Haptics in Robot-Assisted Surgery: Challenges and Benefits

Robotic surgery is transforming the current surgical practice, not only by improving the conventional surgical methods but also by introducing innovative robot-enhanced approaches that broaden the capabilities of clinicians. Being mainly of man-machine collaborative type, surgical robots are seen as media that transfer pre- and intra-operative information to the operator and reproduce his/her motion, with appropriate filtering, scaling, or limitation, to physically interact with the patient. The field, however, is far from maturity and, more critically, is still a subject of controversy in medical communities. Limited or absent haptic feedback is reputed to be among reasons that impede further spread of surgical robots. In this paper objectives and challenges of deploying haptic technologies in surgical robotics is discussed and a systematic review is performed on works that have studied the effects of providing haptic information to the users in major branches of robotic surgery. It has been tried to encompass both classical works and the state of the art approaches, aiming at delivering a comprehensive and balanced survey both for researchers starting their work in this field and for the experts

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

Non linear force feedback enhancement for cooperative robotic neurosurgery enforces virtual boundaries on cortex surface

Surgeons can benefit from the cooperation with a robotic assistant during the repetitive execution of precise targeting tasks on soft tissues, such as brain cortex stimulation procedures in open-skull neurosurgery. Position-based force-to-motion control schemes may not be satisfactory solution to provide the manipulator with the high compliance desirable during guidance along wide trajectories. A new torque controller with non-linear force feedback enhancement (FFE) is presented to provide augmented haptic perception to the operator from instrument-tissue interaction. Simulation tests were performed to evaluate the system stability according to different non-linear force modulation functions (power, sigmoidal and arc tangent). The FFE controller with power modulation was experimentally validated with a pool of non-expert users using brain-mimicking gelatin phantoms (8%-16% concentration). Besides providing hand tremor rejection for a stable holding of the tool, the FFE controller was proven to allow for a safer tissue contact with respect to both robotic assistance without force feedback and freehand executions (50% and 75% reduction of the indentation depth, respectively). Future work will address the evaluation of the safety features of the FFE controller with expert surgeons on a realistic brain phantom, also accounting for unpredictable tissue's motions as during seizures due to cortex stimulation

Development of an intelligent surgical training system for Thoracentesis

Surgical training improves patient care, helps to reduce surgical risks, increases surgeon’s confidence, and thus enhances overall patient safety. Current surgical training systems are more focused on developing technical skills, e.g. dexterity, of the surgeons while lacking the aspects of context-awareness and intra-operative real-time guidance. Context-aware intelligent training systems interpret the current surgical situation and help surgeons to train on surgical tasks. As a prototypical scenario, we chose Thoracentesis procedure in this work. We designed the context-aware software framework using the surgical process model encompassing ontology and production rules, based on the procedure descriptions obtained through textbooks and interviews, and ontology-based and marker-based object recognition, where the system tracked and recognised surgical instruments and materials in surgeon’s hands and recognised surgical instruments on the surgical stand. The ontology was validated using annotated surgical videos, where the system identified “Anaesthesia” and “Aspiration” phase with 100% relative frequency and “Penetration” phase with 65% relative frequency. The system tracked surgical swab and 50 mL syringe with approximately 88.23% and 100% accuracy in surgeon’s hands and recognised surgical instruments with approximately 90% accuracy on the surgical stand. Surgical workflow training with the proposed system showed equivalent results as the traditional mentor-based training regime, thus this work is a step forward a new tool for context awareness and decision-making during surgical training

Toward a Knowledge-Driven Context-Aware System for Surgical Assistance

Complex surgeries complications are increasing, thus making an efficient surgical assistance is a real need. In this work, an ontology-based context-aware system was developed for surgical training/assistance during Thoracentesis by using image processing and semantic technologies. We evaluated the Thoracentesis ontology and implemented a paradigmatic test scenario to check the efficacy of the system by recognizing contextual information, e.g. the presence of surgical instruments on the table. The framework was able to retrieve contextual information about current surgical activity along with information on the need or presence of a surgical instrument

APPLICATION IN SPORTS OF THE "ELITE": A SYSTEM FOR REAL TIME PROCESSING OF TV SIGNALS

Competitive sport requires a deep engagement of the athletes that have to improve continuously physical and technical qualities with heavy programs of training. The help of the coaches is an important tool both to plan the training and to perform it correctly. The coach evaluates the work of the athlete with quantitative and qualitative inspections. Quantitatively he measures the actual performance or useful parameters (time, length, height) obtaining information on the total efficiency of the athlete. Qualitatively he analyzes the technical aspects of the sport. The analysis is done by a direct visual inspection or by video tape records. The final result is a synthesis of sensations that, through experience and knowledge, becomes practical suggestions. When the same analysis is quantitative, the intervention may he more complete as the coach is supported by powerful information: knowledge of quantities not easy or possible to be detected by visual inspection (velocities, accelerations, forces), accurate description of each phase of the movement, data storage allowing objective comparison in time

Analysis of joint and hand impedance during teleoperation and free-hand task execution

partially_open4Teleoperated robotic surgery allows filtering andscaling the hand motion to achieve high precision during thesurgical interventions. Teleoperation represents a very complexsensory-motor task, mainly due to the kinematic and kineticredundancies that characterize the human motor control. Itrequires an intensive training phase to acquire sufficient famil-iarity with the master-slave architecture.We estimated the hand stiffness modulation during theexecution of a simulated suturing task in teleoperation, withtwo different master devices, and in free-hand. Kinematicdata of eight right-handed users were acquired, using elec-tromagnetic and optical tracking systems, and analysed usinga musculoskeletal model. Through inverse dynamics, muscularactivation was computed and used to obtain the joint torqueand stiffness, leading to end-point stiffness estimation. Themaximal stiffness value and its angular displacement withrespect to the trajectory tangent was computed. The resultsshow that there is a difference in how the main stiffness axiswas modulated by using the two master devices with respectto free-hand, with higher values and variability for the seriallink manipulator. Moreover, a directional modulation of thehand stiffness through the trajectory was found, showing thatthe users were aligning the direction of the main stiffness axisperpendicularly to the trajectory.openBuzzi, Jacopo; Gatti, Cecilia; Ferrigno, Giancarlo; De Momi, ElenaBuzzi, Jacopo; Gatti, Cecilia; Ferrigno, Giancarlo; DE MOMI, Elen

Improved human-robot collaborative control of redundant robot for teleoperated minimally invasive surgery

© 2016 IEEE. An improved human-robot collaborative control scheme is proposed in a teleoperated minimally invasive surgery scenario, based on a hierarchical operational space formulation of a seven-degree-of-freedom redundant robot. Redundancy is exploited to guarantee a remote center of motion (RCM) constraint and to provide a compliant behavior for the medical staff. Based on the implemented hierarchical control framework, an RCM constraint and a safe constraint are applied to the null-space motion to achieve the surgical tasks with human-robot interaction. Due to the physical interactions, safety and accuracy of the surgery may be affected. The control framework integrates an adaptive compensator to enhance the accuracy of the surgical tip and to maintain the RCM constraint in a decoupled way avoiding any physical interactions. The system performance is verified on a patient phantom. Compared with the methods proposed in the literature, results show that the accuracy of both the RCM constraint and the surgical tip is improved. The compliant swivel motion of the robot arm is also constrained in a defined area, and the interaction force on the abdominal wall becomes smaller