Optical techniques for 3D surface reconstruction in computer-assisted laparoscopic surgery

One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-opera- tive morphology and motion of soft-tissues. This information is prerequisite to the registration of multi-modal patient-specific data for enhancing the surgeon’s navigation capabilites by observ- ing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted in- struments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This paper reviews the state-of-the-art methods for optical intra-operative 3D reconstruction in laparoscopic surgery and discusses the technical challenges and future perspectives towards clinical translation. With the recent paradigm shift of surgical practice towards MIS and new developments in 3D opti- cal imaging, this is a timely discussion about technologies that could facilitate complex CAS procedures in dynamic and deformable anatomical regions

The cockpit for the 21st century

Interactive surfaces are a growing trend in many domains. As one possible manifestation of Mark Weiser’s vision of ubiquitous and disappearing computers in everywhere objects, we see touchsensitive screens in many kinds of devices, such as smartphones, tablet computers and interactive tabletops. More advanced concepts of these have been an active research topic for many years. This has also influenced automotive cockpit development: concept cars and recent market releases show integrated touchscreens, growing in size. To meet the increasing information and interaction needs, interactive surfaces offer context-dependent functionality in combination with a direct input paradigm. However, interfaces in the car need to be operable while driving. Distraction, especially visual distraction from the driving task, can lead to critical situations if the sum of attentional demand emerging from both primary and secondary task overextends the available resources. So far, a touchscreen requires a lot of visual attention since its flat surface does not provide any haptic feedback. There have been approaches to make direct touch interaction accessible while driving for simple tasks. Outside the automotive domain, for example in office environments, concepts for sophisticated handling of large displays have already been introduced. Moreover, technological advances lead to new characteristics for interactive surfaces by enabling arbitrary surface shapes. In cars, two main characteristics for upcoming interactive surfaces are largeness and shape. On the one hand, spatial extension is not only increasing through larger displays, but also by taking objects in the surrounding into account for interaction. On the other hand, the flatness inherent in current screens can be overcome by upcoming technologies, and interactive surfaces can therefore provide haptically distinguishable surfaces. This thesis describes the systematic exploration of large and shaped interactive surfaces and analyzes their potential for interaction while driving. Therefore, different prototypes for each characteristic have been developed and evaluated in test settings suitable for their maturity level. Those prototypes were used to obtain subjective user feedback and objective data, to investigate effects on driving and glance behavior as well as usability and user experience. As a contribution, this thesis provides an analysis of the development of interactive surfaces in the car. Two characteristics, largeness and shape, are identified that can improve the interaction compared to conventional touchscreens. The presented studies show that large interactive surfaces can provide new and improved ways of interaction both in driver-only and driver-passenger situations. Furthermore, studies indicate a positive effect on visual distraction when additional static haptic feedback is provided by shaped interactive surfaces. Overall, various, non-exclusively applicable, interaction concepts prove the potential of interactive surfaces for the use in automotive cockpits, which is expected to be beneficial also in further environments where visual attention needs to be focused on additional tasks.Der Einsatz von interaktiven Oberflächen weitet sich mehr und mehr auf die unterschiedlichsten Lebensbereiche aus. Damit sind sie eine mögliche Ausprägung von Mark Weisers Vision der allgegenwärtigen Computer, die aus unserer direkten Wahrnehmung verschwinden. Bei einer Vielzahl von technischen Geräten des täglichen Lebens, wie Smartphones, Tablets oder interaktiven Tischen, sind berührungsempfindliche Oberflächen bereits heute in Benutzung. Schon seit vielen Jahren arbeiten Forscher an einer Weiterentwicklung der Technik, um ihre Vorteile auch in anderen Bereichen, wie beispielsweise der Interaktion zwischen Mensch und Automobil, nutzbar zu machen. Und das mit Erfolg: Interaktive Benutzeroberflächen werden mittlerweile serienmäßig in vielen Fahrzeugen eingesetzt. Der Einbau von immer größeren, in das Cockpit integrierten Touchscreens in Konzeptfahrzeuge zeigt, dass sich diese Entwicklung weiter in vollem Gange befindet. Interaktive Oberflächen ermöglichen das flexible Anzeigen von kontextsensitiven Inhalten und machen eine direkte Interaktion mit den Bildschirminhalten möglich. Auf diese Weise erfüllen sie die sich wandelnden Informations- und Interaktionsbedürfnisse in besonderem Maße. Beim Einsatz von Bedienschnittstellen im Fahrzeug ist die gefahrlose Benutzbarkeit während der Fahrt von besonderer Bedeutung. Insbesondere visuelle Ablenkung von der Fahraufgabe kann zu kritischen Situationen führen, wenn Primär- und Sekundäraufgaben mehr als die insgesamt verfügbare Aufmerksamkeit des Fahrers beanspruchen. Herkömmliche Touchscreens stellen dem Fahrer bisher lediglich eine flache Oberfläche bereit, die keinerlei haptische Rückmeldung bietet, weshalb deren Bedienung besonders viel visuelle Aufmerksamkeit erfordert. Verschiedene Ansätze ermöglichen dem Fahrer, direkte Touchinteraktion für einfache Aufgaben während der Fahrt zu nutzen. Außerhalb der Automobilindustrie, zum Beispiel für Büroarbeitsplätze, wurden bereits verschiedene Konzepte für eine komplexere Bedienung großer Bildschirme vorgestellt. Darüber hinaus führt der technologische Fortschritt zu neuen möglichen Ausprägungen interaktiver Oberflächen und erlaubt, diese beliebig zu formen. Für die nächste Generation von interaktiven Oberflächen im Fahrzeug wird vor allem an der Modifikation der Kategorien Größe und Form gearbeitet. Die Bedienschnittstelle wird nicht nur durch größere Bildschirme erweitert, sondern auch dadurch, dass Objekte wie Dekorleisten in die Interaktion einbezogen werden können. Andererseits heben aktuelle Technologieentwicklungen die Restriktion auf flache Oberflächen auf, so dass Touchscreens künftig ertastbare Strukturen aufweisen können. Diese Dissertation beschreibt die systematische Untersuchung großer und nicht-flacher interaktiver Oberflächen und analysiert ihr Potential für die Interaktion während der Fahrt. Dazu wurden für jede Charakteristik verschiedene Prototypen entwickelt und in Testumgebungen entsprechend ihres Reifegrads evaluiert. Auf diese Weise konnten subjektives Nutzerfeedback und objektive Daten erhoben, und die Effekte auf Fahr- und Blickverhalten sowie Nutzbarkeit untersucht werden. Diese Dissertation leistet den Beitrag einer Analyse der Entwicklung von interaktiven Oberflächen im Automobilbereich. Weiterhin werden die Aspekte Größe und Form untersucht, um mit ihrer Hilfe die Interaktion im Vergleich zu herkömmlichen Touchscreens zu verbessern. Die durchgeführten Studien belegen, dass große Flächen neue und verbesserte Bedienmöglichkeiten bieten können. Außerdem zeigt sich ein positiver Effekt auf die visuelle Ablenkung, wenn zusätzliches statisches, haptisches Feedback durch nicht-flache Oberflächen bereitgestellt wird. Zusammenfassend zeigen verschiedene, untereinander kombinierbare Interaktionskonzepte das Potential interaktiver Oberflächen für den automotiven Einsatz. Zudem können die Ergebnisse auch in anderen Bereichen Anwendung finden, in denen visuelle Aufmerksamkeit für andere Aufgaben benötigt wird

Goal Based Human Swarm Interaction for Collaborative Transport

Human-swarm interaction is an important milestone for the introduction of swarm-intelligence based solutions into real application scenarios. One of the main hurdles towards this goal is the creation of suitable interfaces for humans to convey the correct intent to multiple robots. As the size of the swarm increases, the complexity of dealing with explicit commands for individual robots becomes intractable. This brings a great challenge for the developer or the operator to drive robots to finish even the most basic tasks. In our work, we consider a different approach that humans specify only the desired goal rather than issuing individual commands necessary to obtain this task. We explore this approach in a collaborative transport scenario, where the user chooses the target position of an object, and a group of robots moves it by adapting themselves to the environment. The main outcome of this thesis is the design of integration of a collaborative transport behavior of swarm robots and an augmented reality human interface. We implemented an augmented reality (AR) application in which a virtual object is displayed overlapped on a detected target object. Users can manipulate the virtual object to generate the goal configuration for the object. The designed centralized controller translate the goal position to the robots and synchronize the state transitions. The whole system is tested on Khepera IV robots through the integration of Vicon system and ARGoS simulator

Freeform 3D interactions in everyday environments

PhD ThesisPersonal computing is continuously moving away from traditional input using mouse and keyboard, as new input technologies emerge. Recently, natural user interfaces (NUI) have led to interactive systems that are inspired by our physical interactions in the real-world, and focus on enabling dexterous freehand input in 2D or 3D. Another recent trend is Augmented Reality (AR), which follows a similar goal to further reduce the gap between the real and the virtual, but predominately focuses on output, by overlaying virtual information onto a tracked real-world 3D scene. Whilst AR and NUI technologies have been developed for both immersive 3D output as well as seamless 3D input, these have mostly been looked at separately. NUI focuses on sensing the user and enabling new forms of input; AR traditionally focuses on capturing the environment around us and enabling new forms of output that are registered to the real world. The output of NUI systems is mainly presented on a 2D display, while the input technologies for AR experiences, such as data gloves and body-worn motion trackers are often uncomfortable and restricting when interacting in the real world. NUI and AR can be seen as very complimentary, and bringing these two fields together can lead to new user experiences that radically change the way we interact with our everyday environments. The aim of this thesis is to enable real-time, low latency, dexterous input and immersive output without heavily instrumenting the user. The main challenge is to retain and to meaningfully combine the positive qualities that are attributed to both NUI and AR systems. I review work in the intersecting research fields of AR and NUI, and explore freehand 3D interactions with varying degrees of expressiveness, directness and mobility in various physical settings. There a number of technical challenges that arise when designing a mixed NUI/AR system, which I will address is this work: What can we capture, and how? How do we represent the real in the virtual? And how do we physically couple input and output? This is achieved by designing new systems, algorithms, and user experiences that explore the combination of AR and NUI

Microscope Embedded Neurosurgical Training and Intraoperative System

In the recent years, neurosurgery has been strongly influenced by new technologies. Computer Aided Surgery (CAS) offers several benefits for patients\u27 safety but fine techniques targeted to obtain minimally invasive and traumatic treatments are required, since intra-operative false movements can be devastating, resulting in patients deaths. The precision of the surgical gesture is related both to accuracy of the available technological instruments and surgeon\u27s experience. In this frame, medical training is particularly important. From a technological point of view, the use of Virtual Reality (VR) for surgeon training and Augmented Reality (AR) for intra-operative treatments offer the best results. In addition, traditional techniques for training in surgery include the use of animals, phantoms and cadavers. The main limitation of these approaches is that live tissue has different properties from dead tissue and that animal anatomy is significantly different from the human. From the medical point of view, Low-Grade Gliomas (LGGs) are intrinsic brain tumours that typically occur in younger adults. The objective of related treatment is to remove as much of the tumour as possible while minimizing damage to the healthy brain. Pathological tissue may closely resemble normal brain parenchyma when looked at through the neurosurgical microscope. The tactile appreciation of the different consistency of the tumour compared to normal brain requires considerable experience on the part of the neurosurgeon and it is a vital point. The first part of this PhD thesis presents a system for realistic simulation (visual and haptic) of the spatula palpation of the LGG. This is the first prototype of a training system using VR, haptics and a real microscope for neurosurgery. This architecture can be also adapted for intra-operative purposes. In this instance, a surgeon needs the basic setup for the Image Guided Therapy (IGT) interventions: microscope, monitors and navigated surgical instruments. The same virtual environment can be AR rendered onto the microscope optics. The objective is to enhance the surgeon\u27s ability for a better intra-operative orientation by giving him a three-dimensional view and other information necessary for a safe navigation inside the patient. The last considerations have served as motivation for the second part of this work which has been devoted to improving a prototype of an AR stereoscopic microscope for neurosurgical interventions, developed in our institute in a previous work. A completely new software has been developed in order to reuse the microscope hardware, enhancing both rendering performances and usability. Since both AR and VR share the same platform, the system can be referred to as Mixed Reality System for neurosurgery. All the components are open source or at least based on a GPL license

A continuum robotic platform for endoscopic non-contact laser surgery: design, control, and preclinical evaluation

The application of laser technologies in surgical interventions has been accepted in the clinical domain due to their atraumatic properties. In addition to manual application of fibre-guided lasers with tissue contact, non-contact transoral laser microsurgery (TLM) of laryngeal tumours has been prevailed in ENT surgery. However, TLM requires many years of surgical training for tumour resection in order to preserve the function of adjacent organs and thus preserve the patient’s quality of life. The positioning of the microscopic laser applicator outside the patient can also impede a direct line-of-sight to the target area due to anatomical variability and limit the working space. Further clinical challenges include positioning the laser focus on the tissue surface, imaging, planning and performing laser ablation, and motion of the target area during surgery. This dissertation aims to address the limitations of TLM through robotic approaches and intraoperative assistance. Although a trend towards minimally invasive surgery is apparent, no highly integrated platform for endoscopic delivery of focused laser radiation is available to date. Likewise, there are no known devices that incorporate scene information from endoscopic imaging into ablation planning and execution. For focusing of the laser beam close to the target tissue, this work first presents miniaturised focusing optics that can be integrated into endoscopic systems. Experimental trials characterise the optical properties and the ablation performance. A robotic platform is realised for manipulation of the focusing optics. This is based on a variable-length continuum manipulator. The latter enables movements of the endoscopic end effector in five degrees of freedom with a mechatronic actuation unit. The kinematic modelling and control of the robot are integrated into a modular framework that is evaluated experimentally. The manipulation of focused laser radiation also requires precise adjustment of the focal position on the tissue. For this purpose, visual, haptic and visual-haptic assistance functions are presented. These support the operator during teleoperation to set an optimal working distance. Advantages of visual-haptic assistance are demonstrated in a user study. The system performance and usability of the overall robotic system are assessed in an additional user study. Analogous to a clinical scenario, the subjects follow predefined target patterns with a laser spot. The mean positioning accuracy of the spot is 0.5 mm. Finally, methods of image-guided robot control are introduced to automate laser ablation. Experiments confirm a positive effect of proposed automation concepts on non-contact laser surgery.Die Anwendung von Lasertechnologien in chirurgischen Interventionen hat sich aufgrund der atraumatischen Eigenschaften in der Klinik etabliert. Neben manueller Applikation von fasergeführten Lasern mit Gewebekontakt hat sich die kontaktfreie transorale Lasermikrochirurgie (TLM) von Tumoren des Larynx in der HNO-Chirurgie durchgesetzt. Die TLM erfordert zur Tumorresektion jedoch ein langjähriges chirurgisches Training, um die Funktion der angrenzenden Organe zu sichern und damit die Lebensqualität der Patienten zu erhalten. Die Positionierung des mikroskopis chen Laserapplikators außerhalb des Patienten kann zudem die direkte Sicht auf das Zielgebiet durch anatomische Variabilität erschweren und den Arbeitsraum einschränken. Weitere klinische Herausforderungen betreffen die Positionierung des Laserfokus auf der Gewebeoberfläche, die Bildgebung, die Planung und Ausführung der Laserablation sowie intraoperative Bewegungen des Zielgebietes. Die vorliegende Dissertation zielt darauf ab, die Limitierungen der TLM durch robotische Ansätze und intraoperative Assistenz zu adressieren. Obwohl ein Trend zur minimal invasiven Chirurgie besteht, sind bislang keine hochintegrierten Plattformen für die endoskopische Applikation fokussierter Laserstrahlung verfügbar. Ebenfalls sind keine Systeme bekannt, die Szeneninformationen aus der endoskopischen Bildgebung in die Ablationsplanung und -ausführung einbeziehen. Für eine situsnahe Fokussierung des Laserstrahls wird in dieser Arbeit zunächst eine miniaturisierte Fokussieroptik zur Integration in endoskopische Systeme vorgestellt. Experimentelle Versuche charakterisieren die optischen Eigenschaften und das Ablationsverhalten. Zur Manipulation der Fokussieroptik wird eine robotische Plattform realisiert. Diese basiert auf einem längenveränderlichen Kontinuumsmanipulator. Letzterer ermöglicht in Kombination mit einer mechatronischen Aktuierungseinheit Bewegungen des Endoskopkopfes in fünf Freiheitsgraden. Die kinematische Modellierung und Regelung des Systems werden in ein modulares Framework eingebunden und evaluiert. Die Manipulation fokussierter Laserstrahlung erfordert zudem eine präzise Anpassung der Fokuslage auf das Gewebe. Dafür werden visuelle, haptische und visuell haptische Assistenzfunktionen eingeführt. Diese unterstützen den Anwender bei Teleoperation zur Einstellung eines optimalen Arbeitsabstandes. In einer Anwenderstudie werden Vorteile der visuell-haptischen Assistenz nachgewiesen. Die Systemperformanz und Gebrauchstauglichkeit des robotischen Gesamtsystems werden in einer weiteren Anwenderstudie untersucht. Analog zu einem klinischen Einsatz verfolgen die Probanden mit einem Laserspot vorgegebene Sollpfade. Die mittlere Positioniergenauigkeit des Spots beträgt dabei 0,5 mm. Zur Automatisierung der Ablation werden abschließend Methoden der bildgestützten Regelung vorgestellt. Experimente bestätigen einen positiven Effekt der Automationskonzepte für die kontaktfreie Laserchirurgie

Ambient Intelligence for Next-Generation AR

Next-generation augmented reality (AR) promises a high degree of context-awareness - a detailed knowledge of the environmental, user, social and system conditions in which an AR experience takes place. This will facilitate both the closer integration of the real and virtual worlds, and the provision of context-specific content or adaptations. However, environmental awareness in particular is challenging to achieve using AR devices alone; not only are these mobile devices' view of an environment spatially and temporally limited, but the data obtained by onboard sensors is frequently inaccurate and incomplete. This, combined with the fact that many aspects of core AR functionality and user experiences are impacted by properties of the real environment, motivates the use of ambient IoT devices, wireless sensors and actuators placed in the surrounding environment, for the measurement and optimization of environment properties. In this book chapter we categorize and examine the wide variety of ways in which these IoT sensors and actuators can support or enhance AR experiences, including quantitative insights and proof-of-concept systems that will inform the development of future solutions. We outline the challenges and opportunities associated with several important research directions which must be addressed to realize the full potential of next-generation AR.Comment: This is a preprint of a book chapter which will appear in the Springer Handbook of the Metavers