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Register a new userAutonomous Coordinated Control of the Light Guide for Positioning in Vitreoretinal Surgery
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Added by
Murilo Marques Marinho
Publication date
2021
fields
Informatics Engineering
and research's language is
English
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Vitreoretinal surgery is challenging even for expert surgeons owing to the delicate target tissues and the diminutive 7-mm-diameter workspace in the retina. In addition to improved dexterity and accuracy, robot assistance allows for (partial) task automation. In this work, we propose a strategy to automate the motion of the light guide with respect to the surgical instrument. This automation allows the instruments shadow to always be inside the microscopic view, which is an important cue for the accurate positioning of the instrument in the retina. We show simulations and experiments demonstrating that the proposed strategy is effective in a 700-point grid in the retina of a surgical phantom.
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During retinal microsurgery, precise manipulation of the delicate retinal tissue is required for positive surgical outcome. However, accurate manipulation and navigation of surgical tools remain difficult due to a constrained workspace and the top-down view during the surgery, which limits the surgeons ability to estimate depth. To alleviate such difficulty, we propose to automate the tool-navigation task by learning to predict relative goal position on the retinal surface from the current tool-tip position. Given an estimated target on the retina, we generate an optimal trajectory leading to the predicted goal while imposing safety-related physical constraints aimed to minimize tissue damage. As an extended task, we generate goal predictions to various points across the retina to localize eye geometry and further generate safe trajectories within the estimated confines. Through experiments in both simulation and with several eye phantoms, we demonstrate that our framework can permit navigation to various points on the retina within 0.089mm and 0.118mm in xy error which is less than the humans surgeon mean tremor at the tool-tip of 0.180mm. All safety constraints were fulfilled and the algorithm was robust to previously unseen eyes as well as unseen objects in the scene. Live video demonstration is available here: https://youtu.be/n5j5jCCelXk
We propose a new method for six-degree-of-freedom (6-DoF) autonomous camera movement for minimally invasive surgery, which, unlike previous methods, takes into account both the position and orientation information from structures in the surgical scene. In addition to locating the camera for a good view of the manipulated object, our autonomous camera takes into account workspace constraints, including the horizon and safety constraints. We developed a simulation environment to test our method on the wire chaser surgical training task from validated training curricula in conventional laparoscopy and robot-assisted surgery. Furthermore, we propose, for the first time, the application of the proposed autonomous camera method in video-based surgical skill assessment, an area where videos are typically recorded using fixed cameras. In a study with N=30 human subjects, we show that video examination of the autonomous camera view as it tracks the ring motion over the wire leads to more accurate user error (ring touching the wire) detection than when using a fixed camera view, or camera movement with a fixed orientation. Our preliminary work suggests that there are potential benefits to autonomous camera positioning informed by scene orientation, and this can direct designers of automated endoscopes and surgical robotic systems, especially when using chip-on-tip cameras that can be wristed for 6-DoF motion.
Autonomous robotic surgery has the potential to provide efficacy, safety, and consistency independent of individual surgeons skill and experience. Autonomous soft-tissue surgery in unstructured and deformable environments is especially challenging as it necessitates intricate imaging, tissue tracking and surgical planning techniques, as well as a precise execution via highly adaptable control strategies. In the laparoscopic setting, soft-tissue surgery is even more challenging due to the need for high maneuverability and repeatability under motion and vision constraints. We demonstrate the first robotic laparoscopic soft tissue surgery with a level of autonomy of 3 out of 5, which allows the operator to select among autonomously generated surgical plans while the robot executes a wide range of tasks independently. We also demonstrate the first in vivo autonomous robotic laparoscopic surgery via intestinal anastomosis on porcine models. We compared the criteria including needle placement corrections, suture spacing, suture bite size, completion time, lumen patency, and leak pressure between the developed system, manual laparoscopic surgery, and robot-assisted surgery (RAS). The ex vivo results indicate that our system outperforms expert surgeons and RAS techniques in terms of consistency and accuracy, and it leads to a remarkable anastomosis quality in living pigs. These results demonstrate that surgical robots exhibiting high levels of autonomy have the potential to improve consistency, patient outcomes, and access to a standard surgical technique.
Deep Reinforcement Learning (DRL) is a viable solution for automating repetitive surgical subtasks due to its ability to learn complex behaviours in a dynamic environment. This task automation could lead to reduced surgeons cognitive workload, increased precision in critical aspects of the surgery, and fewer patient-related complications. However, current DRL methods do not guarantee any safety criteria as they maximise cumulative rewards without considering the risks associated with the actions performed. Due to this limitation, the application of DRL in the safety-critical paradigm of robot-assisted Minimally Invasive Surgery (MIS) has been constrained. In this work, we introduce a Safe-DRL framework that incorporates safety constraints for the automation of surgical subtasks via DRL training. We validate our approach in a virtual scene that replicates a tissue retraction task commonly occurring in multiple phases of an MIS. Furthermore, to evaluate the safe behaviour of the robotic arms, we formulate a formal verification tool for DRL methods that provides the probability of unsafe configurations. Our results indicate that a formal analysis guarantees safety with high confidence such that the robotic instruments operate within the safe workspace and avoid hazardous interaction with other anatomical structures.
Autonomous multi-robot optical inspection systems are increasingly applied for obtaining inline measurements in process monitoring and quality control. Numerous methods for path planning and robotic coordination have been developed for static and dynamic environments and applied to different fields. However, these approaches may not work for the autonomous multi-robot optical inspection system due to fast computation requirements of inline optimization, unique characteristics on robotic end-effector orientations, and complex large-scale free-form product surfaces. This paper proposes a novel task allocation methodology for coordinated motion planning of multi-robot inspection. Specifically, (1) a local robust inspection task allocation is proposed to achieve efficient and well-balanced measurement assignment among robots; (2) collision-free path planning and coordinated motion planning are developed via dynamic searching in robotic coordinate space and perturbation of probe poses or local paths in the conflicting robots. A case study shows that the proposed approach can mitigate the risk of collisions between robots and environments, resolve conflicts among robots, and reduce the inspection cycle time significantly and consistently.
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