Virtual wall-based haptic-guided teleoperated surgical robotic system for single-port brain tumor removal surgery

The benefits of haptic feedback in robot assisted surgery and their moderators: a meta-analysis

Robot assisted surgery (RAS) provides medical practitioners with valuable tools, decreasing strain during surgery and leading to better patient outcomes. While the loss of haptic sensation is a commonly cited disadvantage of RAS, new systems aim to address this problem by providing artificial haptic feedback. N = 56 papers that compared robotic surgery systems with and without haptic feedback were analyzed to quantify the performance benefits of restoring the haptic modality. Additionally, this study identifies factors moderating the effect of restoring haptic sensation. Overall results showed haptic feedback was effective in reducing average forces (Hedges' g = 0.83) and peak forces (Hedges' g = 0.69) applied during surgery, as well as reducing the completion time (Hedges' g = 0.83). Haptic feedback has also been found to lead to higher accuracy (Hedges' g = 1.50) and success rates (Hedges' g = 0.80) during surgical tasks. Effect sizes on several measures varied between tasks, the type of provided feedback, and the subjects' levels of surgical expertise, with higher levels of expertise generally associated with smaller effect sizes. No significant differences were found between virtual fixtures and rendering contact forces. Implications for future research are discussed.

[Robotics and computer-assisted procedures in cranial neurosurgery]

BACKGROUND

The medical technical innovations over the last decade have made operations in the highly sensitive regions of the brain much safer.

OBJECTIVE

Presentation of how far computer assistance and robotics have become incorporated into clinical neurosurgery.

MATERIAL AND METHOD

Evaluation of the scientific literature and analysis of the certification status of the corresponding medical devices.

RESULTS

The rapid development of computer technology and the switch to digital imaging has led to the widespread introduction of neurosurgical planning software and intraoperative neuronavigation. In the field of robotics, the penetration into clinical neurosurgery is currently still largely limited to the automatic setting of trajectories.

CONCLUSION

The digitalization of imaging has fundamentally transformed neurosurgery. In the field of cranial neurosurgery, computer-assisted procedures can now be distinguished from noncomputer-assisted procedures only in a handful of cases. In the coming years important innovations for the clinical implementation can be expected in the field of robotics.

Usability of cooperative surgical telemanipulation for bone milling tasks

Purpose

Cooperative surgical systems enable humans and machines to combine their individual strengths and collaborate to improve the surgical outcome. Cooperative telemanipulated systems offer the widest spectrum of cooperative functionalities, because motion scaling is possible. Haptic guidance can be used to assist surgeons and haptic feedback makes acting forces at the slave side transparent to the operator, however, overlapping and masking of forces needs to be avoided. This study evaluates the usability of a cooperative surgical telemanipulator in a laboratory setting.

Methods

Three experiments were designed and conducted for characteristic surgical task scenarios derived from field studies in orthopedics and neurosurgery to address bone tissue differentiation, guided milling and depth sensitive milling. Interaction modes were designed to ensure that no overlapping or masking of haptic guidance and haptic feedback occurs when allocating information to the haptic channel. Twenty participants were recruited to compare teleoperated modes, direct manual execution and an exemplary automated milling with respect to usability.

Results

Participants were able to differentiate compact and cancellous bone, both directly manually and teleoperatively. Both telemanipulated modes increased effectiveness measured by the mean absolute depth and contour error for guided and depth sensitive millings. Efficiency is decreased if solely a boundary constraint is used in hard material, while a trajectory guidance and manual milling perform similarly. With respect to subjective user satisfaction trajectory guidance is rated best for guided millings followed by boundary constraints and the direct manual interaction. Haptic feedback only improved subjective user satisfaction.

Conclusion

A cooperative surgical telemanipulator can improve effectiveness and efficiency close to an automated execution and enhance user satisfaction compared to direct manual interaction. At the same time, the surgeon remains part of the control loop and is able to adjust the surgical plan according to the intraoperative situation and his/her expertise at any time.

Multi-Mode Haptic Display of Image Based on Force and Vibration Tactile Feedback Integration

In order to enhance the sense of reality haptic display based on image, it is widely expected to express various characteristics of the objects in the image using different kinds of haptic feedback. To this end, a multi-mode haptic display method of image was proposed in this paper, including the multi-feature extraction of image and the image expression with various types of haptic rendering. First, the device structure integrating force and vibrotactile feedbacks was designed for multi-mode haptic display. Meanwhile, the three-dimensional geometric shape, detail texture and outline of the object in the image were extracted by various image processing algorithms. Then, a rendering method for the object in the image was proposed based on the psychophysical experiments on the piezoelectric ceramic actuator. The 3D geometric shape, detail texture and outline of the object were rendered by force and vibration tactile feedbacks, respectively. Finally, these three features of the image were haptic expressed simultaneously by the integrated device. Haptic perception experiment results show that the multi-mode haptic display method can effectively improve the authenticity of haptic perception.

Development of Phantom Material that Resembles Compression Properties of Human Brain Tissue for Training Models

There is a need to quantify and reproduce the mechanical behavior of brain tissue for a variety of applications from designing proper training models for surgeons to enabling research on the effectiveness of personal protective gear, such as football helmets. The mechanical response of several candidate phantom materials, including hydrogels and emulsions, was characterized and compared to porcine brain tissue under similar strains and strain rates. Some candidate materials were selected since their compositions were similar to brain tissue, such as emulsions that mimic the high content of lipids. Others, like silicone, were included since these are currently used as phantom materials. The mechanical response of the emulsion was closer to that of the native porcine brain tissue than the other candidates. The emulsions, created by addition of oil to a hydrogel, were able to withstand compressive strain greater than 40%. The addition of lipids in the emulsions also prevented the syneresis typically seen with hydrogel materials. This allowed the emulsion material to undergo freeze-thaw cycles with no significant change in their mechanical properties.

DESIGN AND APPLICATION OF BOUNDING VOLUME HIERARCHY COLLISION DETECTION ALGORITHM BASED ON VIRTUAL SPHERE

The result of collision detection is closely related to the further deformation or cutting action of soft tissue. In order to further improve the efficiency and stability of collision detection, in this paper, a collision detection algorithm of bounding volume hierarchy based on virtual sphere was proposed. The proposed algorithm was validated and the results show that the detection efficiency of the bounding volume hierarchy algorithm based on virtual sphere is higher than that of the serial hybrid bounding volume hierarchy algorithm and the parallel hybrid bounding volume hierarchy algorithm. Different collision detection algorithms were tested and the results show that the collision detection algorithm based on virtual sphere has high detection efficiency and good stability. As the number of triangular patches increased, the advantage was more and more obvious. Finally, the proposed algorithm was applied to two large and medium-sized virtual scenes to implement the collision detection between the vastus lateralis muscle, thigh and surgical instrument. Based on the virtual sphere, the collision detection algorithm of bounding volume hierarchy can implement efficient and stable collision detection in a virtual surgery system. Meanwhile, the algorithm can be combined with other acceleration algorithms (such as the multithread acceleration algorithm) to further improve detection efficiency.

A wearable vibrotactile system for distributed guidance in teleoperation and virtual environments

A novel wearable vibrotactile system is proposed in this article to enhance the performance of teleoperation robot systems. Using a wearable vibrotactile glove, the proposed system guides the operator in the master-slave control through a vibrotactile-visual guidance method. Based on sensory substitution, the vibrotactile-visual combined guidance method combines vibration stimuli and visual feedback to substitute the virtual guidance force. A vibrotactile potential field is constructed in the workspace of the master-operator to calculate the frequency of the vibration stimulus. To provide vibration stimuli, a novel vibrotactile glove is designed and manufactured based on the layout of the sensitive region of human hand. As the human hand is unable to discriminate vibration stimuli of all frequencies, the vibration stimulus is discretization according to the result of the vibration discriminability experiment. At last, two contrast experiments in obstacle-free and obstacle-existing environments are conducted to verify the feasibility and effectiveness of the wearable vibrotactile system. The results show that this wearable vibrotactile system is an effective solution for guiding the operators in teleoperation and virtual environments.