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正中胸骨切开术进行的，为所有心脏结构和大血管提供最佳通路，但会给患者带来严重的毁容和疼痛。机器人辅助微创手术（MIS）的出现为提高外科医生的准确性和灵活性，同时最大限度地减少对患者的创伤带来了巨大的希望。然而，机器人辅助心脏MIS的临床成功率很低;患者结局的改善和成本的降低尚未得到证实。我们假设这在很大程度上是由于缺乏触觉反馈呈现给外科医生。如果没有在手术任务中自然使用的触觉，例如精细缝合操作，外科医生的表现就会受到损害。拟议研究的总体目标是在机器人辅助微创手术期间获取和使用触觉信息，重点是精细缝合的操作。预期该方法将提供优于当前系统的两个主要益处：（1）力将直接地或通过感觉替代而真实的反馈给用户，从而改善任务性能，以及（2）触觉信息将用于创建辅助外科医生的自动虚拟夹具，例如，通过防止过度施加的缝合力和保持恒定的牵开力。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）创建虚拟夹具以增强和改善手术任务的执行，以及（4）在体模实验期间应用触觉信息的反馈，创建通向临床应用的直接路径。这些具体目标有助于在机器人辅助微创手术中使用触觉信息的长期研究计划。拟议的工作代表了手术技术的发展，可以提供显着改善患者的结果，以及奠定必要的基础，以解决其他几个令人兴奋的研究问题，如心脏跳动（非体外循环）程序，程序和组织模型，以及虚拟环境的培训。

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.