Augmentation of haptic feedback for teleoperated robotic surgery

Abstract

Purpose A frequently mentioned lack of teleoperated surgical robots is the lack of haptic feedback. Haptics are not only able to mirror force information from the situs, but also to provide spatial guidance according to a surgical plan. However, superposition of the two haptic information can lead to overlapping and masking of the feedback and guidance forces. This study investigates different approaches toward a combination of both information and investigates effects on system usability. Methods Preliminary studies are conducted to define parameters for two main experiments. The two main experiments constitute simulated surgical interventions where haptic guidance as well as haptic feedback provide information for the surgeon. The first main experiment considers drilling for pedicle screw placements, while the second main experiment refers to three-dimensional milling tasks such as during partial knee replacements or craniectomies. For both experiments, different guidance modes in combination with haptic feedback are evaluated regarding effectiveness (e.g., distance to target depth), efficiency and user satisfaction (e.g., detectability of discrepancies in case of technical guidance error). Results Regarding pedicle screw placements a combination of a peripheral visual signal and a vibration constitutes a good compromise regarding distance to target depth and detectability of discrepancies. For milling tasks, trajectory guidance is able to improve efficiency and user satisfaction (e.g., perceived workload), while boundary constraints improve effectiveness. If, assistance cannot be offered in all degrees of freedom (e.g., craniectomies), a visual substitution of the haptic force feedback shows the best results, though participants prefer using haptic force feedback. Conclusion Our results suggest that in case haptic feedback and haptic assistance are combined appropriately, benefits of both haptic modalities can be exploited. Thereby, capabilities of the human-machine system are improved compared to usage of exclusively one of the haptic information.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Usability of cooperative surgical telemanipulation for bone milling tasks

“…For the guided milling experiment, reduced errors are found for both telemanipulated configurations, which confirms findings of previous studies [ 11 , 33 ] and is in line with results of [ 43 ]. Comparing the result to a study on manual milling of neurosurgeons (mean depth and lateral error of 0.7 mm [ 34 ]) shows that novice users can achieve a similar or better accuracy when using the teleoperation setup.…”

“…The first teleoperated mode, the constraint mode, was chosen based on findings of a previous study [ 33 ]. In this mode the user is haptically constrained within a volume such that movements exceeding the boundary are counteracted by artificial guidance forces generated by a unidirectional PD controller with P = 5.4 N/mm and D = 0.03 Ns/mm in the depth direction and P = 2 N/mm and D = 0.05 Ns/mm in the main visual plane.…”

“…The second teleoperated mode was the trajectory mode, which was found to increase efficiency as well as perceived system usability, while reducing the perceived workload for the user [ 33 ]. In this mode users were guided along a milling path in two layers.…”

“…If the velocity guidance is not activated the haptic velocity limit of the constraint mode is active. Pressing the grey foot pedal deactivated the trajectory guidance and replaced it by the constraint mode, because the possibility to switch off the trajectory improves the perceived influence on task execution [ 33 ]. By pressing the grey foot pedal again, the trajectory mode could be reactivated.…”

“…The outer contour of the cavity was haptically constrained in the main visual plane. These two configurations were chosen since a previous study showed that the visual substitution provides superior effectiveness and additional haptic feedback increases perceived usability [ 33 ]. Following each mode participants were asked to fill out a questionnaire containing the SUS questionnaire and the NASA-TLX rating scales.…”