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

Robot Control for Remote Ophthalmology and Pediatric Physical Rehabilitation

The development of a robotic slit-lamp for remote ophthalmology is the primary purpose of this work. In addition to novel mechanical designs and implementation, it was also a goal to develop a control system that was flexible enough to be adapted with minimal user adjustment to various styles and configurations of slit-lamps. The system was developed with intentions of commercialization, so common hardware was used for all components to minimize the costs. In order to improve performance using this low-cost hardware, investigations were made to attempt to achieve better performance by applying control theory algorithms in the system software. Ultimately, the controller was to be flexible enough to be applied to other areas of human-robot interaction including pediatric rehabilitation via the use of humanoid robotic aids. This application especially requires a robust controller to facilitate safe interaction. Though all of the prototypes were successfully developed and made to work sufficiently with the control hardware, the application of advanced control did not yield notable gains as was hoped. Further investigations were made attempting to alter the performance of the control system, but the components selected did not have the physical capabilities for improved response above the original software implemented. Despite this disappointment, numerous novel advances were made in the area of teleoperated ophthalmic technology and pediatric physical rehabilitation tools. This includes a system that is used to remote control a slit-lamp and lens for examinations and some laser procedures. Secondly, a series of of humanoid systems suitable for both medical research and therapeutic modeling were developed. This included a robotic face used as an interactive system for ophthalmic testing and training. It can also be used as one component in an interactive humanoid robotic system that includes hands and arms to allow use of teaching sign language, social skills or modeling occupational therapy tasks. Finally, a humanoid system is presented that can serve as a customized surrogate between a therapist and client to model physical therapy tasks in a realistic manner. These systems are all functional, safe and low-cost to allow for feasible implementation with patients in the near future

Microsurgery robots: addressing the needs of high-precision surgical interventions

Robots can help surgeons perform better quality operations, leading to reductions in the hospitalisation time of patients and in the impact of surgery on their postoperative quality of life

Mobile assistive technologies for the visually impaired

There are around 285 million visually impaired people worldwide, and around 370,000 people are registered as blind or partially sighted in the UK. Ongoing advances in information technology (IT) are increasing the scope for IT-based mobile assistive technologies to facilitate the independence, safety, and improved quality of life of the visually impaired. Research is being directed at making mobile phones and other handheld devices accessible via our haptic (touch) and audio sensory channels. We review research and innovation within the field of mobile assistive technology for the visually impaired and, in so doing, highlight the need for successful collaboration between clinical expertise, computer science, and domain users to realize fully the potential benefits of such technologies. We initially reflect on research that has been conducted to make mobile phones more accessible to people with vision loss. We then discuss innovative assistive applications designed for the visually impaired that are either delivered via mainstream devices and can be used while in motion (e.g., mobile phones) or are embedded within an environment that may be in motion (e.g., public transport) or within which the user may be in motion (e.g., smart homes)

Steady-Hand Eye Robot 3.0: Optimization and Benchtop Evaluation for Subretinal Injection

Subretinal injection methods and other procedures for treating retinal conditions and diseases (many considered incurable) have been limited in scope due to limited human motor control. This study demonstrates the next generation, cooperatively controlled Steady-Hand Eye Robot (SHER 3.0), a precise and intuitive-to-use robotic platform achieving clinical standards for targeting accuracy and resolution for subretinal injections. The system design and basic kinematics are reported and a deflection model for the incorporated delta stage and validation experiments are presented. This model optimizes the delta stage parameters, maximizing the global conditioning index and minimizing torsional compliance. Five tests measuring accuracy, repeatability, and deflection show the optimized stage design achieves a tip accuracy of <30 $\mu$m, tip repeatability of 9.3 $\mu$m and 0.02{\deg}, and deflections between 20-350 $\mu$m/N. Future work will use updated control models to refine tip positioning outcomes and will be tested on in vivo animal models

Gamification Strategies as Socialization Tools in the Context of Paediatric Hospitalization

[ES] En la presente tesis doctoral se aborda el problema de la socialización de los pacientes pediátricos en el contexto de su ingreso hospitalario, estudiando las posibilidades de mejorar este ámbito de la salud del paciente mediante diversas estrategias y herramientas tecnológicas teniendo en cuenta la problemática planteada y las dificultades propias del contexto. En primer lugar, se realizará una evaluación del estado del arte, así como una justificación de la problemática existente, planteando claramente los objetivos e hipótesis del presente trabajo, así como la metodología seguida. A continuación, se presentarán las diferentes herramientas implementadas y evaluadas, analizando los resultados obtenidos y situándolos en su contexto y marco tecnológico. Estas herramientas, que combinan actividades y aplicaciones presenciales, remotas o híbridas, implementan diferentes estrategias para poder valorar cuáles son las más adecuadas o que presentan un mayor impacto en el paciente. Tras esto, se propone un modelo de diseño basado en los resultados obtenidos en estudios anteriores, así como su posible aplicación en diferentes ámbitos, discutiendo el mismo y justificando las decisiones de diseño adoptadas. Finalmente, se establecerán las conclusiones obtenidas tras el análisis de los resultados y se plantearán cuáles son las posibles aplicaciones y trabajos futuros relacionados con el trabajo realizado en el marco de la tesis doctoral.[CA] Aquesta tesi doctoral aborda el problema de la socialització dels pacients pediàtrics durant la seua estada hospitalària, i s'estudien les possibilitats de millorar aquest àmbit de la salut del pacient mitjançant diverses estratègies i eines tecnològiques, considerant la problemàtica plantejada i les dificultats pròpies de l'entorn. En primer lloc, es realitzarà una avaluació de l'estat de l'art, així com una justificació de la problemàtica existent, i es plantejaran clarament els objectius i la hipòtesi del treball, així com la metodologia emprada. Seguidament, es presentaran les diferents eines implementades i avaluades, analitzant els resultats obtinguts i situant-los al seu context i marc tecnològic. Aquestes eines, que combinen activitats i aplicacions presencials, remotes o híbrides, implementen diferents estratègies per a poder valorar quines són les més adients, o les que presenten un major impacte en el pacient. A continuació, es proposa un model de disseny basat en els resultats obtinguts als estudis previs, així com la seua possible aplicació en diferents àmbits, discutint el model i justificant les decisions de disseny adoptades. Finalment, s'establiran les conclusions obtingudes després d'analitzar els resultats i es plantejaran les possibles aplicacions i treballs futurs relacionats amb els continguts desenvolupats durant la tesi doctoral.[EN] In this document, the problems for socialization for pediatric patients in the context of their hospital internment are considered, analyzing the possibilities of improving this aspect of the patient's health through the use of different strategies and technological tools considering the difficulties posed by the environment and the context. In the first place, an evaluation of the state of the literature and a justification of the existing problematic will be presented, clearly stating the objectives and hypothesis of this work, and also the methodology that has been followed. Afterwards, the different tools that have been implemented and evaluated will be described, analyzing the obtained results and placing them in their context and technological frame. These tools, that combine physically placed activities and applications with remote or hybrid ones, implement different strategies in order to be able to analyze which are the most convenient or the ones that show a higher benefit for the patient. In the following section, a design model, which is based on the results obtained in the previous studies, is proposed, with the justification of the design decisions made and a description of different applications and contexts in which the proposed model could be useful. Finally, the conclusions obtained after the analysis of the results will be presented, and a short discussion about possible applications and future related works will be done.Thanks to the Ministry for Education, that have funded my research through grant FPU17/03333Montaner Marco, J. (2023). Gamification Strategies as Socialization Tools in the Context of Paediatric Hospitalization [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/20155

A 5-DOFs Robot for Posterior Segment Eye Microsurgery

In retinal surgery clinicians access the internal volume of the eyeball through small scale trocar ports, typically 0.65 mm in diameter, to treat vitreoretinal disorders like idiopathic epiretinal membrane and age-related macular holes. The treatment of these conditions involves the removal of thin layers of diseased tissue, namely the epiretinal membrane and the internal limiting membrane. These membranes have an average thickness of only 60 &#x03BC;m and 2 &#x03BC;m respectively making extremely challenging even for expert clinicians to peel without damaging the surrounding tissue. In this work we present a novel Ophthalmic microsurgery Robot (OmSR) designed to operate a standard surgical forceps used in these procedures with micrometric precision, overcoming the limitations of current robotic systems associated with the offsetting of the remote centre of motion of the end effector when accessing the sclera. The design of the proposed system is presented, and its performance evaluated. The results show that the end effector can be controlled with an accuracy of less than 30 &#x03BC;m and the surgical forceps opening and closing positional error is less than 4.3 &#x03BC;m. Trajectory-following experiments and membrane peeling experiments are also presented, showing promising results in both scenarios