Vision-Based Autonomous Control in Robotic Surgery

Robotic Surgery has completely changed surgical procedures. Enhanced dexterity, ergonomics, motion scaling, and tremor filtering, are well-known advantages introduced with respect to classical laparoscopy. In the past decade, robotic plays a fundamental role in Minimally Invasive Surgery (MIS) in which the da Vinci robotic system (Intuitive Surgical Inc., Sunnyvale, CA) is the most widely used system for robot-assisted laparoscopic procedures. Robots also have great potentiality in Microsurgical applications, where human limits are crucial and surgical sub-millimetric gestures could have enormous benefits with motion scaling and tremor compensation. However, surgical robots still lack advanced assistive control methods that could notably support surgeon's activity and perform surgical tasks in autonomy for a high quality of intervention. In this scenario, images are the main feedback the surgeon can use to correctly operate in the surgical site. Therefore, in view of the increasing autonomy in surgical robotics, vision-based techniques play an important role and can arise by extending computer vision algorithms to surgical scenarios. Moreover, many surgical tasks could benefit from the application of advanced control techniques, allowing the surgeon to work under less stressful conditions and performing the surgical procedures with more accuracy and safety. The thesis starts from these topics, providing surgical robots the ability to perform complex tasks helping the surgeon to skillfully manipulate the robotic system to accomplish the above requirements. An increase in safety and a reduction in mental workload is achieved through the introduction of active constraints, that can prevent the surgical tool from crossing a forbidden region and similarly generate constrained motion to guide the surgeon on a specific path, or to accomplish robotic autonomous tasks. This leads to the development of a vision-based method for robot-aided dissection procedure allowing the control algorithm to autonomously adapt to environmental changes during the surgical intervention using stereo images elaboration. Computer vision is exploited to define a surgical tools collision avoidance method that uses Forbidden Region Virtual Fixtures by rendering a repulsive force to the surgeon. Advanced control techniques based on an optimization approach are developed, allowing multiple tasks execution with task definition encoded through Control Barrier Functions (CBFs) and enhancing haptic-guided teleoperation system during suturing procedures. The proposed methods are tested on a different robotic platform involving da Vinci Research Kit robot (dVRK) and a new microsurgical robotic platform. Finally, the integration of new sensors and instruments in surgical robots are considered, including a multi-functional tool for dexterous tissues manipulation and different visual sensing technologies

daVinciNet: Joint Prediction of Motion and Surgical State in Robot-Assisted Surgery

This paper presents a technique to concurrently and jointly predict the future trajectories of surgical instruments and the future state(s) of surgical subtasks in robot-assisted surgeries (RAS) using multiple input sources. Such predictions are a necessary first step towards shared control and supervised autonomy of surgical subtasks. Minute-long surgical subtasks, such as suturing or ultrasound scanning, often have distinguishable tool kinematics and visual features, and can be described as a series of fine-grained states with transition schematics. We propose daVinciNet - an end-to-end dual-task model for robot motion and surgical state predictions. daVinciNet performs concurrent end-effector trajectory and surgical state predictions using features extracted from multiple data streams, including robot kinematics, endoscopic vision, and system events. We evaluate our proposed model on an extended Robotic Intra-Operative Ultrasound (RIOUS+) imaging dataset collected on a da Vinci Xi surgical system and the JHU-ISI Gesture and Skill Assessment Working Set (JIGSAWS). Our model achieves up to 93.85% short-term (0.5s) and 82.11% long-term (2s) state prediction accuracy, as well as 1.07mm short-term and 5.62mm long-term trajectory prediction error

daVinciNet: Joint Prediction of Motion and Surgical State in Robot-Assisted Surgery

This paper presents a technique to concurrently and jointly predict the future trajectories of surgical instruments and the future state(s) of surgical subtasks in robot-assisted surgeries (RAS) using multiple input sources. Such predictions are a necessary first step towards shared control and supervised autonomy of surgical subtasks. Minute-long surgical subtasks, such as suturing or ultrasound scanning, often have distinguishable tool kinematics and visual features, and can be described as a series of fine-grained states with transition schematics. We propose daVinciNet - an end-to-end dual-task model for robot motion and surgical state predictions. daVinciNet performs concurrent end-effector trajectory and surgical state predictions using features extracted from multiple data streams, including robot kinematics, endoscopic vision, and system events. We evaluate our proposed model on an extended Robotic Intra-Operative Ultrasound (RIOUS+) imaging dataset collected on a da Vinci Xi surgical system and the JHU-ISI Gesture and Skill Assessment Working Set (JIGSAWS). Our model achieves up to 93.85% short-term (0.5s) and 82.11% long-term (2s) state prediction accuracy, as well as 1.07mm short-term and 5.62mm long-term trajectory prediction error.Comment: Accepted to IROS 202

Robot Assisted Object Manipulation for Minimally Invasive Surgery

Robotic systems have an increasingly important role in facilitating minimally invasive surgical treatments. In robot-assisted minimally invasive surgery, surgeons remotely control instruments from a console to perform operations inside the patient. However, despite the advanced technological status of surgical robots, fully autonomous systems, with decision-making capabilities, are not yet available. In 2017, a structure to classify the research efforts toward autonomy achievable with surgical robots was proposed by Yang et al. Six different levels were identified: no autonomy, robot assistance, task autonomy, conditional autonomy, high autonomy, and full autonomy. All the commercially available platforms in robot-assisted surgery is still in level 0 (no autonomy). Despite increasing the level of autonomy remains an open challenge, its adoption could potentially introduce multiple benefits, such as decreasing surgeons’ workload and fatigue and pursuing a consistent quality of procedures. Ultimately, allowing the surgeons to interpret the ample and intelligent information from the system will enhance the surgical outcome and positively reflect both on patients and society. Three main aspects are required to introduce automation into surgery: the surgical robot must move with high precision, have motion planning capabilities and understand the surgical scene. Besides these main factors, depending on the type of surgery, there could be other aspects that might play a fundamental role, to name some compliance, stiffness, etc. This thesis addresses three technological challenges encountered when trying to achieve the aforementioned goals, in the specific case of robot-object interaction. First, how to overcome the inaccuracy of cable-driven systems when executing fine and precise movements. Second, planning different tasks in dynamically changing environments. Lastly, how the understanding of a surgical scene can be used to solve more than one manipulation task. To address the first challenge, a control scheme relying on accurate calibration is implemented to execute the pick-up of a surgical needle. Regarding the planning of surgical tasks, two approaches are explored: one is learning from demonstration to pick and place a surgical object, and the second is using a gradient-based approach to trigger a smoother object repositioning phase during intraoperative procedures. Finally, to improve scene understanding, this thesis focuses on developing a simulation environment where multiple tasks can be learned based on the surgical scene and then transferred to the real robot. Experiments proved that automation of the pick and place task of different surgical objects is possible. The robot was successfully able to autonomously pick up a suturing needle, position a surgical device for intraoperative ultrasound scanning and manipulate soft tissue for intraoperative organ retraction. Despite automation of surgical subtasks has been demonstrated in this work, several challenges remain open, such as the capabilities of the generated algorithm to generalise over different environment conditions and different patients

Automating Vascular Shunt Insertion with the dVRK Surgical Robot

Vascular shunt insertion is a fundamental surgical procedure used to temporarily restore blood flow to tissues. It is often performed in the field after major trauma. We formulate a problem of automated vascular shunt insertion and propose a pipeline to perform Automated Vascular Shunt Insertion (AVSI) using a da Vinci Research Kit. The pipeline uses a learned visual model to estimate the locus of the vessel rim, plans a grasp on the rim, and moves to grasp at that point. The first robot gripper then pulls the rim to stretch open the vessel with a dilation motion. The second robot gripper then proceeds to insert a shunt into the vessel phantom (a model of the blood vessel) with a chamfer tilt followed by a screw motion. Results suggest that AVSI achieves a high success rate even with tight tolerances and varying vessel orientations up to 30{\deg}. Supplementary material, dataset, videos, and visualizations can be found at https://sites.google.com/berkeley.edu/autolab-avsi