Force sensing micro-forceps for robot assisted retinal surgery

Abstract

Membrane peeling is a standard vitreoretinal procedure, where the surgeon delaminates a very thin membrane from retina surface using surgical picks and forceps. This requires extremely delicate manipulation of the retinal tissue. Applying excessive forces during the surgery can cause serious complications leading to vision loss. For successful membrane peeling, most of the applied forces need to be very small, well below the human tactile sensation threshold. In this paper, we present a robotic system that combines a force sensing forceps tool and a cooperatively-controlled surgical robot. This combination allows us to measure the forces directly at the tool tip and use this information for limiting the applied forces on the retina. This may prevent many iatrogenic injuries and allow safer maneuvers during vitreoretinal procedures. We show that our system can successfully eliminate hand-tremor and excessive forces in membrane peeling experiments on the inner shell membrane of a chicken embryo.

Robot-Assisted Pterygium Surgery: Feasibility Study in a Nonliving Porcine Model

“…This may account for the fact that many experimental prototypes of robots totally dedicated to eye surgery have been developed recently. [19][20][21][22][23] These prototypes have been used in animal models to perform anterior and posterior segment surgeries. This is a promising area of research, specifically for vitreoretinal surgery.…”

Towards robot-assisted vitreoretinal surgery: Force-sensing micro-forceps integrated with a handheld micromanipulator

“…For the handle mechanism, it is desirable to preserve the intuitive actuation mechanism on the existing disposable forceps from Alcon, Inc. (Fort Worth, TX), which was also used in our previous force-sensing micro-forceps for the Steady-Hand Robot [18]. This mechanism can be actuated simply by squeezing the tool handle.…”

“…This enables removal of the membrane from the eye in a single step [16], which is why forceps are more practical and more commonly used in vitreoretinal surgery. With this motivation, tool development continued with a manual pair of 2-DOF force-sensing forceps [17], followed by a 2-DOF forceps that can be used with the Steady-Hand Robot [18]. These can sense only the transverse tool-to-tissue interaction forces, which is a limitation for practical use in membrane peeling.…”

Accurate real-time depth control for CP-SSOCT distal sensor based handheld microsurgery tools

“…Such tool tip visualization is limited in the axial direction by the ability to resolve small changes in position as well as by obstruction of the retinal surface by the tool shaft and tip. A variety of robotassisted systems have been developed to actively overcome such a limitation and to achieve the surgical objectives while minimizing surgical risks [3][4][5][6][7][8][9]. Early in the evolution of this technology, it was the main point to develop a robot-assisted system with high accuracy and user-friendly operating manipulation [3][4][5][6][7].…”