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The lack of force feedback (haptics) in robotic surgery can be considered to be a safety risk leading to accidental tissue damage and puncturing of blood vessels due to excessive forces being applied to tissue and vessels or causing inefficient control over the instruments because of insufficient applied force. This project focuses on providing a satisfactory solution for introducing haptic feedback in robotics-assisted minimally invasive surgical (RAMIS) systems. The research addresses several key issues associated with the incorporation of haptics in a master-slave (teleoperated) robotic environment for minimally invasive surgery (MIS). In this project, we designed a haptics-enabled dual-arm (two masters - two slaves) robotic MIS testbed to investigate and validate various single-arm as well as dual-arm teleoperation scenarios. The most important feature of this setup is the capability of providing haptic feedback in all 7 degrees of freedom (DOF) required for RAMIS (3 translations, 3 rotations and pinch motion of the laparoscopic tool). The setup also enables the evaluation of the effect of replacing haptic feedback by other sensory cues such as visual representation of haptic information (sensory substitution) and the hypothesis that surgical outcomes may be improved by substituting or augmenting haptic feedback by such sensory cues. To provide realistic haptic feedback, it is necessary to measure forces acting at the tip of the laparoscopic instruments in all appropriate directions, as well as when gripping, cutting or palpating tissue. In order to achieve this, we have incorporated two types of laparoscopic instruments in the testbed: A sensorized da Vinci tool, with the capability of measuring grasping forces provided by several strain gauges embedded in the tool shaft, and a customized instrument, the Tactile Sensing Instrument (TSI), which has been developed in our laboratory for soft-tissue palpation in RAMIS. Two surgical scenarios are considered in this project: Tumor localization in soft-tissue palpation, and endoscopic suturing. The first application is to localize tumors embedded in liver and lung tissue through the single-arm master-slave teleoperation system. Since the stiffness of a tumor is higher than that of healthy tissue, it can be distinguished as a hard nodule during remote palpation. Tactile sensing is a method that can be used in RAMIS to localize cancerous tumors prior to performing ablative therapies. However, its performance is highly dependent on the consistency of the exploration force. Using the customized tactile sensing instrument, the pressure distribution over the tissue is captured and provided as a color contour map on a screen. In order to apply the exploration force consistently over the tissue, different force feedback modalities are incorporated with tactile sensing feedback: Direct reflection of force feedback, visual presentation of interaction forces, and a fusion method utilizing an autonomous force control for the exploration force in the palpation direction and direct reflection of the force measured at the location of the tumor to the operator's fingers through the grasper mechanism of the haptic interface. The problem of incorporating haptic feedback in robot-assisted endoscopic suturing is explored as the next telesurgery scenario. The dual-arm teleoperation setup is used for this application. In order to assess the quality of suturing, we divide the suturing task into two phases: stitching and knot tying. Each phase consists of several well-specified sub-tasks. The experiments are performed in three modes: without force feedback, with visual force feedback and with direct force reflection to the user. Three levels are considered for the visual feedback presented to the user. The main objective of showing force in different levels is to assure the user that the force being applied on the suture is sufficient to end up with a secure knot. The main focus on this work is to explore which way of presenting force feedback can be more effectively used, and how each modality can help the user to increase the performance.
An important obstacle in Minimally Invasive Surgery (MIS) is the significant degradation of haptic feedback (sensation of touch) to the surgeon about surgical instrument's interaction with tissue. This monograph is concerned with devices and methods required for incorporating haptic feedback in master-slave robotic MIS systems. In terms of devices, novel mechanisms are designed including a surgical end-effector (slave) with full force sensing capabilities and a surgeon-robot interface (master) with full force feedback capabilities. Using the master-slave system, various haptic teleoperation control schemes are compared in terms of stability and performance, and passivity-based time delay compensation for haptic teleoperation over a long distance is investigated. The monograph also compares haptic feedback with visual feedback and with substitution for haptic feedback by other sensory cues in terms of surgical task performance.
Robot-Assisted Minimally Invasive Surgical (RAMIS) systems frequently have a structure of cooperative teleoperator systems where multiple master-slave pairs are used to collaboratively execute a task. Although multiple studies indicate that haptic feedback improves the realism of tool-tissue interaction to the surgeon and leads to better performance for surgical procedures, current telesurgical systems typically do not provide force feedback, mainly because of the inherent stability issues. The research presented in this thesis is directed towards the development of control algorithms for force reflecting cooperative surgical teleoperator systems with improved stability and transparency characteristics. In the case of cooperative force reflecting teleoperation over networks, conventional passivity based approaches may have limited applicability due to potentially non-passive slave-slave interactions and irregular communication delays imposed by the network. In this thesis, an alternative small gain framework for the design of cooperative network-based force reflecting teleoperator systems is developed. Using the small gain framework, control algorithms for cooperative force-reflecting teleoperator systems are designed that guarantee stability in the presence of multiple network-induced communication constraints. Furthermore, the design conservatism typically associated with the small-gain approach is eliminated by using the Projection-Based Force Reflection (PBFR) algorithms. Stability results are established for networked cooperative teleoperator systems under different types of force reflection algorithms in the presence of irregular communication delays. The proposed control approach is consequently implemented on a dual-arm (two masters/two slaves) robotic MIS testbed. The testbed consists of two Haptic Wand devices as masters and two PA10-7C robots as the slave manipulators equipped with da Vinci laparoscopic surgical instruments. The performance of the proposed control approach is evaluated in three different cooperative surgical tasks, which are knot tightening, pegboard transfer, and object manipulation. The experimental results obtained indicate that the PBFR algorithms demonstrate statistically significant performance improvement in comparison with the conventional direct force reflection algorithms. One possible shortcoming of using PBFR algorithms is that implementation of these algorithms may lead to attenuation of the high-frequency component of the contact force which is important, in particular, for haptic perception of stiff surfaces. In this thesis, a solution to this problem is proposed which is based on the idea of separating the different frequency bands in the force reflection signal and consequently applying the projection-based principle to the low-frequency component, while reflecting the high-frequency component directly. The experimental results demonstrate that substantial improvement in transient fidelity of the force feedback is achieved using the proposed method without negative effects on the stability of the system.
Comprehensively covers the key technologies for the development of tactile perception in minimally invasive surgery Covering the timely topic of tactile sensing and display in minimally invasive and robotic surgery, this book comprehensively explores new techniques which could dramatically reduce the need for invasive procedures. The tools currently used in minimally invasive surgery (MIS) lack any sort of tactile sensing, significantly reducing the performance of these types of procedures. This book systematically explains the various technologies which the most prominent researchers have proposed to overcome the problem. Furthermore, the authors put forward their own findings, which have been published in recent patents and patent applications. These solutions offer original and creative means of surmounting the current drawbacks of MIS and robotic surgery. Key features:- Comprehensively covers topics of this ground-breaking technology including tactile sensing, force sensing, tactile display, PVDF fundamentals Describes the mechanisms, methods and sensors that measure and display kinaesthetic and tactile data between a surgical tool and tissue Written by authors at the cutting-edge of research into the area of tactile perception in minimally invasive surgery Provides key topic for academic researchers, graduate students as well as professionals working in the area
The Encyclopedia of Medical Robotics combines contributions in four distinct areas of Medical robotics, namely: Minimally Invasive Surgical Robotics, Micro and Nano Robotics in Medicine, Image-guided Surgical Procedures and Interventions, and Rehabilitation Robotics. The volume on Minimally Invasive Surgical Robotics focuses on robotic technologies geared towards challenges and opportunities in minimally invasive surgery and the research, design, implementation and clinical use of minimally invasive robotic systems. The volume on Micro and Nano robotics in Medicine is dedicated to research activities in an area of emerging interdisciplinary technology that is raising new scientific challenges and promising revolutionary advancement in applications such as medicine and biology. The size and range of these systems are at or below the micrometer scale and comprise assemblies of micro and nanoscale components. The volume on Image-guided Surgical Procedures and Interventions focuses primarily on the use of image guidance during surgical procedures and the challenges posed by various imaging environments and how they related to the design and development of robotic systems as well as their clinical applications. This volume also has significant contributions from the clinical viewpoint on some of the challenges in the domain of image-guided interventions. Finally, the volume on Rehabilitation Robotics is dedicated to the state-of-the-art of an emerging interdisciplinary field where robotics, sensors, and feedback are used in novel ways to re-learn, improve, or restore functional movements in humans.Volume 1, Minimally Invasive Surgical Robotics, focuses on an area of robotic applications that was established in the late 1990s, after the first robotics-assisted minimally invasive surgical procedure. This area has since received significant attention from industry and researchers. The teleoperated and ergonomic features of these robotic systems for minimally invasive surgery (MIS) have been able to reduce or eliminate most of the drawbacks of conventional (laparoscopic) MIS. Robotics-assisted MIS procedures have been conducted on over 3 million patients to date — primarily in the areas of urology, gynecology and general surgery using the FDA approved da Vinci® surgical system. The significant commercial and clinical success of the da Vinci® system has resulted in substantial research activity in recent years to reduce invasiveness, increase dexterity, provide additional features such as image guidance and haptic feedback, reduce size and cost, increase portability, and address specific clinical procedures. The area of robotic MIS is therefore in a state of rapid growth fueled by new developments in technologies such as continuum robotics, smart materials, sensing and actuation, and haptics and teleoperation. An important need arising from the incorporation of robotic technology for surgery is that of training in the appropriate use of the technology, and in the assessment of acquired skills. This volume covers the topics mentioned above in four sections. The first section gives an overview of the evolution and current state the da Vinci® system and clinical perspectives from three groups who use it on a regular basis. The second focuses on the research, and describes a number of new developments in surgical robotics that are likely to be the basis for the next generation of robotic MIS systems. The third deals with two important aspects of surgical robotic systems — teleoperation and haptics (the sense of touch). Technology for implementing the latter in a clinical setting is still very much at the research stage. The fourth section focuses on surgical training and skills assessment necessitated by the novelty and complexity of the technologies involved and the need to provide reliable and efficient training and objective assessment in the use of robotic MIS systems.In Volume 2, Micro and Nano Robotics in Medicine, a brief historical overview of the field of medical nanorobotics as well as the state-of-the-art in the field is presented in the introductory chapter. It covers the various types of nanorobotic systems, their applications and future directions in this field. The volume is divided into three themes related to medical applications. The first theme describes the main challenges of microrobotic design for propulsion in vascular media. Such nanoscale robotic agents are envisioned to revolutionize medicine by enabling minimally invasive diagnostic and therapeutic procedures. To be useful, nanorobots must be operated in complex biological fluids and tissues, which are often difficult to penetrate. In this section, a collection of four papers review the potential medical applications of motile nanorobots, catalytic-based propelling agents, biologically-inspired microrobots and nanoscale bacteria-enabled autonomous drug delivery systems. The second theme relates to the use of micro and nanorobots inside the body for drug-delivery and surgical applications. A collection of six chapters is presented in this segment. The first chapter reviews the different robot structures for three different types of surgery, namely laparoscopy, catheterization, and ophthalmic surgery. It highlights the progress of surgical microrobotics toward intracorporeally navigated mechanisms for ultra-minimally invasive interventions. Then, the design of different magnetic actuation platforms used in micro and nanorobotics are described. An overview of magnetic actuation-based control methods for microrobots, with eventually biomedical applications, is also covered in this segment. The third theme discusses the various nanomanipulation strategies that are currently used in biomedicine for cell characterization, injection, fusion and engineering. In-vitro (3D) cell culture has received increasing attention since it has been discovered to provide a better simulation environment of in-vivo cell growth. Nowadays, the rapid progress of robotic technology paves a new path for the highly controllable and flexible 3D cell assembly. One chapter in this segment discusses the applications of micro-nano robotic techniques for 3D cell culture using engineering approaches. Because cell fusion is important in numerous biological events and applications, such as tissue regeneration and cell reprogramming, a chapter on robotic-tweezers cell manipulation system to achieve precise laser-induced cell fusion using optical trapping has been included in this volume. Finally, the segment ends with a chapter on the use of novel MEMS-based characterization of micro-scale tissues instead of mechanical characterization for cell lines studies.Volume 3, Image-guided Surgical Procedures and Interventions, focuses on several aspects ranging from understanding the challenges and opportunities in this domain, to imaging technologies, to image-guided robotic systems for clinical applications. The volume includes several contributions in the area of imaging in the areas of X-Ray fluoroscopy, CT, PET, MR Imaging, Ultrasound imaging, and optical coherence tomography. Ultrasound-based diagnostics and therapeutics as well as ultrasound-guided planning and navigation are also included in this volume in addition to multi-modal imaging techniques and its applications to surgery and various interventions. The application of multi-modal imaging and fusion in the area of prostate biopsy is also covered. Imaging modality compatible robotic systems, sensors and actuator technologies for use in the MRI environment are also included in this work., as is the development of the framework incorporating image-guided modeling for surgery and intervention. Finally, there are several chapters in the clinical applications domain covering cochlear implant surgery, neurosurgery, breast biopsy, prostate cancer treatment, endovascular interventions, neurovascular interventions, robotic capsule endoscopy, and MRI-guided neurosurgical procedures and interventions.Volume 4, Rehabilitation Robotics, is dedicated to the state-of-the-art of an emerging interdisciplinary field where robotics, sensors, and feedback are used in novel ways to relearn, improve, or restore functional movements in humans. This volume attempts to cover a number of topics relevant to the field. The first section addresses an important activity in our daily lives: walking, where the neuromuscular system orchestrates the gait, posture, and balance. Conditions such as stroke, vestibular deficits, or old age impair this important activity. Three chapters on robotic training, gait rehabilitation, and cooperative orthoses describe the current works in the field to address this issue. The second section covers the significant advances in and novel designs of soft actuators and wearable systems that have emerged in the area of prosthetic lower limbs and ankles in recent years, which offer potential for both rehabilitation and human augmentation. These are described in two chapters. The next section addresses an important emphasis in the field of medicine today that strives to bring rehabilitation out from the clinic into the home environment, so that these medical aids are more readily available to users. The current state-of-the-art in this field is described in a chapter. The last section focuses on rehab devices for the pediatric population. Their impairments are life-long and rehabilitation robotics can have an even bigger impact during their lifespan. In recent years, a number of new developments have been made to promote mobility, socialization, and rehabilitation among the very young: the infants and toddlers. These aspects are summarized in two chapters of this volume.
Soft and Stiffness-controllable Robotics Solutions for Minimally Invasive Surgery presents the results of a research project, funded by European Commission, STIFF-FLOP: STIFFness controllable Flexible and Learn-able manipulator for surgical Operations. In Minimally Invasive Surgery (MIS), tools go through narrow openings and manipulate soft organs that can move, deform, or change stiffness. There are limitations on modern laparoscopic and robot-assisted surgical systems due to restricted access through Trocar ports, lack of haptic feedback, and difficulties with rigid robot tools operating inside a confined space filled with organs. Also, many control algorithms suffer from stability problems in the presence of unexpected conditions. Yet biological "manipulators", like the octopus arm can manipulate objects while controlling the stiffness of selected body parts and being inherently compliant when interacting with objects. STIFF-FLOP robot is an innovative soft robotic arm that can squeeze through a standard MIS, reconfigure itself and stiffen by hydrostatic actuation to perform compliant force control tasks while facing unexpected situations. Technical topics discussed in the book include:Soft actuatorsContinuum soft manipulatorsControl, kinematics and navigation of continuum manipulatorsOptical sensors for force, torque, and curvatureHaptic feedback and human interface for surgical systemsValidation of soft stiffness controllable robots
The advent of minimally invasive surgery (MIS) led to significant benefits for patients at a cost of increase technical difficulty for surgeons. Robotic minimally invasive surgery (RMIS) was introduced to help eliminate some of the outstanding challenges by introducing improvements such as enhanced 3D vision and additional degrees of freedom. Unfortunately, RMIS resulted in a complete loss of haptic feedback, a problem that has persisted even after more than a decade of technology development. The limitations introduced by the loss of feedback in robotic surgery gave birth to innovations and significant research on haptic feedback systems (HFS). These systems aimed to provide an artificial sense of touch. Researchers have focused on many varieties of feedback technologies, most often relying on one specific feedback modality to help improve performance in a few, limited robotic surgical procedures. This research project set out to investigate multi-modal haptic feedback systems capable of providing benefits for many different robotic surgical applications. Having inherited an existing tactile feedback system designed for reducing crush injuries in robotic surgical procedures, this project implemented various critical enhancements for pneumatic normal force tactile feedback. Improvements to the sensing technology such as design of shear sensing mechanisms helped expand the application of haptics beyond grip force reduction. The development and integration of additional modalities of feedback including kinesthetic force feedback and vibration feedback, and design of a highly configurable software architecture allowed the application of the multi-modal HFS in several different RMIS applications. Evaluation of the system for knot tying in robotic surgery showed significant benefits in reducing suture breakage and improving knot quality. Application of the multi-modal HFS for palpation in robotic surgery helped improve detection non-compressible structures such as tumors and vessels in soft tissue phantoms. Finally, the system improved upon the previously developed unimodal tactile feedback systems with regards to reduction of grip force in RMIS. The results of these investigations highlight the importance of developing multi-modal haptic feedback systems that are able simulate the synergistic relationship between the various feedback modalities involved in real human touch. Robotic surgical systems have long been held back by their lack of comprehensive haptic feedback solutions. Multi-modal haptic feedback systems hold the promise of eliminating this long-standing problem and helping expand the application of robotics in surgical sciences.
Tactile Internet with Human-in-the-Loop describes the change from the current Internet, which focuses on the democratization of information independent of location or time, to the Tactile Internet, which democratizes skills to promote equity that is independent of age, gender, sociocultural background or physical limitations. The book promotes the concept of the Tactile Internet for remote closed-loop human-machine interaction and describes the main challenges and key technologies. Current standardization activities in the field for IEEE and IETF are also described, making this book an ideal resource for researchers, graduate students, and industry R&D engineers in communications engineering, electronic engineering, and computer engineering. Provides a comprehensive reference that addresses all aspects of the Tactile Internet – technologies, engineering challenges, use cases and standards Written by leading researchers in the field Presents current standardizations surrounding the IETF and the IEEE Contains use cases that illustrate practical applications
This work addresses the challenge of providing effective cutaneous haptic feedback in robotic teleoperation, with the objective of achieving the highest degree of transparency whilst guaranteeing the stability of the considered systems. On the one hand, it evaluates teleoperation systems that provide only cutaneous cues to the operator, thus guaranteeing the highest degree of safety. This cutaneous-only approach shows intermediate performance between no force feedback and full haptic feedback provided by a grounded haptic interface, and it is best suitable for those scenarios where the safety of the system is paramount, e.g., robotic surgery. On the other hand, in order to achieve a higher level of performance, this work also investigates novel robotic teleoperation systems with force reflection able to provide mixed cutaneous and kinesthetic cues to the operator. Cutaneous cues can compensate for the temporary reduction of kinesthetic feedback necessary to satisfy certain stability conditions. This state-of-the-art volume is oriented toward researchers, educators, and students who are interested in force feedback techniques for robotic teleoperation, cutaneous device design, cutaneous rendering methods and perception studies, as well as readers from different disciplines who are interested in applying cutaneous haptic technologies and methods to their field of interest.