A microsurgical robot research platform for robot-assisted microsurgery research and training

FF-ViT: probe orientation regression for robot-assisted endomicroscopy tissue scanning

PURPOSE

Probe-based confocal laser endomicroscopy (pCLE) enables visualization of cellular tissue morphology during surgical procedures. To capture high-quality pCLE images during tissue scanning, it is important to maintain close contact between the probe and the tissue, while also keeping the probe perpendicular to the tissue surface. Existing robotic pCLE tissue scanning systems, which rely on macroscopic vision, struggle to accurately place the probe at the optimal position on the tissue surface. As a result, the need arises for regression of longitudinal distance and orientation via endomicroscopic vision.

METHOD

This paper introduces a novel method for automatically regressing the orientation between a pCLE probe and the tissue surface during robotic scanning, utilizing the fast Fourier vision transformer (FF-ViT) to extract local frequency representations and use them for probe orientation regression. Additionally, the FF-ViT incorporates a blur mapping attention (BMA) module to refine latent representations, which is combined with the pyramid angle regressor (PAR) to precisely estimate probe orientation.

RESULT

A first of its kind dataset for pCLE probe-tissue orientation (pCLE-PTO) has been created. The performance evaluation demonstrates that our proposed network surpasses other top regression networks in accuracy, stability, and generalizability, while maintaining low computational complexity (1.8G FLOPs) and high inference speed (90 fps).

CONCLUSION

The performance evaluation study verifies the clinical value of the proposed framework and its potential to be integrated into surgical robotic platforms for intraoperative tissue scanning.

A Lightweight and Affordable Wearable Haptic Controller for Robot-Assisted Microsurgery

In robot-assisted microsurgery (RAMS), surgeons often face the challenge of operating with minimal feedback, particularly lacking in haptic feedback. However, most traditional desktop haptic devices have restricted operational areas and limited dexterity. This report describes a novel, lightweight, and low-budget wearable haptic controller for teleoperated microsurgical robotic systems. We designed a wearable haptic interface entirely made using off-the-shelf material-PolyJet Photopolymer, fabricated using liquid and solid hybrid 3D co-printing technology. This interface was designed to resemble human soft tissues and can be wrapped around the fingertips, offering direct contact feedback to the operator. We also demonstrated that the device can be easily integrated with our motion tracking system for remote microsurgery. Two motion tracking methods, marker-based and marker-less, were compared in trajectory-tracking experiments at different depths to find the most effective motion tracking method for our RAMS system. The results indicate that within the 4 to 8 cm tracking range, the marker-based method achieved exceptional detection rates. Furthermore, the performance of three fusion algorithms was compared to establish the unscented Kalman filter as the most accurate and reliable. The effectiveness of the wearable haptic controller was evaluated through user studies focusing on the usefulness of haptic feedback. The results revealed that haptic feedback significantly enhances depth perception for operators during teleoperated RAMS.

Microsurgery Robots: Applications, Design, and Development

Microsurgical techniques have been widely utilized in various surgical specialties, such as ophthalmology, neurosurgery, and otolaryngology, which require intricate and precise surgical tool manipulation on a small scale. In microsurgery, operations on delicate vessels or tissues require high standards in surgeons' skills. This exceptionally high requirement in skills leads to a steep learning curve and lengthy training before the surgeons can perform microsurgical procedures with quality outcomes. The microsurgery robot (MSR), which can improve surgeons' operation skills through various functions, has received extensive research attention in the past three decades. There have been many review papers summarizing the research on MSR for specific surgical specialties. However, an in-depth review of the relevant technologies used in MSR systems is limited in the literature. This review details the technical challenges in microsurgery, and systematically summarizes the key technologies in MSR with a developmental perspective from the basic structural mechanism design, to the perception and human-machine interaction methods, and further to the ability in achieving a certain level of autonomy. By presenting and comparing the methods and technologies in this cutting-edge research, this paper aims to provide readers with a comprehensive understanding of the current state of MSR research and identify potential directions for future development in MSR.

Using the language of surgery to enhance ophthalmology surgical education

Background

Currently, surgical education utilizes a combination of the apprentice model, wet-lab training, and simulation, but due to reliance on subjective data, the quality of teaching and assessment can be variable. The "language of surgery," an established concept in engineering literature whose incorporation into surgical education has been limited, is defined as the description of each surgical maneuver using quantifiable metrics. This concept is different from the traditional notion of surgical language, generally thought of as the qualitative definitions and terminology used by surgeons.

Methods

A literature search was conducted through April 2023 using MEDLINE/PubMed using search terms to investigate wet-lab, virtual simulators, and robotics in ophthalmology, along with the language of surgery and surgical education. Articles published before 2005 were mostly excluded, although a few were included on a case-by-case basis.

Results

Surgical maneuvers can be quantified by leveraging technological advances in virtual simulators, video recordings, and surgical robots to create a language of surgery. By measuring and describing maneuver metrics, the learning surgeon can adjust surgical movements in an appropriately graded fashion that is based on objective and standardized data. The main contribution is outlining a structured education framework that details how surgical education could be improved by incorporating the language of surgery, using ophthalmology surgical education as an example.

Conclusion

By describing each surgical maneuver in quantifiable, objective, and standardized terminology, a language of surgery can be created that can be used to learn, teach, and assess surgical technical skill with an approach that minimizes bias.

Key message

The "language of surgery," defined as the quantification of each surgical movement's characteristics, is an established concept in the engineering literature. Using ophthalmology surgical education as an example, we describe a structured education framework based on the language of surgery to improve surgical education.

Classifications

Surgical education, robotic surgery, ophthalmology, education standardization, computerized assessment, simulations in teaching.

Competencies

Practice-Based Learning and Improvement.

Advanced medical micro-robotics for early diagnosis and therapeutic interventions

Recent technological advances in micro-robotics have demonstrated their immense potential for biomedical applications. Emerging micro-robots have versatile sensing systems, flexible locomotion and dexterous manipulation capabilities that can significantly contribute to the healthcare system. Despite the appreciated and tangible benefits of medical micro-robotics, many challenges still remain. Here, we review the major challenges, current trends and significant achievements for developing versatile and intelligent micro-robotics with a focus on applications in early diagnosis and therapeutic interventions. We also consider some recent emerging micro-robotic technologies that employ synthetic biology to support a new generation of living micro-robots. We expect to inspire future development of micro-robots toward clinical translation by identifying the roadblocks that need to be overcome.

Concepts and Trends n Autonomy for Robot-Assisted Surgery

Surgical robots have been widely adopted with over 4000 robots being used in practice daily. However, these are telerobots that are fully controlled by skilled human surgeons. Introducing "surgeon-assist"-some forms of autonomy-has the potential to reduce tedium and increase consistency, analogous to driver-assist functions for lanekeeping, cruise control, and parking. This article examines the scientific and technical backgrounds of robotic autonomy in surgery and some ethical, social, and legal implications. We describe several autonomous surgical tasks that have been automated in laboratory settings, and research concepts and trends.

Workspace Volume of Human Bimanual Precision Manipulation Influenced by the Wrist Configuration and Finger Combination

Bimanual precision manipulation is an essential ability in daily human lives. However, the kinematic ability of bimanual precision manipulation due to its complexity and randomness was rarely discussed. This study firstly presents an objective quantitative evaluation of bimanual precision manipulation based on workspace volume. It focuses on studying the effects of the wrist and finger factors on the bimanual manipulation abilities by measuring the workspaces through which ten participants manipulated an object under the 12 situations (3 wrist configurations × 4 finger combinations). The results show that the wrists participation significantly increases the workspace for bimanual precision manipulation, while different finger combinations also substantially affect workspace volume. Therefore, we found an optimal hand situation (two indexes cooperating with the wrists participation), allowing the workspace to reach a volume of 1600cm³, which is ten times higher than the worst situation. Furthermore, the involvement of the right thumb can significantly increase the contribution ratio of finger movement in bimanual precision manipulation, making the movement more accurate and stable. The study has the potential to contribute to the researches in many domains, ranging from developing surgical devices, training doctors in microsurgical techniques, providing normative data for rehabilitation.

A comparative review of artificial muscles for microsystem applications

Artificial muscles are capable of generating actuation in microsystems with outstanding compliance. Recent years have witnessed a growing academic interest in artificial muscles and their application in many areas, such as soft robotics and biomedical devices. This paper aims to provide a comparative review of recent advances in artificial muscle based on various operating mechanisms. The advantages and limitations of each operating mechanism are analyzed and compared. According to the unique application requirements and electrical and mechanical properties of the muscle types, we suggest suitable artificial muscle mechanisms for specific microsystem applications. Finally, we discuss potential strategies for energy delivery, conversion, and storage to promote the energy autonomy of microrobotic systems at a system level.

Research progress and development trend of surgical robot and surgical instrument arm

BACKGROUND

In recent years, surgical robots have become an indispensable part of the medical field. Surgical robots are increasingly being used in the areas of gynaecological surgery, urological surgery, orthopaedic surgery, general surgery and so forth. In this paper, the development of surgical robots in different operations is reviewed and analysed. In the type of master-slave surgical robotic system, the robotic surgical instrument arms were located in the execution terminal of a surgical robot system, as one of the core components, and directly contact with the patient during the operation, which plays an important role in the efficiency and safety of the operation. In clinical, the arm function and design in different systems varies. Furtherly, the current research progress of robotic surgical instrument arms used in different operations is analysed and summarised. Finally, the challenge and trend are concluded.

METHODS

According to the classification of surgical types, the development of surgical robots for laparoscopic surgery, neurosurgery, orthopaedics and microsurgery are analysed and summarised. Then, focusing on the research of robotic surgical instrument arms, according to structure type, the research and application of straight-rod surgical instrument arm, joint surgical instrument arm and continuous surgical instrument arm are analysed respectively.

RESULTS

According to the discussion and summary of the characteristics of the existing surgical robots and instrument arms, it is concluded that they still have a lot of room for development in the future. Therefore, the development trends of the surgical robot and instrument arm are discussed and analysed in the five aspects of structural materials, modularisation, telemedicine, intelligence and human-machine collaboration.

CONCLUSION

Surgical robots have shown the development trend of miniaturisation, intelligence, autonomy and dexterity. Thereby, in the field of science and technology, the research on the next generation of minimally invasive surgical robots will usher in a peak period of development.

A novel encountered-type master device with precise manipulation for robot-assisted microsurgery

BACKGROUND

The unconstrained master devices have emerged as attractive alternatives to the existing linkage-based counterparts. However, the conventional unconstrained master device's manipulation methods have several disadvantages in efficiency and precision.

METHODS

We propose an encountered-type master device based on an electromagnetic tracking solution with a prismatic joint at the tip, capable of continuous spatial manipulation with the tip supported on the surface. We performed path-following task and pointing tasks to analyze the performance of the master device.

RESULTS

The most convenient, efficient, accurate positioning and precise pointing were possible with a closed loop support condition. Moreover, the tasks under this condition were also completed with higher accuracy, and precision when applying lower motion scale factors.

CONCLUSIONS

The proposed master device allowed precise and accurate manipulation for microsurgical tasks. Compared with the conventional unconstrained master devices, the proposed master device provides the ability to perform precise work with a clutching-free motion.