Toward Assistive Technologies for Focus Adjustment in Teleoperated Robotic Non-Contact Laser Surgery

In the last decade, focused laser radiation has become an alternative instrumentation for soft tissue surgery due to precise ablation with simultaneous coagulation. However, adjustment of the focal position with respect to the tissue surface is crucial for optimal energy input and minimised trauma....

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Bibliographic Details
Published in:IEEE transactions on medical robotics and bionics 2019-08, Vol.1 (3), p.145-157
Main Authors: Kundrat, Dennis, Schoob, Andreas, Piskon, Thomas, Grasslin, Rene, Schuler, Patrick J., Hoffmann, Thomas K., Kahrs, Luder A., Ortmaier, Tobias
Format: Article
Language:English
Subjects:
Ablation
augmented reality
Biomimetics
Coagulation
continuum robot
Error reduction
Feedback
haptic cues
Haptic interfaces
Laser ablation
Laser surgery
Lasers
Performance measurement
Position errors
Robot kinematics
Robotic surgery
Soft tissues
Surgery
Task analysis
user assistance
user study
visual feedback
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Summary:In the last decade, focused laser radiation has become an alternative instrumentation for soft tissue surgery due to precise ablation with simultaneous coagulation. However, adjustment of the focal position with respect to the tissue surface is crucial for optimal energy input and minimised trauma. Advantageous laser delivery without tissue contact poses challenges and demands for assistance. This contribution introduces three novel concepts for user assistance during focal adaptation in noncontact laser surgery with robotic teleoperation. Visual, haptic, and visuo-haptic feedback modalities are designed based on real-time scene reconstruction and laser-to-camera registration. The performance of proposed methods was assessed in a phantom study with positioning tasks under different assistance conditions using a teleoperated extensible continuum robot. Focal position error and task execution time were selected as performance metrics. In total, 15 subjects conducted trials under four different conditions ( N=240 ). A mean error reduction from 1.2 mm for nonassisted to 0.25 mm for visuo-haptic feedback was revealed and error outliers were eliminated efficiently. Mean execution times of below 13 s were achieved for applied conditions. Presented work decreased the error to one-fifth in comparison to absence of assistance in teleoperation. The results strongly motivate prospective integration to surgical devices for noncontact laser delivery.
ISSN:2576-3202
2576-3202
DOI:10.1109/TMRB.2019.2931438