Haptic Feedback for Robot-Assisted Surgical Systems

描述(由申请人提供)： 心脏手术传统上是通过胸骨正中切开进行的，提供了进入所有心脏结构和大血管的最佳通道，但会给患者带来严重的毁容和疼痛。机器人辅助微创手术的出现为提高外科医生的准确性和灵活性，同时将对患者的创伤降至最低，带来了巨大的希望。然而，机器人辅助的心脏管理系统的临床成功是微乎其微的；改善的预后和降低的成本还没有得到证实。我们推测，这在很大程度上是由于缺乏提供给外科医生的触觉反馈。如果没有外科手术中自然使用的触觉，如精细缝合操作，外科医生的表现就会受到威胁。这项研究的总体目标是在机器人辅助的微创手术中获取和使用触觉信息，重点是精细缝合的操作。预计该方法将提供当前系统的两个主要优点：(1)力将被实时地、直接地或通过感觉替代反馈给用户，从而改善任务性能，以及(2)将使用触觉信息来创建辅助外科医生的自动虚拟固定装置，例如，通过防止过度施加缝合力和保持恒定的回缩力。具体目标是：(1)了解微创手术任务的传感要求，(2)在机器人辅助的微创手术环境中测试不同模式的触觉反馈，(3)创建增强和改进手术任务执行的虚拟夹具，以及(4)在体模实验中应用触觉信息反馈，为临床应用创造一条直接的途径。这些特定的目标有助于在机器人辅助的微创手术中使用触觉信息的长期研究计划。这项拟议的工作代表了手术技术的发展，可以显著改善患者的预后，并为解决其他几个令人兴奋的研究问题奠定必要的基础，例如心脏不停跳(非体外循环)程序、程序和组织模型以及用于培训的虚拟环境。

DESCRIPTION (provided by applicant): Cardiac surgery is traditionally performed through a median sternotomy, providing optimal access to all cardiac structures and great vessels, but generating significant disfigurement and pain for the patient. The advent of robot-assisted minimally invasive surgery (MIS) holds great promise for improving the accuracy and dexterity of a surgeon while minimizing trauma to the patient. However, clinical success with robot-assisted cardiac MIS has been marginal; improved patlent outcomes and mitigated costs have not been proven. We hypothesize that this is due in large part to the lack of haptic feedback presented to the surgeon. Without the sense of touch naturally used in surgical tasks such as fine suture manipulation, surgeon performance is jeopardized. The general objective of the proposed research is to acquire and use haptic information during robot-assisted minimally invasive surgery, with a focus on manipulation of fine sutures. It is anticipated that this approach will offer two main benefits over current systems: (1) forces will be fed back to the user in real time, directly or through sensory substitution, improving task performance, and (2) haptic information will be used to create automatic virtual fixtures that assist the surgeon, e.g., by prevention of excessive applied suture forces and maintenance of constant retraction forces. The specific aims are: (1) to understand the sensing requirements for minimally invasive surgical tasks, (2) to test different modes of haptic feedback in robot-assisted minimally invasive surgical environment, (3) to create virtual fixtures that augment and improve the execution of surgical tasks, and (4) to apply feedback of haptic information during phantom experiments, creating a direct path to clinical applications. These specific aims contribute to a Iong-term research plan for using haptic information in robot-assisted minimally invasive surgery. The proposed work represents the development of operative technology that can provide significant improvements in patient outcomes, as well as Iay the groundwork necessary to address several other exciting research issues such as beating-heart (off-pump) procedures, procedure and tissue models, and virtual environments for training.