“Stereoscopic visualization and haptic technology used to create a virtual environment for remote surgery.”
Bornhoft, J. M., K. W. Strabala, et al. (2011).
Biomedical Sciences Instrumentation 47: 76-81.
The objective of this research is to study the effectiveness of using a stereoscopic visualization system for performing remote surgery. The use of stereoscopic vision has become common with the advent of the da Vinci® system (Intuitive, Sunnyvale CA). This system creates a virtual environment that consists of a 3-D display for visual feedback and haptic tactile feedback, together providing an intuitive environment for remote surgical applications. This study will use simple in vivo robotic surgical devices and compare the performance of surgeons using the stereoscopic interfacing system to the performance of surgeons using one dimensional monitors. The stereoscopic viewing system consists of two cameras, two monitors, and four mirrors. The cameras are mounted to a multi-functional miniature in vivo robot; and mimic the depth perception of the actual human eyes. This is done by placing the cameras at a calculated angle and distance apart. Live video streams from the left and right cameras are displayed on the left and right monitors, respectively. A system of angled mirrors allows the left and right eyes to see the video stream from the left and right monitor, respectively, creating the illusion of depth. The haptic interface consists of two PHANTOM Omni® (SensAble, Woburn Ma) controllers. These controllers measure the position and orientation of a pen-like end effector with three degrees of freedom. As the surgeon uses this interface, they see a 3-D image and feel force feedback for collision and workspace limits. The stereoscopic viewing system has been used in several surgical training tests and shows a potential improvement in depth perception and 3-D vision. The haptic system accurately gives force feedback that aids in surgery. Both have been used in nonsurvival animal surgeries, and have successfully been used in suturing and gallbladder removal. Bench top experiments using the interfacing system have also been conducted. A group of participants completed two different surgical training tasks using both a two dimensional visual system and the stereoscopic visual system. Results suggest that the stereoscopic visual system decreased the amount of time taken to complete the tasks. All participants also reported that the stereoscopic system was easier to utilize than the two dimensional system. Haptic controllers combined with stereoscopic vision provides for a more intuitive virtual environment. This system provides the surgeon with 3-D vision, depth perception, and the ability to receive feedback through forces applied in the haptic controller while performing surgery. These capabilities potentially enable the performance of more complex surgeries with a higher level of precision. © 2011 ISA.
“Predicting the Long-Term Effects of Human-Robot Interaction: A Reflection on Responsibility in Medical Robotics.”
Datteri, E. (2011).
Science and Engineering Ethics.
This article addresses prospective and retrospective responsibility issues connected with medical robotics. It will be suggested that extant conceptual and legal frameworks are sufficient to address and properly settle most retrospective responsibility problems arising in connection with injuries caused by robot behaviours (which will be exemplified here by reference to harms occurred in surgical interventions supported by the Da Vinci robot, reported in the scientific literature and in the press). In addition, it will be pointed out that many prospective responsibility issues connected with medical robotics are nothing but well-known robotics engineering problems in disguise, which are routinely addressed by roboticists as part of their research and development activities: for this reason they do not raise particularly novel ethical issues. In contrast with this, it will be pointed out that novel and challenging prospective responsibility issues may emerge in connection with harmful events caused by normal robot behaviours. This point will be illustrated here in connection with the rehabilitation robot Lokomat.
“The influence of haptic guidance on the production of spatio-temporal patterns.”
Luttgen, J. and H. Heuer (2011).
Hum Mov Sci.
Haptic guidance by a robot is a recent technology to support motor learning. Its mechanisms and effects are not yet well understood. One of the hypotheses is that learning of temporal characteristics is particularly susceptible to the beneficial effects of robotic guidance. In this study we investigate the influence of robotic guidance on the production of spatio-temporal patterns. Participants practiced to draw circles with the velocity profile of ellipses. Performance during the practice phase, when participants were assisted by a robotic device, as well as during the test phase, when assistance was switched off, was compared to a control group. During practice participants with robotic assistance performed better on all three dependent measures, shape, timing of the velocity modulation, and modulation amplitude. However, these differences between groups largely disappeared in the test phase. Only the difference in the amplitude of the velocity modulation remained, which was more accurate in the robot-guidance group than in the control group. This remaining difference likely results from a secondary effect of robotic guidance, namely the experience of smaller visual errors and weaker velocity modulations during practice.
“Evolution of autonomous and semi-autonomous robotic surgical systems: a review of the literature.”
Moustris, G. P., S. C. Hiridis, et al. (2011).
Int J Med Robot.
BACKGROUND: Autonomous control of surgical robotic platforms may offer enhancements such as higher precision, intelligent manoeuvres, tissue-damage avoidance, etc. Autonomous robotic systems in surgery are largely at the experimental level. However, they have also reached clinical application. METHODS: A literature review pertaining to commercial medical systems which incorporate autonomous and semi-autonomous features, as well as experimental work involving automation of various surgical procedures, is presented. Results are drawn from major databases, excluding papers not experimentally implemented on real robots. RESULTS: Our search yielded several experimental and clinical applications, describing progress in autonomous surgical manoeuvres, ultrasound guidance, optical coherence tomography guidance, cochlear implantation, motion compensation, orthopaedic, neurological and radiosurgery robots. CONCLUSION: Autonomous and semi-autonomous systems are beginning to emerge in various interventions, automating important steps of the operation. These systems are expected to become standard modality and revolutionize the face of surgery. Copyright (c) 2011 John Wiley & Sons, Ltd.
“Lapabot: A compact telesurgical robot system for minimally invasive surgery: Part II. Telesurgery evaluation.”
Park, J. W., D. H. Lee, et al. (2011).
Minim Invasive Ther Allied Technol.
Abstract As described in Part I, the Lapabot was developed considering telesurgery from the initial design stage. The robot configuration is based on the master-slave structure in which the operator can be separated spatially from the patient. The distributed control architecture communicating through high-speed network enables remote control of surgical robot manipulators. In this work, we added network communication modules using user datagram protocol/internet protocol for implementation of the telesurgical system. For a stable network environment, a dedicated research network was adopted. To characterize the network environment, a data packet sender and a repeater whose packet length and packet structure are similar to those of the real data packet were developed. The developed system was evaluated through in-vitro and in-vivo experiments. With the developed system, we have successfully performed remote control of the Lapabot. The roundtrip time delay for the control signal ranged from 1.4 to 4.1 ms. The total time delay for the operator including image signal acquisition and transmission delays was under 333 ms. It did not impede surgical procedures. Initial evaluation results demonstrate the feasibility of the developed telesurgical system.
“Human movement variability, nonlinear dynamics, and pathology: Is there a connection?”
Stergiou, N. and L. M. Decker (2011).
Hum Mov Sci.
Fields studying movement generation, including robotics, psychology, cognitive science, and neuroscience utilize concepts and tools related to the pervasiveness of variability in biological systems. The concept of variability and the measures for nonlinear dynamics used to evaluate this concept open new vistas for research in movement dysfunction of many types. This review describes innovations in the exploration of variability and their potential importance in understanding human movement. Far from being a source of error, evidence supports the presence of an optimal state of variability for healthy and functional movement. This variability has a particular organization and is characterized by a chaotic structure. Deviations from this state can lead to biological systems that are either overly rigid and robotic or noisy and unstable. Both situations result in systems that are less adaptable to perturbations, such as those associated with unhealthy pathological states or absence of skillfulness.