Robot Autonomy for Surgery

Autonomous surgery involves having surgical tasks performed by a robot operating under its own will, with partial or no human involvement. There are several important advantages of automation in surgery, which include increasing precision of care due to sub-millimeter robot control, real-time utilization of biosignals for interventional care, improvements to surgical efficiency and execution, and computer-aided guidance under various medical imaging and sensing modalities. While these methods may displace some tasks of surgical teams and individual surgeons, they also present new capabilities in interventions that are too difficult or go beyond the skills of a human. In this chapter, we provide an overview of robot autonomy in commercial use and in research, and present some of the challenges faced in developing autonomous surgical robots

Trajectory Deformations from Physical Human-Robot Interaction

Robots are finding new applications where physical interaction with a human is necessary: manufacturing, healthcare, and social tasks. Accordingly, the field of physical human-robot interaction (pHRI) has leveraged impedance control approaches, which support compliant interactions between human and robot. However, a limitation of traditional impedance control is that---despite provisions for the human to modify the robot's current trajectory---the human cannot affect the robot's future desired trajectory through pHRI. In this paper, we present an algorithm for physically interactive trajectory deformations which, when combined with impedance control, allows the human to modulate both the actual and desired trajectories of the robot. Unlike related works, our method explicitly deforms the future desired trajectory based on forces applied during pHRI, but does not require constant human guidance. We present our approach and verify that this method is compatible with traditional impedance control. Next, we use constrained optimization to derive the deformation shape. Finally, we describe an algorithm for real time implementation, and perform simulations to test the arbitration parameters. Experimental results demonstrate reduction in the human's effort and improvement in the movement quality when compared to pHRI with impedance control alone

Skill-based human-robot cooperation in tele-operated path tracking

This work proposes a shared-control tele-operation framework that adapts its cooperative properties to the estimated skill level of the operator. It is hypothesized that different aspects of an operatorâ\u80\u99s performance in executing a tele-operated path tracking task can be assessed through conventional machine learning methods using motion-based and task-related features. To identify performance measures that capture motor skills linked to the studied task, an experiment is conducted where users new to tele-operation, practice towards motor skill proficiency in 7 training sessions. A set of classifiers are then learned from the acquired data and selected features, which can generate a skill profile that comprises estimations of userâ\u80\u99s various competences. Skill profiles are exploited to modify the behavior of the assistive robotic system accordingly with the objective of enhancing user experience by preventing unnecessary restriction for skilled users. A second experiment is implemented in which novice and expert users execute the path tracking on different pathways while being assisted by the robot according to their estimated skill profiles. Results validate the skill estimation method and hint at feasibility of shared-control customization in tele-operated path tracking

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

Autonomy Infused Teleoperation with Application to BCI Manipulation

Robot teleoperation systems face a common set of challenges including latency, low-dimensional user commands, and asymmetric control inputs. User control with Brain-Computer Interfaces (BCIs) exacerbates these problems through especially noisy and erratic low-dimensional motion commands due to the difficulty in decoding neural activity. We introduce a general framework to address these challenges through a combination of computer vision, user intent inference, and arbitration between the human input and autonomous control schemes. Adjustable levels of assistance allow the system to balance the operator's capabilities and feelings of comfort and control while compensating for a task's difficulty. We present experimental results demonstrating significant performance improvement using the shared-control assistance framework on adapted rehabilitation benchmarks with two subjects implanted with intracortical brain-computer interfaces controlling a seven degree-of-freedom robotic manipulator as a prosthetic. Our results further indicate that shared assistance mitigates perceived user difficulty and even enables successful performance on previously infeasible tasks. We showcase the extensibility of our architecture with applications to quality-of-life tasks such as opening a door, pouring liquids from containers, and manipulation with novel objects in densely cluttered environments

Expert-in-the-Loop Multilateral Telerobotics for Haptics-Enabled Motor Function and Skills Development

Among medical robotics applications are Robotics-Assisted Mirror Rehabilitation Therapy (RAMRT) and Minimally-Invasive Surgical Training (RAMIST) that extensively rely on motor function development. Haptics-enabled expert-in-the-loop motor function development for such applications is made possible through multilateral telerobotic frameworks. While several studies have validated the benefits of haptic interaction with an expert in motor learning, contradictory results have also been reported. This emphasizes the need for further in-depth studies on the nature of human motor learning through haptic guidance and interaction. The objective of this study was to design and evaluate expert-in-the-loop multilateral telerobotic frameworks with stable and human-safe control loops that enable adaptive “hand-over-hand” haptic guidance for RAMRT and RAMIST. The first prerequisite for such frameworks is active involvement of the patient or trainee, which requires the closed-loop system to remain stable in the presence of an adaptable time-varying dominance factor. To this end, a wave-variable controller is proposed in this study for conventional trilateral teleoperation systems such that system stability is guaranteed in the presence of a time-varying dominance factor and communication delay. Similar to other wave-variable approaches, the controller is initially developed for the Velocity-force Domain (VD) based on the well-known passivity assumption on the human arm in VD. The controller can be applied straightforwardly to the Position-force Domain (PD), eliminating position-error accumulation and position drift, provided that passivity of the human arm in PD is addressed. However, the latter has been ignored in the literature. Therefore, in this study, passivity of the human arm in PD is investigated using mathematical analysis, experimentation as well as user studies involving 12 participants and 48 trials. The results, in conjunction with the proposed wave-variables, can be used to guarantee closed-loop PD stability of the supervised trilateral teleoperation system in its classical format. The classic dual-user teleoperation architecture does not, however, fully satisfy the requirements for properly imparting motor function (skills) in RAMRT (RAMIST). Consequently, the next part of this study focuses on designing novel supervised trilateral frameworks for providing motor learning in RAMRT and RAMIST, each customized according to the requirements of the application. The framework proposed for RAMRT includes the following features: a) therapist-in-the-loop mirror therapy; b) haptic feedback to the therapist from the patient side; c) assist-as-needed therapy realized through an adaptive Guidance Virtual Fixture (GVF); and d) real-time task-independent and patient-specific motor-function assessment. Closed-loop stability of the proposed framework is investigated using a combination of the Circle Criterion and the Small-Gain Theorem. The stability analysis addresses the instabilities caused by: a) communication delays between the therapist and the patient, facilitating haptics-enabled tele- or in-home rehabilitation; and b) the integration of the time-varying nonlinear GVF element into the delayed system. The platform is experimentally evaluated on a trilateral rehabilitation setup consisting of two Quanser rehabilitation robots and one Quanser HD2 robot. The framework proposed for RAMIST includes the following features: a) haptics-enabled expert-in-the-loop surgical training; b) adaptive expertise-oriented training, realized through a Fuzzy Interface System, which actively engages the trainees while providing them with appropriate skills-oriented levels of training; and c) task-independent skills assessment. Closed-loop stability of the architecture is analyzed using the Circle Criterion in the presence and absence of haptic feedback of tool-tissue interactions. In addition to the time-varying elements of the system, the stability analysis approach also addresses communication delays, facilitating tele-surgical training. The platform is implemented on a dual-console surgical setup consisting of the classic da Vinci surgical system (Intuitive Surgical, Inc., Sunnyvale, CA), integrated with the da Vinci Research Kit (dVRK) motor controllers, and the dV-Trainer master console (Mimic Technology Inc., Seattle, WA). In order to save on the expert\u27s (therapist\u27s) time, dual-console architectures can also be expanded to accommodate simultaneous training (rehabilitation) for multiple trainees (patients). As the first step in doing this, the last part of this thesis focuses on the development of a multi-master/single-slave telerobotic framework, along with controller design and closed-loop stability analysis in the presence of communication delays. Various parts of this study are supported with a number of experimental implementations and evaluations. The outcomes of this research include multilateral telerobotic testbeds for further studies on the nature of human motor learning and retention through haptic guidance and interaction. They also enable investigation of the impact of communication time delays on supervised haptics-enabled motor function improvement through tele-rehabilitation and mentoring

Recent Advancements in Augmented Reality for Robotic Applications: A Survey

Robots are expanding from industrial applications to daily life, in areas such as medical robotics, rehabilitative robotics, social robotics, and mobile/aerial robotics systems. In recent years, augmented reality (AR) has been integrated into many robotic applications, including medical, industrial, human–robot interactions, and collaboration scenarios. In this work, AR for both medical and industrial robot applications is reviewed and summarized. For medical robot applications, we investigated the integration of AR in (1) preoperative and surgical task planning; (2) image-guided robotic surgery; (3) surgical training and simulation; and (4) telesurgery. AR for industrial scenarios is reviewed in (1) human–robot interactions and collaborations; (2) path planning and task allocation; (3) training and simulation; and (4) teleoperation control/assistance. In addition, the limitations and challenges are discussed. Overall, this article serves as a valuable resource for working in the field of AR and robotic research, offering insights into the recent state of the art and prospects for improvement

Overcoming barriers and increasing independence: service robots for elderly and disabled people

This paper discusses the potential for service robots to overcome barriers and increase independence of elderly and disabled people. It includes a brief overview of the existing uses of service robots by disabled and elderly people and advances in technology which will make new uses possible and provides suggestions for some of these new applications. The paper also considers the design and other conditions to be met for user acceptance. It also discusses the complementarity of assistive service robots and personal assistance and considers the types of applications and users for which service robots are and are not suitable