A comprehensive review of haptic feedback in minimally invasive robotic liver surgery: Advancements and challenges

Mostafa Selim, Douwe Dresscher, Momen Abayazid
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Abstract

Background

Liver medical procedures are considered one of the most challenging because of the liver's complex geometry, heterogeneity, mechanical properties, and movement due to respiration. Haptic features integrated into needle insertion systems and other medical devices could support physicians but are uncommon. Additional training time and safety concerns make it difficult to implement in robot-assisted surgery. The main challenges of any haptic device in a teleoperated system are the stability and transparency levels required to develop a safe and efficient system that suits the physician's needs.

Purpose

The objective of the review article is to investigate whether haptic-based teleoperation potentially improves the efficiency and safety of liver needle insertion procedures compared with insertion without haptic feedback. In addition, it looks into haptic technology that can be integrated into simulators to train novice physicians in liver procedures.

Methods

This review presents the physician's needs during liver interventions and the consequent requirements of haptic features to help the physician. This paper provides an overview of the different aspects of a teleoperation system in various applications, especially in the medical field. It finally presents the state-of-the-art haptic technology in robot-assisted procedures for the liver. This includes 3D virtual models of the liver and force measurement techniques used in haptic rendering to estimate the real-time position of the surgical instrument relative to the liver.

Results

Haptic feedback technology can be used to navigate the surgical tool through the desired trajectory to reach the target accurately and avoid critical regions. It also helps distinguish between various textures of liver tissue.

Conclusion

Haptic feedback can complement the physician's experience to compensate for the lack of real-time imaging during Computed Tomography guided (CT-guided) liver procedures. Consequently, it helps the physician mitigate the destruction of healthy tissues and takes less time to reach the target.

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全面回顾微创机器人肝脏手术中的触觉反馈:进步与挑战
肝脏医疗程序被认为是最具挑战性的程序之一,因为肝脏具有复杂的几何形状、异质性、机械特性以及因呼吸而产生的运动。集成到插针系统和其他医疗设备中的触觉功能可以为医生提供支持,但并不常见。额外的培训时间和安全问题使其难以在机器人辅助手术中应用。远程手术系统中的任何触觉设备所面临的主要挑战是开发一个安全、高效且符合医生需求的系统所需的稳定性和透明度。
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来源期刊
CiteScore
4.50
自引率
12.00%
发文量
131
审稿时长
6-12 weeks
期刊介绍: The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.
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