Haptic Intracorporeal Palpation Using a Cable-Driven Parallel Robot: A User Study

Abstract

Intraoperative palpation is a surgical gesture jeopardized by the lack of haptic feedback which affects robotic minimally invasive surgery. Restoring the force reflection in teleoperated systems may improve both surgeons' performance and procedures' outcome. Methods: A force-based sensing approach was developed, based on a cable-driven parallel manipulator with anticipated seamless and low-cost integration capabilities in teleoperated robotic surgery. No force sensor on the end-effector is used, but tissue probing forces are estimated from measured cable tensions. A user study involving surgical trainees (n=22) was conducted to experimentally evaluate the platform in two palpation-based test-cases on silicone phantoms. Two modalities were compared: visual feedback alone and both visual + haptic feedbacks available at the master site. Results: Surgical trainees' preference for the modality providing both visual and haptic feedback is corroborated by both quantitative and qualitative metrics. Hard nodules detection sensitivity improves (94.35 ± 9.1% vs 76.09 ± 19.15 % for visual feedback alone), while also exerting smaller forces (4.13 ± 1.02 N vs 4.82 ± 0.81 N for visual feedback alone) on the phantom tissues. At the same time, the subjective perceived workload decreases. Conclusion: Tissueprobe contact forces are estimated in a low cost and unique way, without the need of force sensors on the end-effector. Haptics demonstrated an improvement in the tumor detection rate, a reduction of the probing forces, and a decrease in the perceived workload for the trainees. Significance: Relevant benefits are demonstrated from the usage of combined cable-driven parallel manipulators and haptics during robotic minimally invasive procedures. The translation of robotic intraoperative palpation to clinical practice could improve the detection and dissection of cancer nodules.

An Application-Based Review of Haptics Technology

“…The platform uses two haptic devices to transfer the sense of touch to both hands of a surgeon. A haptic intracorporeal palpation was proposed that Uses a cable-driven robotic system that includes a remote sensing strategy [47]. The platform employs teleoperated cable-driven parallel manipulator that is a new, simple, and cost-effective approach for restoring haptic sensation during the performance of intracorporeal palpation.…”

Accelerating Surgical Robotics Research: A Review of 10 Years With the da Vinci Research Kit

“…Numerous hardware and software developments [65]- [67], [79], [80], [106], [107], [114], [124], [193] worked on implementing haptics or force-sensing integration with the dVRK. The researchers also explored how such systems can link to automation [118], [212], [213], [224], [228]. The use of virtual fixtures, previously mentioned in the "Training, Skill Assessment, and Gesture Recognition" section as an intraoperative guidance tool, were investigated in [26]- [28], [77], [84], [167], [168], [205], [208], and [209] by providing constraints on the instruments' workspace.…”

Design of a 4-DoF (degree of freedom) hybrid-haptic device for laparoscopic surgery

“…This limitation makes the design of master and slave robots for MIS teleoperation systems challenging. In fact, the development and control of teleoperation systems for MIS are still up to date (Boabang et al, 2020;Iijima et al, 2020;Saracino et al, 2020). Since there are always possible improvements, many studies focus on the identification of the required workspace for MIS (Thakre et al, 2008;Pisla et al, 2008;Cavusoglu et al, 2001).…”