Auditory Display for Telerobotic Transnasal Surgery Using a Continuum Robot

Abstract

Tubular continuum robots can follow complex curvilinear paths to reach restricted areas within the body. Using teleoperation, these robots can help minimize incisions and reduce trauma. However, drawbacks include the lack of haptic feedback and a limited view of the situs, often due to camera occlusion. This work presents novel auditory display to enhance interaction with such continuum robots to increase accuracy and path-following efficiency and reduce cognitive workload. We recreate a typical use case with a test environment that simulates a transnasal intervention through the sphenoidal sinus including a simulated continuum robot. Distance information is mapped to changes in a real-time audio synthesizer using sung voice to provide navigation cues. User studies with novice participants and clinicians were performed to evaluate the effects of auditory display on accuracy, task time, path following efficiency, subjective workload, and usability. When using auditory display, participants exhibit significant increase in accuracy, efficiency, and task time compared to visual-only display. Auditory display reduced subjective workload and raised usefulness and satisfaction ratings. The addition of auditory display for augmenting interaction with a teleoperated continuum robot has shown to benefit performance as well as usability. The method could benefit other scenarios in navigated surgery to increase accuracy and reduce workload.

Augmentation of haptic feedback for teleoperated robotic surgery

“…If assistance cannot be offered in all DOF (P2), trajectories are rather disadvantageous and a visual substitution of the force feedback shows best results, though participants prefer to use haptic feedback. Findings in the literature also report on positive effects using additional auditory guidance and hypothesize that even multimodal applications including auditory, haptic and visual feedback are conceivable to further improve performance [36]. However, based on our results of PS1 an excessive amount of feedback modalities can also overburden users and should be considered.…”

Continuum robots for endoscopic sinus surgery: Recent advances, challenges, and prospects

“…As shown in Figure 11A, these pathways could be fused with the endoscopic image, indicating the surgeon's operation intraoperatively. In, 58 the movement of a CR's end effector was transmitted to an auditory display synthesizer, which subsequently generated audio feedback to notify the operator of the CR's location within the environment. As shown in Figure 11B, the auditory display could assist the user in steering the CR's end effector to each waypoint in the transnasal surgery.…”

“… (A) The surgical pathway created by KARL STORZ NAV1 SinusTracker navigation software 57 (Copyright ⓒ 2020, Linxweiler et al.). (B) Visualization of the implemented simulation environment with waypoints for navigation guidance 58 (Copyright ⓒ 2019, World Scientific Publishing Company). …”

A multi‐module soft robotic arm with soft actuator for minimally invasive surgery

“…However, it is very difficult for surgeons to manipulate the instrument into a narrow working space accurately (such as internal organs of the human body), which causes great limitations during surgery 5,6 . At present, most of the instruments used for minimally invasive surgery are rigid, with low degrees of freedom, and can only perform specific surgical tasks, but cannot reach hard‐to‐reach areas and more complex parts 7–9 …”