Robot-assisted Surgery System Research Articles

High-Precision Visual-Tracking using the IMM Algorithm and Discrete GPI Observers (IMM-DGPIO)

In this work, we propose the integration of a bank of Discrete Generalized Proportional Integral Observers (DGPIO) within an Interacting Multiple Model (IMM) structure in order to improve the precision of visual-tracking tasks. Applications such as visual servoing, robotic assisted surgery and optronic weapon systems require accurate and high-precision measurements provided by real-time visual-tracking systems. In this case, the DGPIO-Bank was designed using two kinematic models based in constant velocity (CV) and constant acceleration (CA) motion profiles. The main feature of the DGPIO-Bank is the active disturbance rejection (ADR) feature which reduces noise in the position signal of a moving object. The resultant algorithm uses a fusion of four important features: state interaction, Kalman filtering, active disturbance rejection and multiple models combination. For performance comparison, we evaluated our proposed IMM-DGPIO algorithm and other state of the art IMM algorithms. Experimental results show that our proposed strategy had the best performance.

Augmented Reality for Robotics: A Review

Augmented reality (AR) is used to enhance the perception of the real world by integrating virtual objects to an image sequence acquired from various camera technologies. Numerous AR applications in robotics have been developed in recent years. The aim of this paper is to provide an overview of AR research in robotics during the five year period from 2015 to 2019. We classified these works in terms of application areas into four categories: (1) Medical robotics: Robot-Assisted surgery (RAS), prosthetics, rehabilitation, and training systems; (2) Motion planning and control: trajectory generation, robot programming, simulation, and manipulation; (3) Human-robot interaction (HRI): teleoperation, collaborative interfaces, wearable robots, haptic interfaces, brain-computer interfaces (BCIs), and gaming; (4) Multi-agent systems: use of visual feedback to remotely control drones, robot swarms, and robots with shared workspace. Recent developments in AR technology are discussed followed by the challenges met in AR due to issues of camera localization, environment mapping, and registration. We explore AR applications in terms of how AR was integrated and which improvements it introduced to corresponding fields of robotics. In addition, we summarize the major limitations of the presented applications in each category. Finally, we conclude our review with future directions of AR research in robotics. The survey covers over 100 research works published over the last five years.

Robotic Surgery in Gastrointestinal Surgery.

Robotic surgery is expanding in the minimally invasive treatment of gastrointestinal cancer. In the field of gastrointestinal cancer, robotic surgery is performed using a robot-assisted surgery system. In this system, the robot does not operate automatically but is controlled by the surgeon. The surgery assistant robot currently used in clinical practice worldwide is the leader-follower type, including the da Vinci® Surgical System (Intuitive Surgical). This review describes the current state of robotic surgery in the treatment of gastrointestinal cancer and discusses the future development of robotic systems in gastrointestinal surgery.

Improving the Efficiency of Dental Implantation Process Using Guided Local Search Models and Continuous Time Neural Networks With Robotic Assistance

Nowadays, robotics plays a vital role in medical applications, especially in dentistry, where robots can track oral hygiene and perform dental surgeries. Dental implant replacement is one of the most challenging issues in dental surgery; quality procedures and safety measures need to be considered during this process. Manual dental implant is usually incapable to reach the satisfactory levels of accuracy and safety. In addition, it requires well-trained dentists and consumes a long time. Therefore, robot-assisted surgery systems are of utmost importance for dental implant placement as they can maintain higher level of dental examination precision and safety. More specifically, robotic arms can be manufactured with intelligent models for drilling identified locations in teeth. These intelligent robots have a high degree of autonomy, can automatically adjust during intraoperative procedures, and can execute dental surgical tasks directly on patients without any apparent control by a surgeon. In this article, we propose a novel approach to develop a robot-assisted intelligent system that improves the efficiency of dental implant process based on Guided Local Search with Continuous Time Neural Network (GLCTNN). Firstly, dental facts are collected from PubMed articles and Maryland school children datasets. Secondly, using the collected facts, an intelligent robot-assisted model based on GLCTNN is developed. The second step comprises data preprocessing to remove unsolicited details, extracting useful features from the clean data, and utilizing the extracted features to train the GLCTNN model. The proposed system recognizes the implantation location with high accuracy and maximizes implantation rate. The efficiency of the system is evaluated using experimental analysis at lab scale. The proposed GLCTNN-based approach ensures maximum average accuracy (99.5%) and minimum average deviation error (0.323) compared to W-J48, Naïve Bayes (NB), Support Vector Machine (SVM), K-Nearest Neighboring (KNN), Nearest Neighbors with Structural Risk Minimization (NNSRM) and Generalized Regression Neural Network (GRNN) approaches.

A Robot-Assisted Spine Surgery System Based on Intraoperative 2D Fluoroscopy Navigation

In this paper, a robotic system based on intraoperative 2D fluoroscopy navigation in which fluoroscopy images are obtained by C-arm popularized in the clinic, for spine surgery is proposed. The procedure of robot-assisted spine surgery is designed and described. An improved special 6-dof hybrid robot considering both the stiffness and workspace is proposed. And the kinematic model and jacobian matrix of robot are established. To realize fluroscopy images acquisition and avoid interfering with the patient during the process of positioning, human-robot cooperation based on fuzzy variable admittance control considering arm stiffness which would influence the stability of robot, is applied in robotic system. In addition, navigation techniques containing a novel bi-planar design, a robust circular control point detector and closed-loop positioning of tool, based on fluoroscopy images are proposed. In experiments, kinematic model of hybrid robot is test based on laser tracker and the distance error is 0.17 mm which is much smaller than the motion range. The effect of tool weight compensation is measured and the max mean force and torque errors are 0.7477N and 0.0617 N.M. The experimental results could meet requirements in human-robot cooperation. Furthermore, we test the the robotic system proposed in this paper on spine model bone and cadaver with the help of surgeons. The experimental results are validated by 2D image c-arm-based and 3D image CT-based and considered clinically acceptable.

A Review of Augmented Reality in Robotic-Assisted Surgery

Augmented reality (AR) and robotic-assisted surgery (RAS) are both rapidly evolving technologies in recent years. RAS systems, such as the da Vinci Surgical System, aim to improve surgical precision and dexterity, as well as access to minimally-invasive procedures, while AR provides an advanced interface to enhance user perception. Combining the features of both, AR-integrated RAS has become an appealing concept with increased interest among the academic community. In this paper, we review the existing literature about AR-integrated RAS. We discuss the hardware components, application paradigms and clinical relevance of the literature. The concept of AR-integrated RAS has been shown to be feasible for various procedures. Encouraging preliminary results include reduced sight diversion and improved situation awareness. Special techniques, e.g., activation-on-demand, are taken into consideration to address visual clutter of the AR interface and ensure that the system is fail-safe. Although AR-integrated RAS is not yet mature, we believe that if the current trend of development continues, it will soon demonstrate its clinical value.

Artificial intelligence, robotics and digitalization in the concept of military surgery of the German medical service

As in other areas, military surgery is being transformed by developments in artificial intelligence, robotics and digitalization. Although the prospect of operating with arobot-assisted surgery system in the country of deployment while the responsible surgeon is in Germany is still along way off, the training of military surgeons and the treatment of injured soldiers on deployment would nowadays be unimaginable without the digitalization of surgery in the armed forces. The structure of the medical environment in German clinics places restrictions on training that is close to operational reality. In the daily routine it is not possible to carry out the necessary numbers of deployment-relevant emergency surgical procedures under the expected conditions. Such procedures thus require the use of appropriate simulators or simulated scenarios that are as close to reality as possible. Although military surgeons are qualified in at least two specialist areas, the availability of telemedicine on deployment is helping to noticeably improve the treatment of injured soldiers. Telemedical consultation with colleagues in Germany makes it possible, for example, to reach joint decisions across different branches and disciplines. Until now it has not been possible to substitute the attending surgeon in the country of deployment with robot-assisted surgery systems or even robots for carrying out life-saving and stabilizing procedures; however, in order to provide surgeons with the necessary tools to successfully operate in situations where there is ashortage of personnel and materials in an inhospitable environment, use is made of the means that are currently available in the German medical services and constant efforts are made to explore the future possibilities of digital simulation. This article shows the reader the current status of digitalization in surgical training and deployments in the German armed forces.

A robot-assisted cutting surgery of human-like tissues using a haptic master operated by magnetorheological clutches and brakes

This study presents the preliminary experimental results of a robot-assisted surgery system featuring a six-degrees-of-freedom (6-dof) haptic master activated by magnetorheological (MR) actuators. The haptic master is designed to have a parallel mechanism to achieve structural stability and decoupled dynamic equations for translational and rotational motions. The translational motion is generated by MR clutches to achieve the repulsive force, while the rotational motion is generated by MR brakes to achieve the repulsive torque. After analyzing both the kinematic and dynamics equations of the slave robot, it is integrated with the haptic master. Subsequently, a feedback control system is established to achieve accurate tracking performance of the end-effector of the robot, and the desired motions are presented by dynamic animations and simulations. Further, a simple cutting surgery is performed on porcine specimens to demonstrate the effectiveness of the proposed haptic master-robot surgical system. A triangle-shaped section of the tumor is marked and dyed with black color on each specimen, and the cutting surgery to remove the tumor is performed, with and without the haptic feedback control system. It is observed that the surgical performance, in terms of surgical accuracy, achieved with the haptic feedback control system is much better than that obtained with only visual information without the haptic feedback signal.

A sensorless force-feedback system for robot-assisted laparoscopic surgery

The existing surgical robots for laparoscopic surgery offer no or limited force feedback, and there are many problems for the traditional sensor-based solutions. This paper builds a teleoperation surgical system and validates the effectiveness of sensorless force feedback. The tool-tissue interaction force at the surgical grasper tip is estimated using the driving motor's current, and fed back to the master robot with a position-force bilateral control algorithm. The stiffness differentiation experiment and tumor detection experiment were conducted. In the stiffness differentiation experiment, 43 out of 45 pairs of ranking relationships were identified correctly, yielding a success rate of 96%. In the tumor detection experiment, 4 out of 5 participants identified the correct tumor location with force feedback, yielding a success rate of 80%. The proposed sensorless force-feedback system for robot-assisted laparoscopic surgery can help surgeons regain tactile information and distinguish between the healthy and cancerous tissue.

A sensorless force-feedback system for robot-assisted laparoscopic surgery

The existing surgical robots for laparoscopic surgery offer no or limited force feedback, and there are many problems for the traditional sensor-based solutions. This paper builds a teleoperation surgical system and validates the effectiveness of sensorless force feedback. The tool-tissue interaction force at the surgical grasper tip is estimated using the driving motor’s current, and fed back to the master robot with position-force bilateral control algorithm. The stiffness differentiation experiment and tumor detection experiment were conducted. In the stiffness differentiation experiment, 43 out of 45 pairs of ranking relationships were identified correctly, yielding a success rate of 96%. In the tumor detection experiment, 4 out of 5 participants identified the correct tumor location with force feedback, yielding a success rate of 80%. The proposed sensorless force-feedback system for robot-assisted laparoscopic surgery can help surgeons regain tactile information and distinguish between the healthy and cancerous tissue.

Mechanism Design and Optimization of a Haptic Master Manipulator for Laparoscopic Surgical Robots

Serve as the human-robot interface of laparoscopic surgical robot, the master device always plays a crucial role in terms of master-slave manipulation. Growing demands of robot-assisted surgery system also warrant more rational design and optimization for the master manipulator mechanism, which turn out to be important for improving the performance of surgical operations. In this paper, a novel 9 degrees of freedom (DOFs) haptic master manipulator applied to laparoscopic surgical robots is proposed. First of all, the mechanical configuration of the serial master manipulator is presented along with its corresponding kinematic analysis. The proposed strategy can decouple the posture and position completely and to a certain extent simplify the kinematics calculations. Then a mechanism optimization index which synthesizes the global kinematic performances, the global positioning accuracy and the structure length utilization of the manipulator mechanism is introduced. Finally, an improved particle swarm optimization algorithm is proposed to find the optimal mechanism design parameters. The optimization index and algorithm are verified by comparing the optimized parameters with the initial settings. Theoretical analysis and optimization results have demonstrated that the master manipulator can achieve better kinematic performances while maintaining 6 dimensions force feedback.

A Confidence-Based Shared Control Strategy for the Smart Tissue Autonomous Robot (STAR).

Autonomous robotic assisted surgery (RAS) systems aim to reduce human errors and improve patient outcomes leveraging robotic accuracy and repeatability during surgical procedures. However, full automation of RAS in complex surgical environments is still not feasible and collaboration with the surgeon is required for safe and effective use. In this work, we utilize our Smart Tissue Autonomous Robot (STAR) to develop and evaluate a shared control strategy for the collaboration of the robot with a human operator in surgical scenarios. We consider 2D pattern cutting tasks with partial blood occlusion of the cutting pattern using a robotic electrocautery tool. For this surgical task and RAS system, we i) develop a confidence-based shared control strategy, ii) assess the pattern tracking performances of manual and autonomous controls and identify the confidence models for human and robot as well as a confidence-based control allocation function, and iii) experimentally evaluate the accuracy of our proposed shared control strategy. In our experiments on porcine fat samples, by combining the best elements of autonomous robot controller with complementary skills of a human operator, our proposed control strategy improved the cutting accuracy by 6.4%, while reducing the operator work time to 44 % compared to a pure manual control.

Material Characterization of Hardening Soft Sponge Featuring MR Fluid and Application of 6-DOF MR Haptic Master for Robot-Assisted Surgery.

In this work, the material characterization of hardening magneto-rheological (MR) sponge is analyzed and a robot-assisted surgery system integrated with a 6-degrees-of-freedom (DOF) haptic master and slave root is constructed. As a first step, the viscoelastic property of MR sponge is experimentally analyzed. Based on the viscoelastic property and controllability, a MR sponge which can mimic the several reaction force characteristics of human-like organs is devised and manufactured. Secondly, a slave robot corresponding to the degree of the haptic master is manufactured and integrated with the master. In order to manipulate the robot motion by the master, the kinematic analysis of the master and slave robots is performed. Subsequently, a simple robot cutting surgery system which is manipulated by the haptic master and MR sponge is established. It is then demonstrated from this system that using both MR devices can provide more accurate cutting surgery than the case using the haptic master only.

Progress in the application of robot assisted minimally invasive esophagectomy

Robotic assisted surgery system is the most advanced minimally invasive surgical platform in the world, and this system has been widely used in cardiac surgery, urology surgery, gynecology surgery and general surgery. Although the application of this system was relative late in esophageal surgery, it has been developing vigorously. According to the research progress and practical experience in the world, robot assisted minimally invasive esophagectomy (RAMIE) has the same safety and effectiveness as traditional open esophagectomy (OE) and thoracoscopic laparoscopic esophagectomy (TLE). In this paper, several aspects on this novel operation were demonstrated, including the origin, safety evaluation, lymph node dissection, learning curve, prognosis of RAMIE, comparison among RAMIE, OE and TLE and the role of RAMIE in multidisciplinary treatment of esophageal cancer, in order to promote the rational application of RAMIE in esophagectomy.

Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures

Complex joint fractures often require an open surgical procedure, which is associated with extensive soft tissue damages and longer hospitalization and rehabilitation time. Percutaneous techniques can potentially mitigate these risks but their application to joint fractures is limited by the current sub-optimal 2D intra-operative imaging (fluoroscopy) and by the high forces involved in the fragment manipulation (due to the presence of soft tissue, e.g., muscles) which might result in fracture malreduction. Integration of robotic assistance and 3D image guidance can potentially overcome these issues. The authors propose an image-guided surgical robotic system for the percutaneous treatment of knee joint fractures, i.e., the robot-assisted fracture surgery (RAFS) system. It allows simultaneous manipulation of two bone fragments, safer robot-bone fixation system, and a traction performing robotic manipulator. This system has led to a novel clinical workflow and has been tested both in laboratory and in clinically relevant cadaveric trials. The RAFS system was tested on 9 cadaver specimens and was able to reduce 7 out of 9 distal femur fractures (T- and Y-shape 33-C1) with acceptable accuracy (≈1 mm, ≈5°), demonstrating its applicability to fix knee joint fractures. This study paved the way to develop novel technologies for percutaneous treatment of complex fractures including hip, ankle, and shoulder, thus representing a step toward minimally-invasive fracture surgeries.

Recent Patents on Needle Insertion Mechanism

Background: Needle insertion is one of the most popular procedures in minimally invasive surgery (intervention). In order to improve the precision and automatization of the intervention, robot assisted surgery system has been extensively studied. Needle insertion mechanisms are one of the essential parts in the robot assisted surgery system. Keywords: Rigid needle, flexible needle, needle insertion mechanism, structural design, minimally invasive surgery, interventional robot.

A 6-DOF parallel bone-grinding robot for cervical disc replacement surgery.

Artificial cervical disc replacement surgery has become an effective and main treatment method for cervical disease, which has become a more common and serious problem for people with sedentary work. To improve cervical disc replacement surgery significantly, a 6-DOF parallel bone-grinding robot is developed for cervical bone-grinding by image navigation and surgical plan. The bone-grinding robot including mechanical design and low level control is designed. The bone-grinding robot navigation is realized by optical positioning with spatial registration coordinate system defined. And a parametric robot bone-grinding plan and high level control have been developed for plane grinding for cervical top endplate and tail endplate grinding by a cylindrical grinding drill and spherical grinding for two articular surfaces of bones by a ball grinding drill. Finally, the surgical flow for a robot-assisted cervical disc replacement surgery procedure is present. The final experiments results verified the key technologies and performance of the robot-assisted surgery system concept excellently, which points out a promising clinical application with higher operability. Finally, study innovations, study limitations, and future works of this present study are discussed, and conclusions of this paper are also summarized further. This bone-grinding robot is still in the initial stage, and there are many problems to be solved from a clinical point of view. Moreover, the technique is promising and can give a good support for surgeons in future clinical work.

Repulsive torque control of a robot-assisted surgery system using a magnetorheological haptic master

In this work, a repulsive torque control of a robot-assisted surgery system using a 4-degree-of-freedom haptic master which is operated using the properties of magnetorheological fluid is undertaken. The proposed haptic master can generate a repulsive torque along 4-degree-of-freedom motion and provide command signals to the slave robot. This is possible due to controllability of the torque by applying the magnetic field (or current) to magnetorheological fluid domain of the clutch system. For the realization of the master-slave robot-assisted minimally invasive surgery system, an encoder is integrated with the haptic master, and the motion command of the haptic master is realized by the surgical slave robot in the robot-assisted minimally invasive surgery architecture. The haptic master–slave system is then established by incorporating the slave robot with the master device, in which the repulsive torque and position commands are transferred to each other. In order to demonstrate superior performance of the proposed haptic master in terms of torque-tracking controllability between the master and surgical positions, a sliding mode controller is designed and experimentally implemented. It is validated via tracking experiment that superior torque-tracking control performance can be achieved by commanding dynamic motions of the haptic master featured by the inherent characteristics of magnetorheological fluid.

Preliminary analysis of force-torque measurements for robot-assisted fracture surgery.

Our group at Bristol Robotics Laboratory has been working on a new robotic system for fracture surgery that has been previously reported [1]. The robotic system is being developed for distal femur fractures and features a robot that manipulates the small fracture fragments through small percutaneous incisions and a robot that re-aligns the long bones. The robots controller design relies on accurate and bounded force and position parameters for which we require real surgical data. This paper reports preliminary findings of forces and torques applied during bone and soft tissue manipulation in typical orthopaedic surgery procedures. Using customised orthopaedic surgical tools we have collected data from a range of orthopaedic surgical procedures at Bristol Royal Infirmary, UK. Maximum forces and torques encountered during fracture manipulation which involved proximal femur and soft tissue distraction around it and reduction of neck of femur fractures have been recorded and further analysed in conjunction with accompanying image recordings. Using this data we are establishing a set of technical requirements for creating safe and dynamically stable minimally invasive robot-assisted fracture surgery (RAFS) systems.

Application of a laser-guided docking system in robot-assisted urologic surgery.

This work explores the clinical significance of a laser-guided docking system for robot-assisted urologic surgery. Between July 2013 and June 2014, 40 patients underwent robot-assisted laparoscopic prostatectomy (RALP), and 32 patients underwent robot-assisted laparoscopic partial nephrectomy (RAPN) performed by a single surgeon. In the RALP and RAPN groups, the robot was docked in the traditional way in 20 and 16 cases, respectively. A laser guiding system was used in the other cases. The docking time and the time required to adjust the angles were recorded. The docking time was significantly shorter for the laser-guided process performed by inexperienced nurses. The time required to adjust the angles was also lower. There were no significant differences between the processes performed by experienced nurses. A laser-guided docking system may simplify and standardize the docking process and shorten the learning curve. Copyright © 2015 John Wiley & Sons, Ltd.