A Cooperative Human-Robot Interface for Constrained Manipulation in Robot-Assisted Endonasal Surgery

A Concurrent Framework for Constrained Inverse Kinematics of Minimally Invasive Surgical Robots

Minimally invasive surgery has undergone significant advancements in recent years, transforming various surgical procedures by minimizing patient trauma, postoperative pain, and recovery time. However, the use of robotic systems in minimally invasive surgery introduces significant challenges related to the control of the robot's motion and the accuracy of its movements. In particular, the inverse kinematics (IK) problem is critical for robot-assisted minimally invasive surgery (RMIS), where satisfying the remote center of motion (RCM) constraint is essential to prevent tissue damage at the incision point. Several IK strategies have been proposed for RMIS, including classical inverse Jacobian IK and optimization-based approaches. However, these methods have limitations and perform differently depending on the kinematic configuration. To address these challenges, we propose a novel concurrent IK framework that combines the strengths of both approaches and explicitly incorporates RCM constraints and joint limits into the optimization process. In this paper, we present the design and implementation of concurrent inverse kinematics solvers, as well as experimental validation in both simulation and real-world scenarios. Concurrent IK solvers outperform single-method solvers, achieving a 100% solve rate and reducing the IK solving time by up to 85% for an endoscope positioning task and 37% for a tool pose control task. In particular, the combination of an iterative inverse Jacobian method with a hierarchical quadratic programming method showed the highest average solve rate and lowest computation time in real-world experiments. Our results demonstrate that concurrent IK solving provides a novel and effective solution to the constrained IK problem in RMIS applications.

A Trust-Assist Framework for Human–Robot Co-Carry Tasks

Robots are increasingly being employed for diverse applications where they must work and coexist with humans. The trust in human–robot collaboration (HRC) is a critical aspect of any shared-task performance for both the human and the robot. The study of a human-trusting robot has been investigated by numerous researchers. However, a robot-trusting human, which is also a significant issue in HRC, is seldom explored in the field of robotics. Motivated by this gap, we propose a novel trust-assist framework for human–robot co-carry tasks in this study. This framework allows the robot to determine a trust level for its human co-carry partner. The calculations of this trust level are based on human motions, past interactions between the human–robot pair, and the human’s current performance in the co-carry task. The trust level between the human and the robot is evaluated dynamically throughout the collaborative task, and this allows the trust to change if the human performs false positive actions, which can help the robot avoid making unpredictable movements and causing injury to the human. Additionally, the proposed framework can enable the robot to generate and perform assisting movements to follow human-carrying motions and paces when the human is considered trustworthy in the co-carry task. The results of our experiments suggest that the robot effectively assists the human in real-world collaborative tasks through the proposed trust-assist framework.

A Review on Tactile Displays for Conventional Laparoscopic Surgery

Laparoscopic surgery (LS) is a minimally invasive technique that offers many advantages over traditional open surgery: it reduces trauma, scarring, and shortens recovery time. However, an important limitation is the loss of tactile sensations. Although some progress has been made in robotic-assisted minimally invasive surgery (RMIS) setups, RMIS is still not widely accessible. This review aims to identify which tactile display technologies have been proposed and experimentally validated for the restoration of tactile sensations during conventional laparoscopic surgical tasks. We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We identified relevant articles published over the past 10 years through a search on Web of science, Scopus, IEEE Xplore Digital, and PubMed repositories. A total of 143 articles met the inclusion criteria and 24 were included in the final review. From the reviewed articles, we classified the proposed tactile displays into two categories based on the use of skin contact: (i) skin tactile displays, which include vibrotactile, skin-indentation, and grip-feedback devices, and (ii) non-contact tactile displays based on visualization tools. This survey aims to contribute to further research in the area of tactile displays for laparoscopic surgery by providing a better understanding of the current state of the art and identifying the remaining challenges.

Robotics in laparoscopic surgery - A review

Because of the increasing use of laparoscopic surgeries, robotic technologies have been developed to overcome the challenges these surgeries impose on surgeons. This paper presents an overview of the current state of surgical robots used in laparoscopic surgeries. Four main categories were discussed: handheld laparoscopic devices, laparoscope positioning robots, master–slave teleoperated systems with dedicated consoles, and robotic training systems. A generalized control block diagram is developed to demonstrate the general control scheme for each category of surgical robots. In order to review these robotic technologies, related published works were investigated and discussed. Detailed discussions and comparison tables are presented to compare their effectiveness in laparoscopic surgeries. Each of these technologies has proved to be beneficial in laparoscopic surgeries.

Enabling personalization of a robotic surgery procedure via a surgery training simulator

Although robotic or robot-assisted surgery has been increasingly used by many surgical disciplines, its application in cranial or skull base surgery is still in its infancy. Master-slave teleoperation setting of these robotic systems enables these surgical procedures to be replicated in a virtual reality environment for surgeon training purposes. A variety of teleoperation modes were previously determined with respect to the motion capability of the surgeon’s hand that wears the ring as the surgeon handles a surgical tool inside the surgical workspace. In this surgery training simulator developed for a robot-assisted endoscopic skull base surgery, a new strategy is developed to identify the preferred motion axes of the surgeon. This simulator is designed specifically for tuning the teleoperation system for each surgeon via the identification. This tuning capability brings flexibility to adjust the system operation with respect to the motion characteristics of the surgeon.

Robotic Handle Prototypes for Endoscopic Endonasal Skull Base Surgery: Pre-clinical Randomised Controlled Trial of Performance and Ergonomics

Endoscopic endonasal skull base surgery is a promising alternative to transcranial approaches. However, standard instruments lack articulation, and thus, could benefit from robotic technologies. The aim of this study was to develop an ergonomic handle for a handheld robotic instrument intended to enhance this procedure. Two different prototypes were developed based on ergonomic guidelines within the literature. The first is a forearm-mounted handle that maps the surgeon's wrist degrees-of-freedom to that of the robotic end-effector; the second is a joystick-and-trigger handle with a rotating body that places the joystick to the position most comfortable for the surgeon. These handles were incorporated into a custom-designed surgical virtual simulator and were assessed for their performance and ergonomics when compared with a standard neurosurgical grasper. The virtual task was performed by nine novices with all three devices as part of a randomised crossover user-study. Their performance and ergonomics were evaluated both subjectively by themselves and objectively by a validated observational checklist. Both handles outperformed the standard instrument with the rotating joystick-body handle offering the most substantial improvement in terms of balance between performance and ergonomics. Thus, it is deemed the more suitable device to drive instrumentation for endoscopic endonasal skull base surgery.

A Review on Methods and Systems for Remote Collaboration

Due to the appearance of COVID-19 in 2019, person-to-person interactions were drastically reduced. The impact of these restrictions on the economic environment was significant. For example, technical assistance for commissioning or adjusting the parameters of some complex machines/installations had to be postponed. Economic operators became interested in the possibility of remote collaboration, depending on the manufactured products and the performance of the production lines that they owned. This bibliographic research was undertaken to address these needs. The purpose of this review was to analyze the current solutions, approaches, and technologies that workers and specialists can implement to obtain a reliable remote collaboration system. This survey focuses on techniques, devices, and tools that are being used in different contexts to provide remote guidance. We present communication cues and methods being employed, the implemented technological support, and the areas that benefit from remote collaboration. We hope that our effort will be useful to those who develop such systems and people who want to learn about the existence of collaborative solutions, and that it will increase awareness about the applications and the importance of the domain. We are convinced that, with the development of communication systems, the advancement of remote support systems will be a goal for many economic operators.

Identification of Inertial Parameters for Position and Force Control of Surgical Assistance Robots

Surgeries or rehabilitation exercises are hazardous tasks for a mechanical system, as the device has to interact with parts of the human body without the hands-on experience that the surgeon or physiotherapist acquires over time. For various gynecological laparoscopic surgeries, such as laparoscopic hysterectomy or laparoscopic pelvic endometriosis, Uterine Manipulators are used. These medical devices allow the uterus to be suitably mobilized. A gap needs to be filled in terms of the precise handling of this type of devices. In this sense, this manuscript first describes the mathematical procedure to identify the inertial parameters of uterine manipulators. These parameters are needed to establish an accurate position and force control for an electromechanical system to assist surgical operations. The method for identifying the mass and the center of mass of the manipulator is based on the solution of the equations for the static equilibrium of rigid solids. Based on the manipulator inertial parameter estimation, the paper shows how the force exerted by the manipulator can be obtained. For this purpose, it solves a matrix system composed of the torques and forces of the manipulator. Different manipulators have been used, and it has been verified that the mathematical procedures proposed in this work allow us to calculate in an accurate and efficient way the force exerted by these manipulators.

Collaborative Robotic Assistant Platform for Endonasal Surgery: Preliminary In-Vitro Trials

Endonasal surgery is a minimally invasive approach for the removal of pituitary tumors (sarcomas). In this type of procedure, the surgeon has to complete the surgical maneuvers for sarcoma resection with extreme precision, as there are many vital structures in this area. Therefore, the use of robots for this type of intervention could increase the success of the intervention by providing accurate movements. Research has focused on the development of teleoperated robots to handle a surgical instrument, including the use of virtual fixtures to delimit the working area. This paper aims to go a step further with a platform that includes a teleoperated robot and an autonomous robot dedicated to secondary tasks. In this way, the aim is to reduce the surgeon’s workload so that he can concentrate on his main task. Thus, the article focuses on the description and implementation of a navigator that coordinates both robots via a force/position control. Finally, both the navigation and control scheme were validated by in-vitro tests.

Optimization-Based Constrained Trajectory Generation for Robot-Assisted Stitching in Endonasal Surgery

The reduced workspace in endonasal endoscopic surgery (EES) hinders the execution of complex surgical tasks such as suturing. Typically, surgeons need to manipulate non-dexterous long surgical instruments with an endoscopic view that makes it difficult to estimate the distances and angles required for precise suturing motion. Recently, robot-assisted surgical systems have been used in laparoscopic surgery with promising results. Although robotic systems can provide enhanced dexterity, robot-assisted suturing is still highly challenging. In this paper, we propose a robot-assisted stitching method based on an online optimization-based trajectory generation for curved needle stitching and a constrained motion planning framework to ensure safe surgical instrument motion. The needle trajectory is generated online by using a sequential convex optimization algorithm subject to stitching kinematic constraints. The constrained motion planner is designed to reduce surrounding damages to the nasal cavity by setting a remote center of motion over the nostril. A dual concurrent inverse kinematics (IK) solver is proposed to achieve convergence of the solution and optimal time execution, in which two constrained IK methods are performed simultaneously; a task-priority based IK and a nonlinear optimization-based IK. We evaluate the performance of the proposed method in a stitching experiment with our surgical robotic system in a robot-assisted mode and an autonomous mode in comparison to the use of a conventional surgical tool. Our results demonstrate a noticeable improvement in the stitching success ratio in the robot-assisted mode and the shortest completion time for the autonomous mode. In addition, the force interaction with the tissue was highly reduced when using the robotic system.