A hand-held micro surgical device for contact force regulation against involuntary movements

Abstract

Involuntary movements such as heart beating in surgical environment and surgeon's tremor disturb a micro surgical manipulation and cause a risk of patient wound. Although the delicate operation is performed by a skilled surgeon, the sensitivity of the surgeon is limited to quantify the range of safe contact forces. In this paper, we developed a compact hand-held surgical device to maintain a required contact force to maintain a required contact force using a custom force sensor and a linear delta mechanism. The custom optical force sensor measured the contact force of the device tip and the linear delta mechanism compensated undesired forces to maintain a consistent contact force. The proposed device is consisted of force sensing unit and actuating unit. The device was improved from our previous Linear Delta mechanism based prototype in terms of size, weight, and force sensing capability. The developed device was validated by investigation of contact force accuracy in a fixed condition and a hand-held condition. In hand-held condition, the visual feedback of the current contact force was provided, and the performance of the contact force regulation was investigated by comparing the root mean square (RMS) contact force errors and standard deviation in with and without control cases. The fluctuation (less than 50 mN) of the force regulation control of the device showed the feasibility of the device for the use in delicate operations.

3-DOF Force-Sensing Motorized Micro-Forceps for Robot-Assisted Vitreoretinal Surgery

“…Furthermore, such mechanical coupling between the tool handle and tip for actuation challenges the integration of the tool with many of the available systems for robot-assisted surgery as it can easily interfere with the operation of the attached robotic system. To address these issues, the design goal in our work has been devising a compact, lightweight and modular unit that can be controlled independently and remotely when necessary regardless of its site of attachment (such as a manual tool handle, a handheld micromanipulator [24–28,40] or a teleoperated/cooperatively-controlled robot [19–23,29]), resulting in the motorized micro-forceps shown in Fig. 1b.…”

“…During this time, various teleoperated [19–21,29], cooperatively-controlled [22,23] and handheld [24–28,40,57] robotic devices have been proposed with the common goal of suppressing involuntary motion components, such as the physiological hand tremor of the surgeon. These systems were shown to improve the tool manipulation accuracy in studies using artificial phantoms and animal models, and therefore posed the potential to facilitate the safety and performance of the surgery.…”

“…For stapedectomy, a force-sensing micro-forceps was developed using fiber Bragg grating (FBG) strain sensors, and was used in combination with a robot to quantify the forces involved in crimping a stapes prosthesis, ranging from 2.4 N to 5.2 N [38]. Based on a monolithic structure flexure and photo-sensors, a compact axial force sensor was developed providing a force resolution of 0.48 N [39], and was shown to properly work with a handheld robotic device to maintain a fixed contact force (200 and 400 mN) at the tool tip [40]. Recently, by integrating two sets of strain gauges in two orthogonal directions a force-sensing bipolar forceps was developed to quantify axial and planar forces ranging up to 1.20 N during neurosurgical tasks in cadaveric brain experiments [41].…”

Towards Robot-Assisted Retinal Vein Cannulation: A Motorized Force-Sensing Microneedle Integrated with a Handheld Micromanipulator †

“…In order to provide a more precise tool manipulation in vitreoretinal surgery, various robotic systems have been developed during the past 20 years [ 27 ]. These research platforms include teleoperated devices [ 28 , 29 , 30 , 31 , 32 ], cooperatively-controlled systems [ 33 , 34 ], injectable ocular microrobots [ 35 , 36 ], or handheld tools [ 37 , 38 , 39 , 40 , 41 , 42 , 43 ], and mostly shared the common goal of suppressing involuntary components of motion, such as the physiological hand tremor of the operator. Studies have now shown improved precision during procedures performed in artificial phantoms and animal models [ 18 ], and the potential to facilitate a safer operation on the extremely delicate retinal tissues during human surgery.…”

“…In microsurgery, specifically in stapedectomy, integration of fiber Bragg grating (FBG) strain sensors on a micro-forceps enabled the first time quantification of forces involved in crimping of a stapes prosthesis, which ranged from 2.4 N to 5.2 N [ 53 ]. Based on a monolithic structure flexure and photo-sensors, a compact axial force sensor was developed providing a force resolution of 0.48 N [ 54 ], and was shown to properly work with a handheld robotic device to maintain a fixed contact force (200 and 400 mN) at the tool tip [ 42 ]. Recently, a strain-gauge-based force-sensing bipolar forceps was developed and used to measure axial and planar forces ranging up to 1.20 N during neurosurgical tasks in cadaveric brain experiments [ 55 ].…”