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

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

Automated pick-up of suturing needles for robotic surgical assistance

Robot-assisted laparoscopic prostatectomy (RALP) is a treatment for prostate cancer that involves complete or nerve sparing removal prostate tissue that contains cancer. After removal the bladder neck is successively sutured directly with the urethra. The procedure is called urethrovesical anastomosis and is one of the most dexterity demanding tasks during RALP. Two suturing instruments and a pair of needles are used in combination to perform a running stitch during urethrovesical anastomosis. While robotic instruments provide enhanced dexterity to perform the anastomosis, it is still highly challenging and difficult to learn. In this paper, we presents a vision-guided needle grasping method for automatically grasping the needle that has been inserted into the patient prior to anastomosis. We aim to automatically grasp the suturing needle in a position that avoids hand-offs and immediately enables the start of suturing. The full grasping process can be broken down into: a needle detection algorithm; an approach phase where the surgical tool moves closer to the needle based on visual feedback; and a grasping phase through path planning based on observed surgical practice. Our experimental results show examples of successful autonomous grasping that has the potential to simplify and decrease the operational time in RALP by assisting a small component of urethrovesical anastomosis

Towards retrieving force feedback in robotic-assisted surgery: a supervised neuro-recurrent-vision approach

Robotic-assisted minimally invasive surgeries have gained a lot of popularity over conventional procedures as they offer many benefits to both surgeons and patients. Nonetheless, they still suffer from some limitations that affect their outcome. One of them is the lack of force feedback which restricts the surgeon's sense of touch and might reduce precision during a procedure. To overcome this limitation, we propose a novel force estimation approach that combines a vision based solution with supervised learning to estimate the applied force and provide the surgeon with a suitable representation of it. The proposed solution starts with extracting the geometry of motion of the heart's surface by minimizing an energy functional to recover its 3D deformable structure. A deep network, based on a LSTM-RNN architecture, is then used to learn the relationship between the extracted visual-geometric information and the applied force, and to find accurate mapping between the two. Our proposed force estimation solution avoids the drawbacks usually associated with force sensing devices, such as biocompatibility and integration issues. We evaluate our approach on phantom and realistic tissues in which we report an average root-mean square error of 0.02 N.Peer ReviewedPostprint (author's final draft

Intention recognition for gaze controlled robotic minimally invasive laser ablation

Eye tracking technology has shown promising results for allowing hands-free control of robotically-mounted cameras and tools. However existing systems present only limited capabilities in allowing the full range of camera motions in a safe, intuitive manner. This paper introduces a framework for the recognition of surgeon intention, allowing activation and control of the camera through natural gaze behaviour. The system is resistant to noise such as blinking, while allowing the surgeon to look away safely at any time. Furthermore, this paper presents a novel approach to control the translation of the camera along its optical axis using a combination of eye tracking and stereo reconstruction. Combining eye tracking and stereo reconstruction allows the system to determine which point in 3D space the user is fixating, enabling a translation of the camera to achieve the optimal viewing distance. In addition, the eye tracking information is used to perform automatic laser targeting for laser ablation. The desired target point of the laser, mounted on a separate robotic arm, is determined with the eye tracking thus removing the need to manually adjust the laser's target point before starting each new ablation. The calibration methodology used to obtain millimetre precision for the laser targeting without the aid of visual servoing is described. Finally, a user study validating the system is presented, showing clear improvement with median task times under half of those of a manually controlled robotic system

Computer- and robot-assisted Medical Intervention

Medical robotics includes assistive devices used by the physician in order to make his/her diagnostic or therapeutic practices easier and more efficient. This chapter focuses on such systems. It introduces the general field of Computer-Assisted Medical Interventions, its aims, its different components and describes the place of robots in that context. The evolutions in terms of general design and control paradigms in the development of medical robots are presented and issues specific to that application domain are discussed. A view of existing systems, on-going developments and future trends is given. A case-study is detailed. Other types of robotic help in the medical environment (such as for assisting a handicapped person, for rehabilitation of a patient or for replacement of some damaged/suppressed limbs or organs) are out of the scope of this chapter.Comment: Handbook of Automation, Shimon Nof (Ed.) (2009) 000-00

Magnetic-Visual Sensor Fusion-based Dense 3D Reconstruction and Localization for Endoscopic Capsule Robots

Reliable and real-time 3D reconstruction and localization functionality is a crucial prerequisite for the navigation of actively controlled capsule endoscopic robots as an emerging, minimally invasive diagnostic and therapeutic technology for use in the gastrointestinal (GI) tract. In this study, we propose a fully dense, non-rigidly deformable, strictly real-time, intraoperative map fusion approach for actively controlled endoscopic capsule robot applications which combines magnetic and vision-based localization, with non-rigid deformations based frame-to-model map fusion. The performance of the proposed method is demonstrated using four different ex-vivo porcine stomach models. Across different trajectories of varying speed and complexity, and four different endoscopic cameras, the root mean square surface reconstruction errors 1.58 to 2.17 cm.Comment: submitted to IROS 201