Yen-Yi Juo, MD, MPH, Ahmad Abiri, PhD, Jake Pensa, James Bisley, PhD, Warren Grundfest, Erik Dutson. UCLA
OBJECTIVE: Most commercial robotic surgical systems lack haptic feedback or only provide rudimentary kinesthetic feedback. We developed an add-on multi-modal haptic feedback system that can be modified to fit on most existent master-slave robotic surgical systems and provide the robotic surgeon with both tactile and kinesthetic feedback during surgery.
DESCRIPTION: Using the da Vinci Robotic Surgical System as an example, we waterproofed and attached normal force sensors to strategically chosen positions along the tip and shaft of the robotic instruments. The measured force signals were encoded by a microcontroller board before being transmitted via Bluetooth to a signal processing software on a separate laptop. Following calibration, these force signals were transmitted to pneumatic actuators that were fitted on the robotic surgical console in order to provide tactile and kinesthetic feedback to the surgeon’s fingertips in correspondence with the magnitude of the force signal being detected. The signal latency between sensor to actuator activation has been minimized to below 500 milliseconds.
PRELIMINARY RESULTS: The addition of haptic feedback during performance of basic robotic surgical tasks such as peg transfer and tissue handling has been demonstrated to substantially reduce grip forces, visual-perceptual mismatch and task completion time. Its performance has been tested both under ex-vivo and in-vivo conditions, where decreased soft tissue injury during manipulation of intestinal tissue was observed in live pig experiments. Furthermore, the incorporation of kinesthetic feedback on top of tactile feedback allowed further enhancement of the observed beneficial effect of haptic feedback, allowing grip forces approaching that of fingers with native haptic feedback. The add-on haptic feedback system has also demonstrated efficacy in optimizing intracorporeal knot tying quality with reduction of suture breakage and loose knots. Finally, the restoration of haptic feedback during robotic surgery has shown potential for artificial palpation, whereby a surgeon may better assess tissue integrity or localize soft tissue structure via the sense of touch.
FUTURE DIRECTIONS: Our add-on multi-modal haptic feedback system represents one of the most advanced and robust haptic feedback systems that have been described, being potentially compatible with most existent master-slave robotic surgery systems. The success of our system has two major implications: first, future iterations of robotic surgery system refinement may be executed via add-on hardware units. This allows the negation of significant capital acquirement costs associated with the purchase of an entirely new robot. Second, the benefits associated with the restoration of haptic feedback to surgeons are correlated with the fidelity of the haptic modalities. A multi-modal feedback system with both tactile and kinesthetic feedback may bring about substantial improvement to robotic surgeon performance by restoring the native sense of touch.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 98760
Program Number: ET007
Presentation Session: Emerging Technology Session
Presentation Type: Podium