the description of two FAS case studies performed with the platform during in-vivo porcine experiments. These studies demonstrate the ability of the platform to perform large area explorations within the peritoneal cavity and to provide a stable base for the deployment of interventional instruments and imaging probes

Design of a Flexible Control Platform and Miniature in vivo Robots for Laparo-Endoscopic Single-Site Surgeries

Minimally-invasive laparoscopic procedures have proven efficacy for a wide range of surgical procedures as well as benefits such as reducing scarring, infection, recovery time, and post-operative pain. While the procedures have many advantages, there are significant shortcomings such as limited instrument motion and reduced dexterity. In recent years, robotic surgical technology has overcome some of these limitations and has become an effective tool for many types of surgeries. These robotic platforms typically have an increased workspace, greater dexterity, improved ergonomics, and finer control than traditional laparoscopic methods. This thesis presents the designs of both a four degree-of-freedom (DOF) and 5-DOF miniature in vivo surgical robot as well as a software architecture for development and control of such robots. The proposed surgical platform consists of a two-armed robotic prototype, distributed motor control modules, custom robot control software, and remote surgeon console. A plug-in architecture in the control software provides the user a wide range of user input devices and control algorithms, including a numerical inverse kinematics solver, to allow intuitive control and rapid development of future robot prototypes. A variety of experiments performed by a surgeon at the University of Nebraska Medical Center were used to evaluate the performance of the robotic platform. Adviser: Shane Farrito

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