IEEE transactions on medical robotics and bionics最新文献

The introduction of a teleoperated surgical robotic system designed for minimally invasive procedures enables the emulation of two distinct control modes through a dedicated input device of the surgical console: (1) Inside Control Mode, which emulates tool manipulation near the distal end (i.e., as if the surgeon was holding the tip of the instrument inside the patient's body), and (2) Outside Control Mode, which emulates manipulation near the proximal end (i.e., as if the surgeon was holding the tool externally). The overarching aim of this reported research is to study and compare the surgeon's performance utilizing these two control modes of operation along with various scaling factors in a simulated vitreoretinal surgical setting. The console of Intraocular Robotic Interventional Surgical System (IRISS) was utilized but the surgical robot itself and the human eye anatomy was simulated by a virtual environment (VR) projected microscope view of an intraocular setup to a VR headset. Five experienced vitreoretinal surgeons and five subjects with no surgical experience used the system to perform fundamental tool/tissue tasks common to vitreoretinal surgery including: (1) touch and reset; (2) grasp and drop; (3) inject; (4) circular tracking. The results indicate that Inside Control outperforms Outside Control across multiple tasks and performance metrics. Higher scaling factors (20 and 30) generally provided better performance, particularly for reducing trajectory errors and tissue damage. This improvement suggests that larger scaling factors enable more precise control, making them the preferred option for fine manipulation tasks. However, task completion time was not consistently reduced across all conditions, indicating that surgeons may need to balance speed and accuracy/precision based on specific surgical requirements. By optimizing control dynamics and user interface, robotic teleoperation has the potential to reduce complications, enhance surgical dexterity, and expand the accessibility of high-precision procedures to a broader range of practitioners.

Retinal surgery typically requires bimanual manipulation of tools in the eye. Freehand retinal vein cannulation (RVC) is a highly challenging operation mainly due to typical hand tremors relative to the small size of retinal veins. Robot-assisted technology resolves hand tremor issues and gives ophthalmologists higher positioning resolution to enable RVC. Bimanual robot manipulation of the eyeball typically requires kinematics-based control to maintain each robotic tool's remote center of motion (RCM) constraint and registration between the two robots to avoid scleral injury. Any potential relative movement of the robot base can impact patient safety. To avoid these problems, we developed a bimanual adaptive cooperative (BMAC) control framework. Each robot is independently controlled via a hybrid adaptive position-force control algorithm using fiber Bragg grating-based force-sensing surgical instruments. This algorithm minimizes the tool-sclera interaction forces automatically, resulting in maintaining the sclera forces within a safe threshold and avoiding over-stretch of the sclera, which guarantees patient safety despite the absence of kinematic RCM constraint and registration of the two robots. The effectiveness of this approach is validated through a pilot study with five users in a vessel-following experiment on an eye phantom under a surgical microscope.