An Asynchronous Simulation Framework for Multi-User Interactive Collaboration: Application to Robot-Assisted Surgery

The field of surgery is continually evolving as there is always room for improvement in the post-operative health of the patient as well as the comfort of the Operating Room (OR) team. While the success of surgery is contingent upon the skills of the surgeon and the OR team, the use of specialized robots has shown to improve surgery-related outcomes in some cases. These outcomes are currently measured using a wide variety of metrics that include patient pain and recovery, surgeon’s comfort, duration of the operation and the cost of the procedure. There is a need for additional research to better understand the optimal criteria for benchmarking surgical performance. Presently, surgeons are trained to perform robot-assisted surgeries using interactive simulators. However, in the absence of well-defined performance standards, these simulators focus primarily on the simulation of the operative scene and not the complexities associated with multiple inputs to a real-world surgical procedure. Because interactive simulators are typically designed for specific robots that perform a small number of tasks controlled by a single user, they are inflexible in terms of their portability to different robots and the inclusion of multiple operators (e.g., nurses, medical assistants). Additionally, while most simulators provide high-quality visuals, simplification techniques are often employed to avoid stability issues for physics computation, contact dynamics and multi-manual interaction. This study addresses the limitations of existing simulators by outlining various specifications required to develop techniques that mimic real-world interactions and collaboration. Moreover, this study focuses on the inclusion of distributed control, shared task allocation and assistive feedback -- through machine learning, secondary and tertiary operators -- alongside the primary human operator

Soft Gloves: A Review on Recent Developments in Actuation, Sensing, Control and Applications

Interest in soft gloves, both robotic and haptic, has enormously grown over the past decade, due to their inherent compliance, which makes them particularly suitable for direct interaction with the human hand. Robotic soft gloves have been developed for hand rehabilitation, for ADLs assistance, or sometimes for both. Haptic soft gloves may be applied in virtual reality (VR) applications or to give sensory feedback in combination with prostheses or to control robots. This paper presents an updated review of the state of the art of soft gloves, with a particular focus on actuation, sensing, and control, combined with a detailed analysis of the devices according to their application field. The review is organized on two levels: a prospective review allows the highlighting of the main trends in soft gloves development and applications, and an analytical review performs an in-depth analysis of the technical solutions developed and implemented in the revised scientific research. Additional minor evaluations integrate the analysis, such as a synthetic investigation of the main results in the clinical studies and trials referred in literature which involve soft gloves

Haptics: Science, Technology, Applications

This open access book constitutes the proceedings of the 12th International Conference on Human Haptic Sensing and Touch Enabled Computer Applications, EuroHaptics 2020, held in Leiden, The Netherlands, in September 2020. The 60 papers presented in this volume were carefully reviewed and selected from 111 submissions. The were organized in topical sections on haptic science, haptic technology, and haptic applications. This year's focus is on accessibility

Investigating the Effects of Subclinical Neck Pain, Cervical Treatment, and Neck Muscle Fatigue on Wrist Joint Position Sense

The purpose of this work was to evaluate the effects of neck pain, cervical treatment, and neck muscle fatigue on joint position sense of the wrist. 12 healthy participants and 12 participants with chronic subclinical neck pain were recruited. Participants took part in two sessions, separated by 48 hours. On the first day, participants preformed two wrist proprioception sessions using a haptic robotic device separated by an isometric cervical extensor fatigue protocol. On the second day participants performed an additional two proprioception sessions, this time separated either by a neck treatment (pain group) or 20 minutes of rest (control group). Each session consisted of 12 trials; 6 in wrist flexion and 6 in wrist extension. Matching error, error bias and variability were measured for each trial. Kinematic data for each trial was recorded from the robotic device and analyzed. Results showed significantly higher error scores for the pain group when compared to the control group at baseline (p=<0.05). Joint position error scores increased significantly in the control group after the fatigue protocol (p= <0.05). Error scores for the pain group decreased significantly after a single treatment session (p= <0.05). This study confirms that altered afferent input from the neck (due to pain and/or fatigue) can influence wrist joint position sense (JPS). Furthermore, the results suggest that a single treatment can improve wrist JPS accuracy

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

Touch Technology in Affective Human, Robot, Virtual-Human Interactions: A Survey

Given the importance of affective touch in human interactions, technology designers are increasingly attempting to bring this modality to the core of interactive technology. Advances in haptics and touch-sensing technology have been critical to fostering interest in this area. In this survey, we review how affective touch is investigated to enhance and support the human experience with or through technology. We explore this question across three different research areas to highlight their epistemology, main findings, and the challenges that persist. First, we review affective touch technology through the human–computer interaction literature to understand how it has been applied to the mediation of human–human interaction and its roles in other human interactions particularly with oneself, augmented objects/media, and affect-aware devices. We further highlight the datasets and methods that have been investigated for automatic detection and interpretation of affective touch in this area. In addition, we discuss the modalities of affective touch expressions in both humans and technology in these interactions. Second, we separately review how affective touch has been explored in human–robot and real-human–virtual-human interactions where the technical challenges encountered and the types of experience aimed at are different. We conclude with a discussion of the gaps and challenges that emerge from the review to steer research in directions that are critical for advancing affective touch technology and recognition systems. In our discussion, we also raise ethical issues that should be considered for responsible innovation in this growing area

Haptics: Science, Technology, Applications

This open access book constitutes the proceedings of the 12th International Conference on Human Haptic Sensing and Touch Enabled Computer Applications, EuroHaptics 2020, held in Leiden, The Netherlands, in September 2020. The 60 papers presented in this volume were carefully reviewed and selected from 111 submissions. The were organized in topical sections on haptic science, haptic technology, and haptic applications. This year's focus is on accessibility

Modeling of frictional forces during bare-finger interactions with solid surfaces

Touching an object with our fingers yields frictional forces that allow us to perceive and explore its texture, shape, and other features, facilitating grasping and manipulation. While the relevance of dynamic frictional forces to sensory and motor function in the hand is well established, the way that they reflect the shape, features, and composition of touched objects is poorly understood. Haptic displays -electronic interfaces for stimulating the sense of touch- often aim to elicit the perceptual experience of touching real surfaces by delivering forces to the fingers that mimic those felt when touching real surfaces. However, the design and applications of such displays have been limited by the lack of knowledge about what forces are felt during real touch interactions. This represents a major gap in current knowledge about tactile function and haptic engineering. This dissertation addresses some aspects that would assist in their understanding. The goal of this research was to measure, characterize, and model frictional forces produced by a bare finger sliding over surfaces of multiple shapes. The major contributions of this work are (1) the design and development of a sensing system for capturing fingertip motion and forces during tactile exploration of real surfaces; (2) measurement and characterization of contact forces and the deformation of finger tissues during sliding over relief surfaces; (3) the development of a low order model of frictional force production based on surface specifications; (4) the analysis and modeling of contact geometry, interfacial mechanics, and their effects in frictional force production during tactile exploration of relief surfaces. This research aims to guide the design of algorithms for the haptic rendering of surface textures and shape. Such algorithms can be used to enhance human-machine interfaces, such as touch-screen displays, by (1) enabling users to feel surface characteristics also presented visually; (2) facilitating interaction with these devices; and (3) reducing the need for visual input to interact with them.Ph.D., Electrical Engineering -- Drexel University, 201

Touching on elements for a non-invasive sensory feedback system for use in a prosthetic hand

Hand amputation results in the loss of motor and sensory functions, impacting activities of daily life and quality of life. Commercially available prosthetic hands restore the motor function but lack sensory feedback, which is crucial to receive information about the prosthesis state in real-time when interacting with the external environment. As a supplement to the missing sensory feedback, the amputee needs to rely on visual and audio cues to operate the prosthetic hand, which can be mentally demanding. This thesis revolves around finding potential solutions to contribute to an intuitive non-invasive sensory feedback system that could be cognitively less burdensome and enhance the sense of embodiment (the feeling that an artificial limb belongs to one’s own body), increasing acceptance of wearing a prosthesis.A sensory feedback system contains sensors to detect signals applied to the prosthetics. The signals are encoded via signal processing to resemble the detected sensation delivered by actuators on the skin. There is a challenge in implementing commercial sensors in a prosthetic finger. Due to the prosthetic finger’s curvature and the fact that some prosthetic hands use a covering rubber glove, the sensor response would be inaccurate. This thesis shows that a pneumatic touch sensor integrated into a rubber glove eliminates these errors. This sensor provides a consistent reading independent of the incident angle of stimulus, has a sensitivity of 0.82 kPa/N, a hysteresis error of 2.39±0.17%, and a linearity error of 2.95±0.40%.For intuitive tactile stimulation, it has been suggested that the feedback stimulus should be modality-matched with the intention to provide a sensation that can be easily associated with the real touch on the prosthetic hand, e.g., pressure on the prosthetic finger should provide pressure on the residual limb. A stimulus should also be spatially matched (e.g., position, size, and shape). Electrotactile stimulation has the ability to provide various sensations due to it having several adjustable parameters. Therefore, this type of stimulus is a good candidate for discrimination of textures. A microphone can detect texture-elicited vibrations to be processed, and by varying, e.g., the median frequency of the electrical stimulation, the signal can be presented on the skin. Participants in a study using electrotactile feedback showed a median accuracy of 85% in differentiating between four textures.During active exploration, electrotactile and vibrotactile feedback provide spatially matched modality stimulations, providing continuous feedback and providing a displaced sensation or a sensation dispatched on a larger area. Evaluating commonly used stimulation modalities using the Rubber Hand Illusion, modalities which resemble the intended sensation provide a more vivid illusion of ownership for the rubber hand.For a potentially more intuitive sensory feedback, the stimulation can be somatotopically matched, where the stimulus is experienced as being applied on a site corresponding to their missing hand. This is possible for amputees who experience referred sensation on their residual stump. However, not all amputees experience referred sensations. Nonetheless, after a structured training period, it is possible to learn to associate touch with specific fingers, and the effect persisted after two weeks. This effect was evaluated on participants with intact limbs, so it remains to evaluate this effect for amputees.In conclusion, this thesis proposes suggestions on sensory feedback systems that could be helpful in future prosthetic hands to (1) reduce their complexity and (2) enhance the sense of body ownership to enhance the overall sense of embodiment as an addition to an intuitive control system