Using intermittent synchronization to compensate for rhythmic body motion during autonomous surgical cutting and debridement

Abstract

Anatomical structures are rarely static during a surgical procedure due to breathing, heartbeats, and peristaltic movements. Inspired by observing an expert surgeon, we propose an intermittent synchronization with the extrema of the rhythmic motion (i.e., the lowest velocity windows). We performed 2 experiments: (1) pattern cutting, and (2) debridement. In (1), we found that the intermittent synchronization approach, while 1.8x slower than tracking motion, was significantly more robust to noise and control latency, and it reduced the max cutting error by 2.6x In (2), a baseline approach with no synchronization achieves 62% success rate for each removal, while intermittent synchronization achieves 80%.

Combining Time-Dependent Force Perturbations in Robot-Assisted Surgery Training

“…Another approach revealed by our analysis is a change in the number of cuts during the training. This result is consistent with [36], where a surgeon who performed a pattern-cutting task with a moving platform timed the cuts according to the movement of the platform.…”

Review of Advanced Medical Telerobots

“…The shared autonomy frameworks are designed to reduce the mental and physical burden on the surgeon and maximize the quality of surgery up to the level which is not possible to achieve without the use of a telerobotic system. Some examples can be found in [2,[65][66][67][68][69][70][71][72][73][74][75][76].…”

“…Besides sensory augmentation, telerobotic surgical systems are known to augment the motor performance of surgeons to directly correct and enhance the manipulations generated by the surgeon to minimize errors and increase the quality of surgery. In this regard, tremor compensation [2,65,66], organ motion compensation [75,76], surgeon's motion scaling [2,5,185], guiding force fields [67][68][69][70][71], and forbidden virtual fixtures [67,68,111,112,[186][187][188] are existing examples of motor augmentation achieved using teleoperated robotic systems [1].…”

SPRK: A low-cost stewart platform for motion study in surgical robotics

“…Moreover, safety spaces were opened up in the middle of the platform in order to prevent damage to the surgical instruments and the platform from collisions in failure cases. Pattern cutting and debridement were some of the first experiments conducted using the platform [12]. For cutting, the gauze was suspended at the edges with clips, or pinned down on a silicone phantom adhered to the platform mount.…”

“…Our lab has used the SPRK to study autonomous surgical robot in three projects: 1) Teleoperation: In June 2016, co-author and expert cardiac surgeon Dr. W. Douglas Boyd performed two FLS tasks, pattern cutting and peg transfer, on the Stewart platform programmed to move in rhythmic motions. The data collected in this study yielded an interesting insight that the surgeon preferred an intermittent synchronization policy, where he synchronized his actions with the minima or maxima of the rhythmic motion (i.e., the lowest velocity time windows) ("Using Intermittent Synchronization to Compensate for Rhythmic Body Motion During Autonomous Surgical Cutting and Debridement" [12]). 2) Surgical Cutting and Debridement: We performed autonomous execution on two tasks: (1) we constructed a simplified variant of the FLS cutting task, where we autonomously cut along a line and translated the platform perpendicular to the line at 0.2Hz, and (2) we consider surgical debridement where foreign inclusions are removed from a tissue phantom that is moving with at 1.25 cm, 0.5 Hz [12].…”