Surgical Robotics Research Papers - Academia.edu (original) (raw)

—A tele-operated robotic catheterization system can significantly alleviate the surgeons from radiation exposure and fatigue resulted from long standing time with protective suits. Proximal force/torque signals imply the critical... more

—A tele-operated robotic catheterization system can significantly alleviate the surgeons from radiation exposure and fatigue resulted from long standing time with protective suits. Proximal force/torque signals imply the critical information about the contact forces between the catheter and its surrounding structures. This paper presents a compact, cost-effective force and torque sensing device suitable for catheterization procedures to measure the proximal force/torque signals of the input catheter. The device consists of a rotatable and linear retractable mechanism , a laser mouse sensor, and a coil spring. As the stretched, compressed, and twisted values vary due to the sliding joint, the force and torque signals can be computed based on the Hooke's law. The proposed sensing device has many advantages such as cost-effective, easily miniaturized and customized, and can be extended to the MRI compatible sensors. The experimental results with step response and time-varying loads by comparing to an ATI Nano17 force/torque sensor show that the Root Mean Squared Error (RMSE) for force and torque measurement are 0.042 N and 0.228 mNm respectively.

This paper first describes the workflow of the Pathfinder image-guided surgical robot that has been designed to replace the stereotactic frame in neurosurgery, and then details the calibration stages employed in order to achieve... more

This paper first describes the workflow of the Pathfinder image-guided surgical robot that has been designed to replace the stereotactic frame in neurosurgery, and then details the calibration stages employed in order to achieve submillimetre positioning accuracy of a tool tip. The process uses non-linear parameter identification techniques in conjunction with some procedures for camera calibration, which exploit the fact that the camera is mounted to a calibrated robot arm that executes precise motions.

This paper presents the concept design, the fabrication and the experimental characterization of a unit of a modular manipulator for minimal access surgery. Traditional surgical manipulators are usually based on metallic steerable... more

This paper presents the concept design, the fabrication and the experimental characterization of a unit of a modular manipulator for minimal access surgery. Traditional surgical manipulators are usually based on metallic steerable needles, tendon driven mechanisms or articulated motorized links. In this work the main idea is to combine flexible fluidic actuators enabling omnidirectional bending and elongation capability and the granular jamming phenomenon to implement a selective stiffness changing. The proposed manipulator is based on a series of identical modules, each one consisting of a silicone tube with pneumatic chambers for allowing 3D motion and one central channel for the implementation of the granular jamming phenomenon for stiffening. The silicone is covered by a novel bellows-shaped braided structure maximizing the bending still limiting lateral expansion. In this paper one single module is tested in terms of bending range, elongation capability, generated forces and stiffness changing.

The invention consists of three parts made to work together to ensure safe, fast and effective deployment to the end users, which include but are not limited to surgeons and doctors in emergency and operating rooms, occupational hazards... more

The invention consists of three parts made to work together to ensure safe, fast and effective deployment to the end users, which include but are not limited to surgeons and doctors in emergency and operating rooms, occupational hazards equipment goggles, visors and shields, defensive protective armors and high impact vision wear, high performance athletic equipment, and avionics surfaces. The three parts are the anti-fog coating materials composition, their methods of preparation and processing in large, medium or small scale manufacturing, and a single unit delivery device with the coating materials to apply on any existing surface, lens, scope, tools or dials, as a wet or quickly drying coating.

This paper presents the concept design of a modular soft manipulator for minimally invasive surgery. Unlike traditional surgical manipulators based on metallic steerable needles, tendon-driven mechanisms, or articulated motorized links,... more

This paper presents the concept design of a modular soft manipulator for minimally invasive surgery. Unlike traditional surgical manipulators based on metallic steerable needles, tendon-driven mechanisms, or articulated motorized links, we combine flexible fluidic actuators to obtain multidirectional bending and elongation with a variable stiffness mechanism based on granular jamming. The idea is to develop a manipulator based on a series of modules, each consisting of a silicone matrix with pneumatic chambers for 3-D motion, and one central channel for the integration of granular-jamming-based stiffening mechanism. A bellows-shaped braided structure is used to contain the lateral expansion of the flexible fluidic actuator and to increase its motion range. In this paper, the design and experimental characterization of a single module composed of such a manipulator is presented. Possible applications of the manipulator in the surgical field are discussed.

This paper introduces a novel, bioinspired manipulator for minimally invasive surgery (MIS). The manipulator is entirely composed of soft materials, and it has been designed to provide similar motion capabilities as the octopus's arm in... more

This paper introduces a novel, bioinspired manipulator for minimally invasive surgery (MIS). The manipulator is entirely composed of soft materials, and it has been designed to provide similar motion capabilities as the octopus's arm in order to reach the surgical target while exploiting its whole length to actively interact with the biological structures. The manipulator is composed of two identical modules (each of them can be controlled independently) with multi-directional bending and stiffening capabilities, like an octopus arm. In the authors' previous works, the design of the single module has been addressed. Here a two-module manipulator is presented, with the final aim of demonstrating the enhanced capabilities that such a structure can have in comparison with rigid surgical tools currently employed in MIS. The performances in terms of workspace, stiffening capabilities, and generated forces are characterized through experimental tests. The combination of stiffening capabilities and manipulation tasks is also addressed to confirm the manipulator potential employment in a real surgical scenario.

The robotic arm used in minimally invasive surgery enters patient’s body through a port which constrains its end-effector translation along two axes. We aim to achieve the minimally-invasive operations using a general articulated robotic... more

The robotic arm used in minimally invasive surgery enters patient’s body through a port which constrains its end-effector translation along two axes. We aim to achieve the minimally-invasive operations using a general articulated robotic arm (GARA). The algorithm is applicable to articulated robotic arm independent of its design; given only end-link is constrained. Geometric transformations based on the constraints acting on the end-link coupled with kinematic-relations obtained using conventional techniques, were used to drive a simulated 6-DOF GARA for minimally-invasive operations. The method was verified by tracing predefined planar and 3D trajectories using this simulated arm. The mean deviation of the traced trajectories was of the order of 10-03 cm and the mean absolute error in maintaining remote center-of-motion (RCM) at the port was ~0 (< 10^-15 cm). The proposed method enabled a GARA to perform minimally-invasive operations without specialized design and with sufficient accuracy.

With the UK government's announcement of robotics and autonomous systems (RAS) being one of the Eight Great Technologies that can potentially propel the nation's future growth, we have seen increasingly united effort across all... more

With the UK government's announcement of robotics and autonomous systems (RAS) being one of the Eight Great Technologies that can potentially propel the nation's future growth, we have seen increasingly united effort across all disciplines underpinning the RAS research and development. With improved safety, efficacy and reduced costs, robotic platforms are approaching a tipping point, moving beyond early adopters to become standard surgical practice. Other drivers for healthcare robots are the aging population and the increasing importance of quality-of-life, independence and autonomy for those with chronic illnesses and disabilities.

Wachter, S., Mittelstadt, B., & Floridi, L. (2017). Transparent, explainable, and accountable AI for
robotics. Science Robotics, 2(6), eaan6080.

With the UK government's announcement of robotics and autonomous systems (RAS) being one of the Eight Great Technologies that can potentially propel the nation's future growth, we have seen increasingly united effort across all... more

With the UK government's announcement of robotics and autonomous systems (RAS) being one of the Eight Great Technologies that can potentially propel the nation's future growth, we have seen increasingly united effort across all disciplines underpinning the RAS research and development. With improved safety, efficacy and reduced costs, robotic platforms are approaching a tipping point, moving beyond early adopters to become standard surgical practice. Other drivers for healthcare robots are the aging population and the increasing importance of quality-of-life, independence and autonomy for those with chronic illnesses and disabilities.

This paper presents an enhanced haptic-enabled master-slave teleoperation system which can be used to provide force feedback to surgeons in minimally invasive surgery (MIS). One of the research goals was to develop a combined-control... more

This paper presents an enhanced haptic-enabled master-slave teleoperation system which can be used to provide force feedback to surgeons in minimally invasive surgery (MIS). One of the research goals was to develop a combined-control architecture framework that included both direct force reflection (DFR) and position-error-based (PEB) control strategies. To achieve this goal, it was essential to measure accurately the direct contact forces between deformable bodies and a robotic tool tip. To measure the forces at a surgical tool tip and enhance the performance of the teleoperation system, an optical force sensor was designed, prototyped, and added to a robot manipulator. The enhanced teleoperation architecture was formulated by developing mathematical models for the optical force sensor, the extended slave robot manipulator, and the combined-control strategy. Human factor studies were also conducted to (a) examine experimentally the performance of the enhanced teleoperation system w...

The development of robotic devices for the manipulation of minimally invasive instruments is focused on two major categories divided by their approach with regard to the insertion point in the patient body, each solution having both... more

The development of robotic devices for the manipulation of minimally invasive instruments is focused on
two major categories divided by their approach with regard to the insertion point in the patient body, each
solution having both advantages and drawbacks. The paper presents a spherical positioning robotic arm
which combines these two categories, summing the advantages and minimizing the drawbacks. The
inverse and direct kinematic models are solved. The workspace analysis, precision mapping and
singularities analysis are performed. Several configurations are proposed to suit different operating
scenarios.

Artykuł ma charakter przeglądowy i ma na celu przybliżenie czytelnikom miesięcznika "Napędy i sterowanie", głównie inżynierom zajmującym się automatyką i robotyką przemysłową, historii i stanu obecnego bardzo specjalnego działu techniki,... more

Artykuł ma charakter przeglądowy i ma na celu przybliżenie czytelnikom miesięcznika "Napędy i sterowanie", głównie inżynierom zajmującym się automatyką i robotyką przemysłową, historii i stanu obecnego bardzo specjalnego działu techniki, jakim są roboty chirurgiczne. Opisane są pierwsze próby zastosowania robotów na sali operacyjnej, sukcesy i niepowodzenia pionierów tego typu zastosowań, oraz opisane są właściwości robotów chirurgicznych da Vinci, które są aktualnie stosowane w szpitalach.

One of the fastest growing sectors in the medical devices industry is medical robotics, and within the realm of medical robotics it is robotic surgery that is spurring public interest, as well as concern. By drawing on the extant body of... more

One of the fastest growing sectors in the medical devices industry is medical robotics, and within the realm of medical robotics it is robotic surgery that is spurring public interest, as well as concern. By drawing on the extant body of literature, this paper explores the emergent role of robots in surgery and examines their merits and drawbacks in traditional settings as well as in extreme environments where surgeons must work remotely. The subject of artificial intelligence (AI) and autonomous surgical robots will also be discussed. Although it is difficult to predict with precision to what extent surgical robots will be used in the next 20 years, certain possibilities are more probable than others.

With the UK government's announcement of robotics and autonomous systems (RAS) being one of the Eight Great Technologies that can potentially propel the nation's future growth, we have seen increasingly united effort across all... more

With the UK government's announcement of robotics and autonomous systems (RAS) being one of the Eight Great Technologies that can potentially propel the nation's future growth, we have seen increasingly united effort across all disciplines underpinning the RAS research and development. With improved safety, efficacy and reduced costs, robotic platforms are approaching a tipping point, moving beyond early adopters to become standard surgical practice. Other drivers for healthcare robots are the aging population and the increasing importance of quality-of-life, independence and autonomy for those with chronic illnesses and disabilities.

This paper presents a recent study on robotic control of a continuum manipulator. In view of nonlinear dynamic characteristics of its model, we propose a fuzzy logic controller that is designed based on state-feedback control of the... more

This paper presents a recent study on robotic control of a continuum manipulator. In view of nonlinear dynamic characteristics of its model, we propose a fuzzy logic controller that is designed based on state-feedback control of the system linearizations. First, a unified kinematic model and the Jacobians are described. Then, we derive the state-space model form and linearize it at six operating points. Next, we design a controller for each linearized local model. Last, a fuzzy logic methodology is utilized to smoothly blend the six designed local controllers. The proposed controller is verified in MATLAB simulation and manipulator tip is autonomously navigated to the designated target. Besides, a comparison result for the optimized controller and the non-optimized counterpart is presented.

In minimally invasive robotic surgery (MIRS), a surgeon teleoperates a robotic arm from a master console. This arm operates inside the patient's body through a small orifice which constrains the end-effector's translation along two axes.... more

In minimally invasive robotic surgery (MIRS), a surgeon teleoperates a robotic arm from a
master console. This arm operates inside the patient's body through a small orifice which constrains
the end-effector's translation along two axes. The workspace of such a robotic arm depends on its
design as well as orifice location. Conventionally, the design of such an arm is optimized for large
workspace and high dexterity. However, this large workspace might be reachable through only a few
orifices, thus making the workspace volume and operation quite sensitive to the orifice location. To
overcome this problem, we optimized the design of a 3 degrees of freedom serial robotic arm to attain
multiple adjacent (desired number of) possible orifice locations, through which a planar workspace of
pre-specified geometry can be traced. To achieve this goal, an algorithm was developed to relate the
design of such an MIRS arm to the possible orifice positions. The optimization problem was solved
using several metaheuristics such as simulated annealing, Tabu search, artificial bee colonization and
genetic algorithm, and their performance was compared.

Burgeoning transendoscopic procedures, such as endoscopic submucosal dissection (ESD), provide a promising means of treating early-stage gastric neoplasia in a minimally-invasive way. However, the remote locations of these lesions,... more

Burgeoning transendoscopic procedures, such as endoscopic submucosal dissection (ESD), provide a promising means of treating early-stage gastric neoplasia in a minimally-invasive way. However, the remote locations of these lesions, coupled with their origination in the submucosal layers of the gastrointestinal tract, often lead to extreme technical, cogni-tive and ergonomic challenges which combat the widespread applicability and adoption of these techniques. Among these challenges is achieving the in vivo dexterity required to retract and dissect tissue. By leveraging workspace and force data obtained through clinical studies, we developed a modular, disposable, distally-mounted actuator (an 'active endcap') that can augment an endoscopist's distal dexterity in ways that are not achievable with the endoscope's built-in degrees-of-freedom. The device consists of a flexible articulating 'exoskeleton' manufactured via printed-circuit MEMS (PCMEMS) which engages and deflects electrosurgical tools that are passed through the endoscopic working channel. Embedded proprioceptive sensing is implemented on-board using distributed LED/phototransistor pairs and the principle of light intensity modulation (LIM). The distal degree-of-freedom is actuated using shape memory alloy (SMA) technology, and the actuation transmission system is fully contained within a 1-inch-long end cap that can be mounted on the distal end of the endoscope, thereby obviating the need for a mechanical connection to a proximal source. Proof-of-concept tests demonstrate that the actuator adds over 50 degrees of distal articulation to existing tools and can generate 450 mN of lateral force which has been clinically determined to be sufficient for performing circumferential incisions in ESD.

Long-term complex activity recognition and localisation can be crucial for the decision-making process of several autonomous systems, such as smart cars and surgical robots. Nonetheless, most current methods are designed to merely... more

Long-term complex activity recognition and localisation can be crucial for the decision-making process of several autonomous systems, such as smart cars and surgical robots. Nonetheless, most current methods are designed to merely localise short-term action/activities or combinations of atomic actions that only last for a few frames or seconds. In this paper, we address the problem of longterm complex activity detection via a novel deformable, spatiotemporal parts-based model. Our framework consists of three main building blocks: (i) action tube detection, (ii) the modelling of the deformable geometry of parts, and (iii) a sparsity mechanism. Firstly, action tubes are detected in a series of snippets using an action tube detector. Next, a new 3D deformable RoI pooling layer is designed for learning the flexible, deformable geometry of the constellation of parts. Finally, a sparsity strategy differentiates between activated and deactivate features. We also provide temporal complex ac...

Background Autonomous control of surgical robotic platforms may offer enhancements such as higher precision, intelligent manoeuvres, tissuedamage avoidance, etc. Autonomous robotic systems in surgery are largely at the experimental level.... more

Background Autonomous control of surgical robotic platforms may offer enhancements such as higher precision, intelligent manoeuvres, tissuedamage avoidance, etc. Autonomous robotic systems in surgery are largely at the experimental level. However, they have also reached clinical application.

Robotic surgery has revolutionized medicine during the last 16 years by transformation of the classic operating theaters into computer-mediated working stations. Numerous procedures have been proved to be feasible and safe by using the... more

Robotic surgery has revolutionized medicine during the last 16 years by transformation of the classic operating theaters into computer-mediated working stations. Numerous procedures have been proved to be feasible and safe by using the continuously evolving, various robotic platforms. From the early beginnings of this revolution, challenging operations such as those concerning the gastroesophageal junction, especially in super-obese patients or during redo operations, proved out to have certain benefits when performed robotically, both for patients as well as for surgeons.

In this paper, the tracking control problem for 5 DOF surgical robot which is affected by tremor of surgeons' hand is considered. Mechanical modeling and dynamic analysis of a robotic arm in slave subsystem of a telesurgery system will be... more

In this paper, the tracking control problem for 5 DOF surgical robot which is affected by tremor of surgeons' hand is considered. Mechanical modeling and dynamic analysis of a robotic arm in slave subsystem of a telesurgery system will be discussed and the reasons for selecting the appropriate materials for different parts of robot will be explained. It would be required this robot, which will do the main part of the surgery, be controlled based on the uncertain properties of the tissues of patients body. Improved Lyapunov Based control method with uncertainty observer is applied to improve the accuracy of tracking procedure for a surgical manipulator to track a specified reference signal in the presence of tremor that is modeled as constant bounded disturbance. Based on the disturbance rejection scheme, tracking controllers are constructed which are asymptotically stabilizing in the sense of Lyapunov. The control strategy was implemented using a PC interface. Computer simulation results demonstrate that accurate trajectory tracking can be achieved by using the proposed controllers.

Continuum robots represent a class of highly sensitive, multiple-degrees-of-freedom robots that are biologically inspired. Because of their flexibility and accuracy, these robots can be used in maxillary sinus surgery. The design of an... more

Continuum robots represent a class of highly sensitive, multiple-degrees-of-freedom robots that are biologically inspired. Because of their flexibility and accuracy, these robots can be used in maxillary sinus surgery. The design of an effective procedure with high accuracy, reliability, robust fault diagnosis, and fault-tolerant control for a surgical robot for the sinus is necessary to maintain the high performance and safety necessary for surgery on the maxillary sinus. Thus, a robust adaptive hybrid observation method using an adaptive, fuzzy auto regressive with exogenous input (ARX) Laguerre Takagi-Sugeno (T-S) fuzzy robust feedback linearization observer for a surgical robot is presented. To address the issues of system modeling, the fuzzy ARX-Laguerre technique is represented. In addition, a T-S fuzzy robust feedback linearization observer is applied to a fuzzy ARX-Laguerre to improve the accuracy of fault estimation, reliability, and robustness for the surgical robot in the presence of uncertainties. For fault-tolerant control in the presence of uncertainties and unknown conditions, an adaptive fuzzy observation-based feedback linearization technique is presented. The effectiveness of the proposed algorithm is tested with simulations. Experimental results show that the proposed method reduces the average position error from 35 mm to 2.45 mm in the presence of faults.

This paper introduces a manufacturing technique which enables the integration of soft materials and soft fluidic micro-actuators in the Pop-up book MEMS paradigm. Such a technique represents a promising approach to the design and... more

This paper introduces a manufacturing technique which enables the integration of soft materials and soft fluidic micro-actuators in the Pop-up book MEMS paradigm. Such a technique represents a promising approach to the design and fabrication of low cost and scalable articulated mechanisms provided with sensing capabilities and on-board actuation with potential applications in the field of minimally invasive surgery. Design and integration of soft components in the rigid-flex laminates is described along with the resulting soft pop-up mechanisms realized at different scales. Prototype characterization is presented, demonstrating forces and dexterity in a range suitable for surgical applications, as well as the possibility to integrate sensing capabilities. Based on these results, a multi-articulated robotic arm is fabricated and mounted on top of an endoscope model to provide a proof of concept of simple robotic mechanisms that could be useful in a surgical scenario.

This paper presents a fully actuated robotic system for percutaneous prostate therapy under continuously acquired live magnetic resonance imaging (MRI) guidance. The system is composed of modular hardware and software to support the... more

This paper presents a fully actuated robotic system for percutaneous prostate therapy under continuously acquired live magnetic resonance imaging (MRI) guidance. The system is composed of modular hardware and software to support the surgical workflow of intraoperative MRI-guided surgical procedures. We present the development of a 6-degree-of-freedom (DOF) needle placement robot for transperineal prostate interventions. The robot consists of a 3-DOF needle driver module and a 3-DOF Cartesian motion module. The needle driver provides needle cannula translation and rotation (2-DOF) and stylet translation (1-DOF). A custom robot controller consisting of multiple piezoelectric motor drivers provides precision closed-loop control of piezoelectric motors and enables simultaneous robot motion and MR imaging. The developed modular robot control interface software performs image-based registration, kinematics calculation, and exchanges robot commands and coordinates between the navigation software and the robot controller with a new implementation of the open network communication protocol OpenIGTLink. Comprehensive compatibility of the robot is evaluated inside a 3-T MRI scanner using standard imaging sequences and the signal-to-noise ratio loss is limited to 15%. The image deterioration due to the present and motion of robot demonstrates unobservable image interference. Twenty-five targeted needle placements inside gelatin phantoms utilizing an 18-gauge ceramic needle demonstrated 0.87-mm root-mean-square (RMS) error in 3-D Euclidean distance based on MRI volume segmentation of the image-guided robotic needle placement procedure.

The versatile uses and excellent soft tissue distinction afforded by magnetic resonance imaging (MRI) has led to the development of many MR-compatible devices for MRI-guided interventions. This paper presents a fully pneumatic... more

The versatile uses and excellent soft tissue distinction afforded by magnetic resonance imaging (MRI) has led to the development of many MR-compatible devices for MRI-guided interventions. This paper presents a fully pneumatic MR-compatible robotic platform designed for neurosurgical interventions. Actuated by nonmagnetic pneumatic
piston-cylinders, the robotic platform manipulates a five degree-of-freedom active cannula designed for deep brain interventions. Long lines of tubing connect the cylinders to remotely located pressure sensors and valves, and MRI-compatible optical sensors
mounted on the robot provide the robot joint positions. A robust, nonlinear, model-based controller precisely translates and rotates the robot joints, with mean steady-state errors of 0.032mm and 0.447 deg, respectively. MRI-compatibility testing in a 3-Tesla closed-bore scanner has shown that the robot has no impact on the signal-to-noise ratio, and that geometric distortion remains within recommended calibration limits for the scanner. These results demonstrate that pneumatic actuation is a promising solution for neurosurgical interventions that either require or can benefit from submillimeter precision. Additionally, this paper provides a detailed solution to the control problems imposed by severe nonlinearities in the pneumatic system, which has not previously been discussed in the context of MR-compatible devices.

Surgeons normally need surgical scissors and tissue grippers to cut through a deformable surgical tissue. The cutting accuracy depends on the skills to manipulate these two tools. Such skills are part of basic surgical skills training as... more

Surgeons normally need surgical scissors and tissue grippers to cut through a deformable surgical tissue. The cutting accuracy depends on the skills to manipulate these two tools. Such skills are part of basic surgical skills training as in the Fundamentals of Laparoscopic Surgery. The gripper is used to pinch a point on the surgical sheet and pull the tissue to a certain direction to maintain the tension while the scissors cut through a trajectory. As the surgical materials are deformable, it requires a comprehensive tensioning policy to yield appropriate tensioning direction at each step of the cutting process. Automating a tensioning policy for a given cutting trajectory will support not only the human surgeons but also the surgical robots to improve the cutting accuracy and reliability. This paper presents a multiple pinch point approach to modelling an autonomous tensioning planner based on a deep reinforcement learning algorithm. Experiments on a simulator show that the proposed method is superior to existing methods in terms of both performance and robustness.

Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a special method that allows surgical operations via natural orifices like mouth, anus, and vagina, without leaving visible scars. The use of flexible tendon-sheath mechanism... more

Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a special method that allows surgical operations via natural orifices like mouth, anus, and vagina, without leaving visible scars. The use of flexible tendon-sheath mechanism (TSM) is common in these systems because of its light weight in structure, flexibility, and easy transmission of power. However, nonlinear friction and backlash hysteresis pose many challenges to control of such systems; in addition, they do not provide haptic feedback to assist the surgeon in the operation of the systems. In this paper, we propose a new dynamic friction model and backlash hysteresis nonlinearity for a pair of TSM to deal with these problems. The proposed friction model, unlike current approaches in the literature, is smooth and able to capture the force at near zero velocity when the system is stationary or operates at small motion. This model can be used to estimate the friction force for haptic feedback purpose. To improve the system tracking performances, a backlash hysteresis model will be introduced, which can be used in a feedforward controller scheme. The controller involves a simple computation of the inverse hysteresis model. The proposed models are configuration independent and able to capture the nonlinearities for arbitrary tendon- sheath shapes. A representative experimental setup is used to validate the proposed models and to demonstrate the improvement in position tracking accuracy and the possibility of providing desired force information at the distal end of a pair of TSM slave manipulator for haptic feedback to the surgeons.

Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a method that allows for performing complex operations via natural orifices without skin incisions. Its main tool is a flexible endoscope. Cable-Conduit Mechanisms (CCMs) are often... more

Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a method that allows for performing complex operations via natural orifices without skin incisions. Its main tool is a flexible endoscope. Cable-Conduit
Mechanisms (CCMs) are often used in NOTES because of its simplicity, safety in design, and easy transmission. Backlash hysteresis nonlinearities between the cable and the conduit pose difficulties in the motion control of the NOTES system. It is challenging to achieve the precise position of robotic arms when the slave
manipulator inside the humans body. This paper presents new approaches to model and control for pairs of CCMs. It is known that the change of cable-conduit configuration will affect the backlash hysteresis nonlinearities. To deal with such change, a new nonlinear and adaptive control scheme will be introduced. The backlash hysteresis parameters are online estimated under the assumption of availability of output feedback
and unknown bound of nonlinear parameters. To validate the proposed approach, a prototype of single-DOF-Master-Slave system, which consists of a master console, a telesurgical workstation, and a slave manipulator, is also presented. The proposed compensation scheme is experimentally validated using the designed system. The results show that the proposed control scheme efficiently improves the tracking performances of the system regardless of the change of endoscope configuration.

Please cite this article in press as: M. Silvestri, et al., A multi-point of view 3D camera system for minimally invasive surgery, Sens. Actuators A: Phys. (2013), http://dx.Available online xxx Keywords: Vision system Endoscopy Minimally... more

Please cite this article in press as: M. Silvestri, et al., A multi-point of view 3D camera system for minimally invasive surgery, Sens. Actuators A: Phys. (2013), http://dx.Available online xxx Keywords: Vision system Endoscopy Minimally invasive surgery 3D vision Multi-view a b s t r a c t Endoscopes and laparoscopes in interventional endoscopy and in minimally invasive surgery (MIS) are the eyes of the surgeon. For this reason, research for innovative and more efficient visualization devices is always active. Furthermore, surgeons appreciate innovation and are generally open to new solutions.

In the future, robotic surgical assistants may assist surgeons by performing specific subtasks such as retraction and suturing to reduce surgeon tedium and reduce the duration of some operations. We propose an apprenticeship learning... more

In the future, robotic surgical assistants may assist surgeons by performing specific subtasks such as retraction and suturing to reduce surgeon tedium and reduce the duration of some operations. We propose an apprenticeship learning approach that has potential to allow robotic surgical assistants to autonomously execute specific trajectories with superhuman performance in terms of speed and smoothness. In the first step, we record a set of trajectories using human-guided backdriven motions of the robot. These are then analyzed to extract a smooth reference trajectory, which we execute at gradually increasing speeds using a variant of iterative learning control. We evaluate this approach on two representative tasks using the Berkeley Surgical Robots: a figure eight trajectory and a two handed knot-tie, a tedious suturing sub-task required in many surgical procedures. Results suggest that the approach enables (i) rapid learning of trajectories, (ii) smoother trajectories than the human-guided trajectories, and (iii) trajectories that are 7 to 10 times faster than the best human-guided trajectories.

The realistic simulation of tool-tissue interactions is necessary for the development of surgical simulators and one of the key element for it realism is accurate bio-mechanical tissue models. In this paper, we determined the mechanical... more

The realistic simulation of tool-tissue interactions is necessary for the development of surgical simulators and one of the key element for it realism is accurate bio-mechanical tissue models. In this paper, we determined the mechanical properties of soft tissue by minimizing the difference between experimental measurements and the analytical or simulated solution of the deformation. Then, we selected the best model parameters that fit the experimental data to simulate a bonded compression and a needle indentation with a flat-tip. We show that the inverse FEM allows accurate material property estimation. We also validated our results using multiple tool-tissue interactions over the same specimen.

Journal of Multibody Systems Dynamics (Elsevier) (Submitted)

BACKGROUND: Rectal cancer treatment is still a challenging frontier in general surgery, as there is no general agreement on which surgical approach is best for its management. Total mesorectal excision (TME), influenced the practical... more

BACKGROUND: Rectal cancer treatment is still a challenging frontier in general surgery, as there is no general agreement on which surgical approach is best for its management. Total mesorectal excision (TME), influenced the practical approach to rectal cancer, and brought a significant improvement on tumor recurrence and patients survival. Robotic transanal surgery is a newer approach to rectal dissection whose purpose is to overcome the limits of the traditional transabdominal approach, improving accuracy of distal dissection and preservation of hypogastric innervation. An increasing interest on this new technique has raised, thanks to the excellent pathological and acceptable short-term clinical outcomes reported. MATERIALS AND METHODS: Three consecutive cases of robotic transanal TME were prospectically performed between May 2017 and October 2017. RESULTS: TME quality was Quirke 3 grade in all cases. Mean operative time was 530 min. None of the patients had intra-operatively or post-operatively complications. CONCLUSIONS: Robotic transanal TME is a very recent procedure. Acclaimed greatest advantage of robotic transanal TME is the facilitation of dissection with an in-line view, which translates in an improved surgical field exposure and visualization. Further investigations are needed to assure the actual value of robotic transanal approach.

BACKGROUND: The recently developed magnetic resonance imaging–guided laser-induced thermal therapy offers a minimally invasive alternative to craniotomies performed for tumor resection or for amygdalohippocampectomy to control seizure... more

BACKGROUND: The recently developed magnetic resonance imaging–guided laser-induced thermal therapy offers a minimally invasive alternative to craniotomies performed for tumor resection or for amygdalohippocampectomy to control seizure disorders. Current laser-induced thermal therapies rely on linear stereotactic trajectories that mandate twist-drill entry into the skull and potentially long approaches traversing healthy brain. The use of robotically driven, telescoping, curved needles has the potential to reduce procedure invasiveness by tailoring trajectories to the curved shape of the ablated structure and by enabling access through natural orifices. OBJECTIVE: To investigate the feasibility of using a concentric tube robot to access the hippocampus through the foramen ovale to deliver thermal therapy and thereby provide a percutaneous treatment for epilepsy without drilling the skull. METHODS: The skull and both hippocampi were segmented from dual computed tomog-raphy/magnetic resonance image volumes for 10 patients. For each of the 20 hippocampi, a concentric tube robot was designed and optimized to traverse a trajectory from the foramen ovale to and through the hippocampus from head to tail. RESULTS: Across all 20 cases, the mean distances (errors) between the hippocampus medial axis and backbone of the needle were 0.55, 1.11, and 1.66 mm for the best, mean, and worst case, respectively. CONCLUSION: These curvilinear trajectories would provide accurate transforamenal delivery of an ablation probe to typical hippocampus volumes. This strategy has the potential both to decrease the invasiveness of the procedure and to increase the completeness of hippocampal ablation.

Surgeons perform minimally invasive surgery using an image delivered by a laparoscope and a camera system that provides a high definition 2D image, but this leaves the surgeon without 3D depth perception. The lack of depth perception can... more

Surgeons perform minimally invasive surgery using an image delivered by a laparoscope and a camera system that provides a high definition 2D image, but this leaves the surgeon without 3D depth perception. The lack of depth perception can slow the surgeon, increase the risk of misidentifying structures, and/or inadvertently cause unwanted injury to tissues surrounding the surgical site. To address the lack of depth perception, we propose a Surgical Structured Light (SSL) system that includes a 3D sensor capable of measuring and modeling the surgical site during a procedure. The 3D information provided by this system can enable the surgeon to: 1) improve the navigation of tools based on precise localization of instruments in relation to structures in the surgical site, 2) allow 3D visualizations side-by-side with a standard 2D color image, and 3) precisely measure sizes of structures (e.g., tumors) and distances between structures with simple mouse clicks. We demonstrate the accuracy of our SSL system using ex-vivo data on both a cylinder calibration object as well as various plastic organs.

The affordance of independent learning is one of the most important advantages of computer simulators for surgical training. This advantage can get dull if the simulator does not provide the useful instructional feedback to the user and... more

The affordance of independent learning is one of the most important advantages of computer simulators for surgical training. This advantage can get dull if the simulator does not provide the useful instructional feedback to the user and the instructor has to supervise and tutor the trainee while using the simulator. In fact the continued need of instructor feedback with most existing simulators is often cited as a primary reason for the reluctance of many medical schools to fully embrace simulator technology [Sewell 2007]. Thus the incorporation of relevant, intuitive metrics in a way that it provides a constructive feedback which facilitates independent learning is essential for the development of efficient simulators. Evaluating a trainee surgeon's performance as per trainer surgeon's desire is always a challenging problem in the development of minimal invasive surgery simulators. In this research we have proposed a novel metric for trainee surgeons' performance evaluation using machine learning algorithms.

In robotic surgery, pattern cutting through a de-formable material is a challenging research field. The cutting procedure requires a robot to concurrently manipulate a scissor and a gripper to cut through a predefined contour trajectory... more

In robotic surgery, pattern cutting through a de-formable material is a challenging research field. The cutting procedure requires a robot to concurrently manipulate a scissor and a gripper to cut through a predefined contour trajectory on the deformable sheet. The gripper ensures the cutting accuracy by nailing a point on the sheet and continuously tensioning the pinch point to different directions while the scissor is in action. The goal is to find a pinch point and a corresponding tensioning policy to minimize damage to the material and increase cutting accuracy measured by the symmetric difference between the predefined contour and the cut contour. Previous study considers finding one fixed pinch point during the course of cutting, which is inaccurate and unsafe when the contour trajectory is complex. In this paper, we examine the soft tissue cutting task by using multiple pinch points, which imitates human operations while cutting. This approach, however, does not require the use of a multi-gripper robot. We use a deep reinforcement learning algorithm to find an optimal tensioning policy of a pinch point. Simulation results show that the multi-point approach outperforms the state-of-the-art method in soft pattern cutting task with respect to both accuracy and reliability.

This invited talk at COSUR 2018 describes a number of aspects of the application of machine learning to surgical robotics, ranging from perception to cognition (the recognition of surgeon actions, anomalous events, and the prediction of... more

This invited talk at COSUR 2018 describes a number of aspects of the application of machine learning to surgical robotics, ranging from perception to cognition (the recognition of surgeon actions, anomalous events, and the prediction of future developments).

Microsurgical interventions are demanding operations that require high precision and dexterity. They also represent an area where computer-assisted surgery and medical robots can have a deep impact, helping surgeons perform more accurate... more

Microsurgical interventions are demanding operations that require high precision and dexterity. They also represent an area where computer-assisted surgery and medical robots can have a deep impact, helping surgeons perform more accurate and safer operations, or even perform autonomous interventions and thereby enable previously impossible procedures. A number of robotic systems are already being used clinically for microsurgeries, including robotic catheters, neurosurgery robots, microrobots and even the Intuitive Surgical's da Vinci system. In addition, many other are being developed around the globe in numerous research centers.

Soft, flexible robotic manipulators offer many advantages to Minimally Invasive Surgery (MIS) compared to using conventional rigid laparoscopic instruments: Soft robots are inherently safe due to the material used for the body structure... more

Soft, flexible robotic manipulators offer many advantages to Minimally Invasive Surgery (MIS) compared to using conventional rigid laparoscopic instruments: Soft robots are inherently safe due to the material used for the body structure and their compliant actuation system allowing safe interaction with its soft environment; the flexibility allows bending around organs and navigating along trajectories within the complex anatomical environment. To feedback the tip position of these manipulators required for position control for instance, it is beneficial to integrate a bending sensor that accurately determines the curvature. This paper presents a bending sensor embedded into a pneumatically actuated, soft manipulator based on a silicone body structure. The sensing system is made of three threads of stretchable electro-conductive yarn inserted in the periphery for direct measurement of the actuation chamber lengths. The bending sensor is able to measure elongation and bending behaviour. The soft structure of the manipulator is maintained. Our sensor is benchmarked using a commercially available magnetic tracking system.

Microsurgical interventions are demanding operations that require high precision and dexterity. They also represent an area where computer-assisted surgery and medical robots can have a deep impact, helping surgeons perform more accurate... more

Microsurgical interventions are demanding operations that require high precision and dexterity. They also represent an area where computer-assisted surgery and medical robots can have a deep impact, helping surgeons perform more accurate and safer operations, or even perform autonomous interventions and thereby enable previously impossible procedures. A number of robotic systems are already being used clinically for microsurgeries, including robotic catheters, neurosurgery robots, microrobots and even the Intuitive Surgical's da Vinci system. In addition, many other are being developed around the globe in numerous research centers.

As a result of the rapid spreading of stereoscopy in the consumer market, three-dimensional (3D) vision systems are replacing two-dimensional devices. A fast growing technology in the 3D visualization systems market is multiviews... more

As a result of the rapid spreading of stereoscopy in the consumer market, three-dimensional (3D) vision systems are replacing two-dimensional devices. A fast growing technology in the 3D visualization systems market is multiviews autostereoscopic displays (ADs). However, these devices have not yet found a direct application in minimally invasive surgery (MIS), as it is really challenging to embed a high number of point-of-views in a device which has to pass through a MIS incision. The aim of this work is the development of a miniaturized vision acquisition system for MIS, which can be interfaced with multi-views ADs. The system is anchored by a magnetic link to the abdomen and freely moved by magnetic actuation to adjust the point of view and the horizon of the cameras. The laparoscope can embed up to 9 cameras, while matching typical MIS access incision size.