Prototypic Force Feedback Instrument for Minimally Invasive Robotic Surgery

Abstract

In recent years the success of the daVinci robotic surgery system (Intuitive Surgical Inc., Sunnyvale, CA, USA) has demonstrated the advantages of a telerobotic approach in minimally invasive surgery (MIS). The worldwide need and acceptance of robotic assistance systems for minimally invasive surgery can be seen with more than 600 sold systems worldwide1. Still haptic feedback, important to surgeons who generally rely on the sense of touch in assessing tissue properties, is missing. This is due to the lack of suitable instruments capable of measuring the manipulation forces inside the human body on one hand and the lack of haptic displays for conveying this force information in a comprehensible way to the surgeon on the other hand. In this chapter we present a prototypic force feedback instrument as well as a surgeon workstation as part of a complete setup for minimally invasive robotic surgery (MIRS). The system serves as technology demonstrator showing the feasibility of integrating advanced manipulator technology, haptic feedback and (semi-) autonomous functionality in the context of MIRS. The system will be used to evaluate the impact and benefit of these technologies and hopefully help to improve the acceptance of advanced MIRS. A selection of surgical applications, notably suturing (anastomosis) of coronary vessels while following the motion of the beating heart (motion compensation), provide the requirements in terms of functionality and performance. In a first step, described in this chapter, components are built and the adherence to the required specifications is assured (objective performance measurement). In a future step the impact and benefit on the selected surgical tasks (subjective performance measurement) will be evaluated by defining relevant experiments and performance metrics. Over the course of the project emphasize is given to generic and modular concepts, as acceptance of MIRS technology will be improved by high usability and good integration into the clinical workflow. After a short introduction into MIS and MIRS (Section 1.1 and 1.2) the DLR scenario is introduced in Section 2 followed by a selection of related research in Section 3. Main focus lies on an instrument and a surgeon workstation providing haptic feedback, which are presented in Section 4, together with initial results. The chapter is concluded with a critical review of the contributions (Section 5) and closes with an outlook about future research (Section 6).