ROBOT 2017 - Collaborative robotic system for hand-assisted laparoscopic surgery

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Hand-assisted laparoscopic surgery is a Minimally Invasive Surgery technique that is based on the insertion of one surgeon’s hand inside the ab-dominal cavity. In this scenario, a robotic assistant can properly collaborate with the surgeon, working side by side with him/her. This paper presents a ro-botic system for this kind of technique, based on a cognitive architecture that makes possible an efficient collaboration with the surgeon, thanks to a better understanding of the environment and the learning mechanisms included. This architecture includes a hand gesture recognition module and two different au-tonomous movement of the robotic arms, one for the camera motion and the other for the tool movement. All of these modules take advantage of the cogni-tive learning mechanisms of the architecture, fitting their behavior to the current user and procedure.

COLLABORATIVE ROBOTIC SYSTEM FOR
HAND-ASSISTED LAPAROSCOPIC SURGERY
MEDICAL ROBOTICS
medicalrobotics.uma.es
Speaker: Dr. Enrique Bauzano Núñez
Authors: M.C. López Casado (mclopezc@uma.es)
E. Bauzano (ebauzano@uma.es)
I. Rivas Blanco (irivas@uma.es)
V.F. Muñoz (vfmm@uma.es)
J.C. Fraile (jcfraile@eii.uva.es)

Some Examples of Surgical Robots
MEDICAL ROBOTICS
medicalrobotics.uma.es
IEEE Spectrum, 2016. Source: https://www.youtube.com/watch?v=2fnv_3qn3Yc
Collaborative Robotic System for Hand-Assisted Laparoscopic Surgery 1 / 13

Classification of Surgical Robots by Autonomy
Collaborative Robotic System for Hand-Assisted Laparoscopic Surgery 2 / 13
GRUPO DE ROBÓTICA MÉDICA
www.roboticamedica.uma.es
• Remote Surgery
• Improvement of
surgeon’s abilities
• …
• Direct Surgeon’s orders
• Visual Guidance
• Virtual Fixturing
• …
• Biopsies
• Palpating,
Cutting and Gluing
• Hair-Graft
• Tumor radiation
• …

MIS Techniques – Laparoscopic Surgery
GRUPO DE ROBÓTICA MÉDICA
www.roboticamedica.uma.es
Collaborative Robotic System for Hand-Assisted Laparoscopic Surgery 3 / 13

MIS Techniques – Single Incision Laparoscopic Surgery
GRUPO DE ROBÓTICA MÉDICA
www.roboticamedica.uma.es
Collaborative Robotic System for Hand-Assisted Laparoscopic Surgery 4 / 13

MIS Techniques – Hand Assisted Laparoscopic Surgery
GRUPO DE ROBÓTICA MÉDICA
www.roboticamedica.uma.es
Collaborative Robotic System for Hand-Assisted Laparoscopic Surgery 5 / 13

How can we design a collaborative surgical robot?
GRUPO DE ROBÓTICA MÉDICA
www.roboticamedica.uma.es
Collaborative Robotic System for Hand-Assisted Laparoscopic Surgery 6 / 13
Environment
Surgeon Patient
Robot
Assistant

Environment
Robot-World
Integration
Surgeon Patient
Robot
Assistant
HMI
Perception
System
Action
System
How can we design a collaborative surgical robot?
GRUPO DE ROBÓTICA MÉDICA
www.roboticamedica.uma.es
High-Priority Orders:
- Voice
- Haptics
- GUI…
Collaborative Robotic System for Hand-Assisted Laparoscopic Surgery 7 / 13
Sensors Processing:
- Image Processing
- Tools Location
- Hand Tracking…
Tools actions:
- Auto-Guided Tools
- Grasp actuation
- Tools Tracing…

How can we design a collaborative surgical robot?
GRUPO DE ROBÓTICA MÉDICA
www.roboticamedica.uma.es
Environment
Robot-World
IntegrationCognition
Long-Term Memory
Surgeon Patient
Robot
Assistant
HMI
Perception
System
Action
System
Procedural
Memory
Semantic
Memory
Decision
Procedure
Reinforcement
Learning
Working Memory
Collaborative Robotic System for Hand-Assisted Laparoscopic Surgery 8 / 13

Cognition
Long-Term Memory
Procedural
Memory
Semantic
Memory
Decision
Procedure
Reinforcement
Learning
Working Memory
Process of the cognition layer
GRUPO DE ROBÓTICA MÉDICA
www.roboticamedica.uma.es
Environment
Robot-World
Integration
Surgeon Patient
Robot
Assistant
HMI
Perception
System
Action
System
Collaborative Robotic System for Hand-Assisted Laparoscopic Surgery 10 / 13
1. Scissors tool
appears on the image
2. IF (Scissors on
image) THEN State =
State + 1
3. State + 1 defines
camera target as
“scissors Tool Tìp”
4. Actuation Algorithm:
Camera follows
“Scissors Tool Tip”
5. Move the camera
to center “Scissors
Tool Tip”
6. Surgeon tells if the
action was correct
7. If required,
updates the trained
camera parameters
on memory

Cognitive Robotic Assistant concept for HALS
Gesture Recognition System Auto-Guided System
GRUPO DE ROBÓTICA MÉDICA
www.roboticamedica.uma.es
Collaborative Robotic System for Hand-Assisted Laparoscopic Surgery 11 / 13

Cognitive Robotic Assistant concept for HALS
Collaborative Robotic System for Hand-Assisted Laparoscopic Surgery 12 / 13
GRUPO DE ROBÓTICA MÉDICA
www.roboticamedica.uma.es

First approach of cognitive mini-camera assistant
GRUPO DE ROBÓTICA MÉDICA
www.roboticamedica.uma.es
Collaborative Robotic System for Hand-Assisted Laparoscopic Surgery 13 / 13

More information - Website
GRUPO DE ROBÓTICA MÉDICA
www.roboticamedica.uma.es
Collaborative Robotic System for Hand-Assisted Laparoscopic Surgery

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Robótica Médica UMA

This paper proposes a robotic system to assist and collaborate with surgeons in Single Incision Laparoscopic Surgery (SILS) operations. The system, aim at solving the main drawbacks of this kind of surgery, is composed of a miniature camera robot and a redundant robotic grasper. Positioning of both robots inside the patient’s abdomen is done by means of magnetic control. External magnetic sources are placed at the end effector of two robotic arms, and permanent magnets are integrated in the robots. Camera robot is provided with three permanent magnets, so both position and orientation can be controlled. Sliding control, which is robust against perturbations and parameter uncertainties, is chosen. Robotic grasper’s redundancy makes possible autonomously obstacle avoidance and increases its workspace. The haptic device is designed so as surgeons can handle the grasper as if it were a conventional tool. In order to this aim, augmented reality is used to simulate a traditional tool in the visual feedback system, in substitution of the robotic grasper. Besides the telemanipulation, requirements for autonomously functions to assist surgeons in the specific tasks of suturing are discussed.

BIOROB 2012 - Maneuvers Recognition in Laparoscopic Surgery: Artificial Neura...

Robótica Médica UMA

The work presented in this paper is focused on movement recognition as a first step to achieve the automation of a two-arm-surgical-robotic-system in the laparoscopic surgical environment. In order to accomplish coordination between the surgeon and the robotic assistant, a system able to recognize and differentiate between certain standard surgical maneuvers should be developed. Two different methodologies are proposed to model and identify several surgical maneuvers. The first method is based on Artificial Neural Networks (ANN), by codifying the movements through their Fourier spectra and the second one is based on HMMs which represents the interaction between the surgical tools. The proposed approaches will be tested through a set of experiments that mimic surgical movements as in tissue cutting, suturing and transporting. In this way, the recognition system is able to distinguish between the different maneuvers which have been modeled.

ROBOT 2011 - Robot Quirúrgico Auto-Guiado para Cirugía Mínimamente Invasiva e...

Robótica Médica UMA

Este artículo se centra en el diseño e implantación de un robot quirúrgico llamado CISOBOT, que ha sido desarrollado en la Universidad de Málaga. La arquitectura de control se basa en un sistema de control de movimientos que permite la navegación auto-guiada de los brazos robóticos a partir de los comandos recibidos por un Interfaz Hombre-Máquina (HMI) multimodal capaz de reconocer gestos quirúrgicos y comandos de voz del cirujano. A su vez, el robot asistente incluye un sistema tolerante a fallos encargado de mejorar la seguridad ante situaciones no previstas o errores en el sistema. Para presentar la validez del funcionamiento del sistema, se han realizado experimentos in-vitro que muestran los movimientos automáticos y el comportamiento del HMI multimodal durante un protocolo quirúrgico ficticio.

IROS 2011 - Surgical Tools Pose Estimation for a Multimodal HMI of a Surgical...

Robótica Médica UMA

The main objective of this paper is to minimize the occluded areas in order to recognize the navigation of the surgeon’s tools for a two-arm autonomous robotic system for laparoscopic procedures. This robotic assistant needs the tracking of the surgeon’s surgical gestures in order to recognize the current maneuver and to execute the automated tasks of the robot. The surgical tools pose estimation is carried out by a Multiple Extended Kalman Filter (MEKF), where the movement models of the surgical tools depend on the maneuver which is being developed. This information is obtained by a maneuvers recognition system which is a part of the multimodal human machine interface (HMI) of the robot. The method proposed for reducing shadows has been applied to three in-vitro maneuvers which appear in the majority of the surgical protocols. The experiments show the behavior of this method for different time intervals of the occlusions.

CASEIB 2011 - Nuevas tendencias en la cirugía mínimamente invasiva

Robótica Médica UMA

Robots camarógrafos: - Control de movimientos: Mediante estrategias de control o por la estructura mecánica. - HMI: Botoneras, joystick, movimientos de cabeza, voz o teleoperación directa. - Movimientos automáticos: seguimiento del instrumental. Robots multibrazos: - Teleoperación directa. - Realimentación de fuerzas. - Visión estereoscópica. - Movimientos automáticos: control compartido

IROS 2010 - Auto-Guided Movements on Minimally Invasive Surgery for Surgeon A...

Robótica Médica UMA

IROS 2009 - Minimally Invasive Surgery Maneuver Recognition Based On Surgeon ...

Robótica Médica UMA

This paper proposes a new user interface based on a maneuver recognition system, which models the surgeon behavior. This interface includes three different modules: data acquisition and coding, training system and on-line recognition system. The aim is defined as recognizing the surgeon movements while is performing a surgical maneuver, by using a 3D surgical tool tracker. The obtained measurements are converted in to movement symbols by means of a Wavelet transform and a fuzzy clustering. These symbols are used both for training HMM and for recognizing the current maneuver. The system has been tested in some in-vitro experiments performing a fictitious surgical protocol.

IROS 2009 - Three-layer Control for Active Wrists in Robotized Laparoscopic S...

Robótica Médica UMA

This paper is focused on the motion control problem for a laparoscopic surgery robot assistant with an actuated wrist. These assistants may apply non-desired efforts to the patient abdomen. Therefore, this article proposes a control methodology based on three feedback levels, which have been defined as layers. These layers control different aspects of the endoscope movement. A low level assures the dynamic of the robot assistant is performed accordingly. The mid level emulates a passive wrist behavior to avoid any efforts over the abdomen. An external high level deals with the global movement planning. This architecture also makes easier to analyze the stability of the whole system. Finally, a real in-vitro experiment has been implemented with an industrial robot in order to contrast the validity of this article procedure.

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