A Mathematical Model of the Pneumatic Force Sensor for Robot-assisted Surgery

Restoring the sense of touch in robotic surgery is an emerging need several researchers tried to address. In this paper, we focused on the slave side proposing a pneumatic sensor to estimate contact forces occurring during the interaction between surgical instruments and anatomical areas. It consists of a tiny pneumatic balloon, which, after being inflated, appears near the tip of the instrument during the measurement phase only. This paper presents a mathematical method relating the intensity of the contact force to the variation of pressure inside the balloon. The latter was modeled as a spherical elastic membrane, whose behavior during contact was characterized taking into account both the deformation of the membrane and the compression of the contained gas. Geometrical considerations combined with an energetic approach allowed us to compute the force of interest. The effectiveness of our sensing device has been confirmed by experimental results, based on comparison with a high-performance commercial force sensor

Rendering of Pressure and Textures Using Wearable Haptics in Immersive VR Environments

Haptic systems have only recently started to be designed with wearability in mind. Compact, unobtrusive, inexpensive, easy-to-wear, and lightweight haptic devices enable researchers to provide compelling touch sensations to multiple parts of the body, significantly increasing the applicability of haptics in many fields, such as robotics, rehabilitation, gaming, and immersive systems. In this respect, wearable haptics has a great potential in the fields of virtual and augmented reality. Being able to touch virtual objects in a wearable and unobtrusive way may indeed open new exciting avenues for the fields of haptics and VR. This work presents a novel wearable haptic system for immersive virtual reality experiences. It conveys the sensation of touching objects made of different materials, rendering pressure and texture stimuli through a moving platform and a vibrotactile abbrv-doi-hyperref-narrowmotor. The device is composed of two platforms: one placed on the nail side of the finger and one in contact with the finger pad, connected by three cables. One small servomotor controls the length of the cables, moving the platform towards or away from the fingertip. One voice coil actuator, embedded in the platform, provides vibrotactile stimuli to the user

A robotic microsurgical forceps for transoral laser microsurgery

Purpose: In transoral laser microsurgery (TLM), the close curved cylindrical structure of the laryngeal region offers functional challenges to surgeons who operate on its malignancies with rigid, single degree-of-freedom (DOF) forceps. These challenges include surgeon hand tremors, poor reachability, poor tissue surface perception, and reduced ergonomy in design. The integrated robotic microsurgical forceps presented here is capable of addressing the above challenges through tele-operated tissue manipulation in TLM. Methods: The proposed device is designed in compliance with the spatial constraints in TLM. It incorporates a novel 2-DOF motorized microsurgical forceps end-effector, which is integrated with a commercial 6-DOF serial robotic manipulator. The integrated device is tele-operated through the haptic master interface, Omega.7. The device is augmented with a force sensor to measure tissue gripping force. The device is called RMF-2F, i.e. robotic microsurgical forceps with 2-DOF end-effector and force sensing. RMF-2F is evaluated through validation trials and pick-n-place experiments with subjects. Furthermore, the device is trialled with expert surgeons through preliminary tasks in a simulated surgical scenario. Results: RMF-2F shows a motion tracking error of less than 400 μm. User trials demonstrate the device’s accuracy in task completion and ease of manoeuvrability using the Omega.7 through improved trajectory following and execution times. The tissue gripping force shows better regulation with haptic feedback (1.624 N) than without haptic feedback (2.116 N). Surgeons positively evaluated the device with appreciation for improved access in the larynx and gripping force feedback. Conclusions: RMF-2F offers an ergonomic and intuitive interface for intraoperative tissue manipulation in TLM. The device performance, usability, and haptic feedback capability were positively evaluated by users as well as expert surgeons. RMF-2F introduces the benefits of robotic teleoperation including, (i) overcoming hand tremors and wrist excursions, (ii) improved reachability and accuracy, and (iii) tissue gripping feedback for safe tissue manipulation

The Use of Tactile Sensors in Oral and Maxillofacial Surgery: An Overview

Background: This overview aimed to characterize the type, development, and use of haptic technologies for maxillofacial surgical purposes. The work aim is to summarize and evaluate current advantages, drawbacks, and design choices of presented technologies for each field of application in order to address and promote future research as well as to provide a global view of the issue. Methods: Relevant manuscripts were searched electronically through Scopus, MEDLINE/PubMed, and Cochrane Library databases until 1 November 2022. Results: After analyzing the available literature, 31 articles regarding tactile sensors and interfaces, sensorized tools, haptic technologies, and integrated platforms in oral and maxillofacial surgery have been included. Moreover, a quality rating is provided for each article following appropriate evaluation metrics. Discussion: Many efforts have been made to overcome the technological limits of computed assistant diagnosis, surgery, and teaching. Nonetheless, a research gap is evident between dental/maxillofacial surgery and other specialties such as endovascular, laparoscopic, and microsurgery; especially for what concerns electrical and optical-based sensors for instrumented tools and sensorized tools for contact forces detection. The application of existing technologies is mainly focused on digital simulation purposes, and the integration into Computer Assisted Surgery (CAS) is far from being widely actuated. Virtual reality, increasingly adopted in various fields of surgery (e.g., sino-nasal, traumatology, implantology) showed interesting results and has the potential to revolutionize teaching and learning. A major concern regarding the actual state of the art is the absence of randomized control trials and the prevalence of case reports, retrospective cohorts, and experimental studies. Nonetheless, as the research is fast growing, we can expect to see many developments be incorporated into maxillofacial surgery practice, after adequate evaluation by the scientific community

Frequency-Dependent Reduction of Cybersickness in Virtual Reality by Transcranial Oscillatory Stimulation of the Vestibular Cortex

Virtual reality (VR) applications are pervasive of everyday life, as in working, medical, and entertainment scenarios. There is yet no solution to cybersickness (CS), a disabling vestibular syndrome with nausea, dizziness, and general discomfort that most of VR users undergo, which results from an integration mismatch among visual, proprioceptive, and vestibular information. In a double-blind, controlled trial, we propose an innovative treatment for CS, consisting of online oscillatory imperceptible neuromodulation with transcranial alternating current stimulation (tACS) at 10 Hz, biophysically modelled to reach the vestibular cortex bilaterally. tACS significantly reduced CS nausea in 37 healthy subjects during a VR rollercoaster experience. The effect was frequency-dependent and placebo-insensitive. Subjective benefits were paralleled by galvanic skin response modulation in 25 subjects, addressing neurovegetative activity. Besides confirming the role of transcranially delivered oscillations in physiologically tuning the vestibular system function (and dysfunction), results open a new way to facilitate the use of VR in different scenarios and possibly to help treating also other vestibular dysfunctions

Operator awareness in human–robot collaboration through wearable vibrotactile feedback

In industrial scenarios, requiring human–robot collaboration, the understanding between the human operator and his/her robot coworker is paramount. On the one side, the robot has to detect human intentions, and on the other side, the human needs to be aware of what is happening during the collaborative task. In this letter, we address the first issue by predicting human behavior through a new recursive Bayesian classifier, exploiting head, and hand tracking data. Human awareness is tackled by endowing the human with a vibrotactile ring that sends acknowledgments to the user during critical phases of the collaborative task. The proposed solution has been assessed in a human–robot collaboration scenario, and we found that adding haptic feedback is particularly helpful to improve the performance when the human–robot cooperation task is performed by nonskilled subjects. We believe that predicting operator's intention and equipping him/her with wearable interface, able to give information about the prediction reliability, are essential features to improve performance in a human–robot collaboration in industrial environments

Endothelial dysfunction and renal fibrosis in endotoxemia-induced oliguric kidney injury: possible role of LPS binding protein

The pathophysiology of endotoxemia-induced acute kidney injury (AKI) is characterized by an intense activation of the host immune system and renal resident cells by lipopolysaccharide (LPS) and derived proinflammatory products. However, the occurrence of renal fibrosis in this setting has been poorly investigated. The aim of the present study was to investigate the possible association between endothelial dysfunction and acute development of tissue fibrosis in a swine model of LPS-induced AKI. Moreover, we studied the possible effects of coupled plasma filtration adsorption (CPFA) in this setting

Implementation and Characterization of Vibrotactile Interfaces

While a standard approach is more or less established for rendering basic vibratory cues in consumer electronics, the implementation of advanced vibrotactile feedback still requires designers and engineers to solve a number of technical issues. Several off-the-shelf vibration actuators are currently available, having different characteristics and limitations that should be considered in the design process. We suggest an iterative approach to design in which vibrotactile interfaces are validated by testing their accuracy in rendering vibratory cues and in measuring input gestures. Several examples of prototype interfaces yielding audio-haptic feedback are described, ranging from open-ended devices to musical interfaces, addressing their design and the characterization of their vibratory output

Microcephaly with or without chorioretinopathy, lymphoedema, or mental retardation (MCLMR): review of phenotype associated with KIF11 mutations

Microcephaly with or without chorioretinopathy, lymphoedema, or mental retardation (MCLMR) (MIM No.152950) is a rare autosomal dominant condition for which a causative gene has recently been identified. Mutations in the kinesin family member 11 (KIF11) gene have now been described in 16 families worldwide. This is a review of the condition based on the clinical features of 37 individuals from 22 families. This report includes nine previously unreported families and additional information for some of those reported previously. The condition arose de novo in 8/20 families (40%). The parental results were not available for two probands. The mutations were varied and include missense, nonsense, frameshift, and splice site and are distributed evenly throughout the KIF11 gene. In our cohort, 86% had microcephaly, 78% had an ocular abnormality consistent with the diagnosis, 46% had lymphoedema, 73% had mild-moderate learning difficulties, 8% had epilepsy, and 8% had a cardiac anomaly. We identified three individuals with KIF11 mutations but no clinical features of MCLMR demonstrating reduced penetrance. The variable expression of the phenotype and the presence of mildly affected individuals indicates that the prevalence may be higher than expected, and we would therefore recommend a low threshold for genetic testing