Abstract

Abstract In robot-assisted procedures, the surgeon controls the surgical instruments from a remote console, while visually monitoring the procedure through the endoscope. There is no haptic feedback available to the surgeon, which impedes the assessment of diseased tissue and the detection of hidden structures beneath the tissue, such as vessels. Only visual clues are available to the surgeon to control the force applied to the tissue by the instruments, which poses a risk for iatrogenic injuries. Additional information on haptic interactions of the employed instruments and the treated tissue that is provided to the surgeon during robotic surgery could compensate for this deficit. Acoustic emissions (AE) from the instrument/tissue interactions, transmitted by the instrument are a potential source of this information. AE can be recorded by audio sensors that do not have to be integrated into the instruments, but that can be modularly attached to the outside of the instruments shaft or enclosure. The location of the sensor on a robotic system is essential for the applicability of the concept in real situations. While the signal strength of the acoustic emissions decreases with distance from the point of interaction, an installation close to the patient would require sterilization measures. The aim of this work is to investigate whether it is feasible to install the audio sensor in non-sterile areas far away from the patient and still be able to receive useful AE signals. To determine whether signals can be recorded at different potential mounting locations, instrument/tissue interactions with different textures were simulated in an experimental setup. The results showed that meaningful and valuable AE can be recorded in the non-sterile area of a robotic surgical system despite the expected signal losses.

Highlights

  • The results showed that meaningful and valuable Acoustic emissions (AE) can be recorded in the non-sterile area of a robotic surgical system despite the expected signal losses

  • The presented results demonstrated that AE caused by interactions of the da Vinci instrument with different structures can be recorded using an audio sensor and are useful for characterization even in the non-sterile zone

  • Many factors are influencing the recordings, such as machine and personal noise as well as AE induced by friction between the instrument and its surroundings

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Summary

Introduction

The da Vinci Surgical System (Intuitive Surgical; California, USA) is the most widely used robotic system for minimally invasive procedures and has become popular for laparoscopic applications. Up to four robotic arms of the da Vinci, equipped with special EndoWrist® instruments, can be controlled from a separate console. The da Vinci offers increased precision and depth perception through 3dimensional imaging. These advantages are reflected in lower complication rates and shorter hospital stays [1, 2]. This is contrasted by the absence of haptic feedback during the intervention. Essential processes such as the palpation of tissue or the controlled application of force by the instrument are difficult or impossible

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