Minimally invasive beating-heart surgery offers substantial benefits for the patient, compared to conventional open surgery. Nevertheless, the motion of the heart poses increased requirements to the surgeon. To support the surgeon, algorithms for an advanced robotic surgery system are proposed, which offer motion compensation of the beating heart. This implies the measurement of heart motion, which can be achieved by tracking natural landmarks. In most cases, the investigated affine tracking scheme can be reduced to an efficient block matching algorithm allowing for realtime tracking of multiple landmarks. Fourier analysis of the motion parameters shows two dominant peaks, which correspond to the heart and respiration rates of the patient. The robustness in case of disturbance or occlusion can be improved by specially developed prediction schemes. Local prediction is well suited for the detection of single tracking outliers. A global prediction scheme takes several landmarks into account simultaneously and is able to bridge longer disturbances. As the heart motion is strongly correlated with the patient's electrocardiogram and respiration pressure signal, this information is included in a novel robust multisensor prediction scheme. Prediction results are compared to those of an artificial neural network and of a linear prediction approach, which shows the superior performance of the proposed algorithms.
While the components of the MiroSurge system are shown to fulfil the rigid design requirements for robotic telesurgery with force feedback, the system remains versatile, which is supposed to be a key issue for the further development and optimisation.
Abstract-This video presents the in-house developed DLR MiroSurge robotic system for surgery. As shown, the system is suitable for both minimally invasive and open surgery. Essential part of the system is the MIRO robot: The soft robotics feature enables intuitive interaction with the robot. In the presented minimally invasive robotic setup three MIROs guide an endoscopic stereo camera and two endoscopic instruments with force feedback sensors. The master console for teleoperation consists of an autostereoscopic monitor and force reflecting input devices for both hands. Versatility is shown with two additional applications: For assistance in manual minimally invasive surgery a MIRO robot automatically guides the endoscope such that the surgical instrument is always in view. In a biopsy application the MIRO robot is positioning the needle with navigation system support.
The stabilisation of motion on the beating heart is investigated in the context of minimally invasive robotic surgery. Although reduced by mechanical stabilisers, residual tissue motion makes safe surgery still difficult and time consuming. Compensation for this movement is therefore highly desirable. Motion can be captured by tracking natural landmarks on the heart surface recorded by a video endoscope. Stabilisation is achieved by transforming the images using a motion field calculated from captured local motion.Since the surface of the beating heart is distorted nonlinearly, compensating the occurring motion with a constant image correction factor is not sufficient. Therefore, heart motion is captured by several landmarks, the motion between which is interpolated such that locally appropriate motion correction values are obtained. To estimate the motion between the landmark positions, a triangulation is built and motion information in each triangle is approximated by linear interpolation. Motion compensation is evaluated by calculating the optical flow remaining in the stabilised images. The proposed linear interpolation model is able to reduce motion significantly and can also be implemented efficiently to stabilise images of the beating heart in realtime.
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