The use of robots in minimally invasive surgery has improved the quality of standard surgical procedures. So far, only the automation of simple surgical actions has been investigated by researchers, while the execution of structured tasks requiring reasoning on the environment and the choice among multiple actions is still managed by human surgeons. In this paper, we propose a framework to implement surgical task automation. The framework consists of a task-level reasoning module based on answer set programming, a low-level motion planning module based on dynamic movement primitives, and a situation awareness module. The logic-based reasoning module generates explainable plans and is able to recover from failure conditions, which are identified and explained by the situation awareness module interfacing to a human supervisor, for enhanced safety. Dynamic Movement Primitives allow to replicate the dexterity of surgeons and to adapt to obstacles and changes in the environment. The framework is validated on different versions of the standard surgical training peg-and-ring task.
Autonomy is the frontier of research in robotic surgery and its aim is to improve the quality of surgical procedures in the next future. One fundamental requirement for autonomy is advanced perception capability through vision sensors. In this paper, we propose a novel calibration technique for a surgical scenario with da Vinci robot. Calibration of the camera and the robot is necessary for precise positioning of the tools in order to emulate the high performance surgeons. Our calibration technique is tailored for RGB-D camera. Different tests performed on relevant use cases for surgery prove …
In robotic surgery, tool tracking is important for providing safe tool-tissue interaction and facilitating surgical skills assessment. Despite recent advances in tool tracking, existing approaches are faced with major difficulties in real-time tracking of articulated tools. Most algorithms are tailored for offline processing with pre-recorded videos. In this paper, we propose a real-time 3D tracking method for articulated tools in robotic surgery. The proposed method is based on the CAD model of the tools as well as robot kinematics to generate online part-based templates for efficient 2D matc…
Suture needle localization is necessary for autonomous suturing. Previous approaches in autonomous suturing often relied on fiducial markers rather than markerless detection schemes for localizing a suture needle due to the inconsistency of markerless detections. However, fiducial markers are not practical for real-world applications and can often be occluded from environmental factors in surgery (e.g., blood). Therefore in this work, we present a robust tracking approach for estimating the 6D pose of a suture needle when using inconsistent detections. We define observation models based on sut…
Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS)（惠康/工程与物理科学研究委员会介入与外科科学中心（WEISS））；University College London（伦敦大学学院）
Objective: Surgical activity recognition is a fundamental step in computer-assisted interventions. This paper reviews the state-of-the-art in methods for automatic recognition of fine-grained gestures in robotic surgery focusing on recent data-driven approaches and outlines the open questions and future research directions. Methods: An article search was performed on 5 bibliographic databases with the following search terms: robotic, robot-assisted, JIGSAWS, surgery, surgical, gesture, fine-grained, surgeme, action, trajectory, segmentation, recognition, parsing. Selected articles were classif…
Technische Universität München（慕尼黑工业大学）；Johns Hopkins University（约翰斯·霍普金斯大学）；Intuitive Surgical Inc.（直观医疗公司）
Detection, tracking, and pose estimation of surgical instruments are crucial tasks for computer assistance during minimally invasive robotic surgery. In the majority of cases, the first step is the automatic segmentation of surgical tools. Prior work has focused on binary segmentation, where the objective is to label every pixel in an image as tool or background. We improve upon previous work in two major ways. First, we leverage recent techniques such as deep residual learning and dilated convolutions to advance binary-segmentation performance. Second, we extend the approach to multi-class se…
Autonomous suturing has been a long-sought-after goal for surgical robotics. Outside of staged environments, accurate localization of suture needles is a critical foundation for automating various suture needle manipulation tasks in the real world. When localizing a needle held by a gripper, previous work usually tracks them separately without considering their relationship. Because of the significant errors that can arise in the stereo-triangulation of objects and instruments, their reconstructions may often not be consistent. This can lead to unrealistic tool-needle grasp reconstructions tha…
National University of Singapore（新加坡国立大学）；Imperial College London（伦敦帝国学院）；Singapore General Hospital（新加坡中央医院）
Learning to infer graph representations and performing spatial reasoning in a complex surgical environment can play a vital role in surgical scene understanding in robotic surgery. For this purpose, we develop an approach to generate the scene graph and predict surgical interactions between instruments and surgical region of interest (ROI) during robot-assisted surgery. We design an attention link function and integrate with a graph parsing network to recognize the surgical interactions. To embed each node with corresponding neighbouring node features, we further incorporate SageConv into the …
Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London（伦敦大学学院威康/EPSRC介入与外科科学中心）；Department of Computer Science, University College London（伦敦大学学院计算机科学系）
Semantic tool segmentation in surgical videos is important for surgical scene understanding and computer-assisted interventions as well as for the development of robotic automation. The problem is challenging because different illumination conditions, bleeding, smoke and occlusions can reduce algorithm robustness. At present labelled data for training deep learning models is still lacking for semantic surgical instrument segmentation and in this paper we show that it may be possible to use robot kinematic data coupled with laparoscopic images to alleviate the labelling problem. We propose a ne…
Scene Graph-Driven Haptic Feedback for Safety Enhancement in Robotic Ophthalmic Surgery via Physically Simulated iOCT
Munich Institute of Robotics and Machine Intelligence (MIRMI), Technical University of Munich (TUM)（慕尼黑工业大学慕尼黑机器人与机器智能研究所）；TUM School of Engineering and Design, Technical University of Munich (TUM)（慕尼黑工业大学工程与设计学院）
The Chinese University of Hong Kong（香港中文大学）；Johns Hopkins University（约翰斯·霍普金斯大学）
Automatic surgical gesture recognition is fundamentally important to enable intelligent cognitive assistance in robotic surgery. With recent advancement in robot-assisted minimally invasive surgery, rich information including surgical videos and robotic kinematics can be recorded, which provide complementary knowledge for understanding surgical gestures. However, existing methods either solely adopt uni-modal data or directly concatenate multi-modal representations, which can not sufficiently exploit the informative correlations inherent in visual and kinematics data to boost gesture recogniti…
NUS Graduate School for Integrative Sciences and Engineering (NGS), National University of Singapore（新加坡国立大学综合科学与工程研究生院）；Dept. of Biomedical Engineering, National University of Singapore（新加坡国立大学生物医学工程系）；Dept. of Instrumentation and Control Engineering, NIT Trichy（印度国立理工学院蒂鲁奇拉帕利分校仪器与控制工程系）；Dept. of Otolaryngology, Singapore General Hospital（新加坡中央医院耳鼻喉科）
Representation learning of the task-oriented attention while tracking instrument holds vast potential in image-guided robotic surgery. Incorporating cognitive ability to automate the camera control enables the surgeon to concentrate more on dealing with surgical instruments. The objective is to reduce the operation time and facilitate the surgery for both surgeons and patients. We propose an end-to-end trainable Spatio-Temporal Multi-Task Learning (ST-MTL) model with a shared encoder and spatio-temporal decoders for the real-time surgical instrument segmentation and task-oriented saliency dete…
Johns Hopkins University（约翰斯·霍普金斯大学）；Department of Computer Science, Johns Hopkins University（约翰斯·霍普金斯大学计算机科学系）；Laboratory for Computer Aided Medical Procedures, Johns Hopkins University（约翰斯·霍普金斯大学计算机辅助医疗程序实验室）
Robot-assisted minimally invasive surgery has shown to improve patient outcomes, as well as reduce complications and recovery time for several clinical applications. While increasingly configurable robotic arms can maximize reach and avoid collisions in cluttered environments, positioning them appropriately during surgery is complicated because safety regulations prevent automatic driving. We propose a head-mounted display (HMD) based augmented reality (AR) system designed to guide optimal surgical arm set up. The staff equipped with HMD aligns the robot with its planned virtual counterpart. I…
The Chinese University of Hong Kong（香港中文大学）；Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences（中国科学院深圳先进技术研究院）；University College London（伦敦大学学院）
Surgical instrument segmentation -- in general a pixel classification task -- is fundamentally crucial for promoting cognitive intelligence in robot-assisted surgery (RAS). However, previous methods are struggling with discriminating instrument types and instances. To address the above issues, we explore a mask classification paradigm that produces per-segment predictions. We propose TraSeTR, a novel Track-to-Segment Transformer that wisely exploits tracking cues to assist surgical instrument segmentation. TraSeTR jointly reasons about the instrument type, location, and identity with instance-…
Robotic-assisted surgeries benefit both surgeons and patients, however, surgeons frequently need to adjust the endoscopic camera to achieve good viewpoints. Simultaneously controlling the camera and the surgical instruments is impossible, and consequentially, these camera adjustments repeatedly interrupt the surgery. Autonomous camera control could help overcome this challenge, but most existing systems are reactive, e.g., by having the camera follow the surgical instruments. We propose a predictive approach for anticipating when camera movements will occur using artificial neural networks. We…
California Institute of Technology（加州理工学院）；University of Southern California（南加州大学）
Surgery is a high-stakes domain where surgeons must navigate critical anatomical structures and actively avoid potential complications while achieving the main task at hand. Such surgical activity has been shown to affect long-term patient outcomes. To better understand this relationship, whose mechanics remain unknown for the majority of surgical procedures, we hypothesize that the core elements of surgery must first be quantified in a reliable, objective, and scalable manner. We believe this is a prerequisite for the provision of surgical feedback and modulation of surgeon performance in pur…
Can DeepSeek Reason Like a Surgeon? An Empirical Evaluation for Vision-Language Understanding in Robotic-Assisted Surgery
The Chinese University of Hong Kong（香港中文大学）；University of Strasbourg（斯特拉斯堡大学）；CNRS（法国国家科学研究中心）；INSERM（法国国家健康与医学研究院）；ICube（ICube实验室）；IHU Strasbourg（斯特拉斯堡大学医院研究所）
Technische Universität München（慕尼黑工业大学）；Johns Hopkins University（约翰斯·霍普金斯大学）
Segmentation of surgical instruments is an important problem in robot-assisted surgery: it is a crucial step towards full instrument pose estimation and is directly used for masking of augmented reality overlays during surgical procedures. Most applications rely on accurate real-time segmentation of high-resolution surgical images. While previous research focused primarily on methods that deliver high accuracy segmentation masks, majority of them can not be used for real-time applications due to their computational cost. In this work, we design a light-weight and highly-efficient deep residual…
VLA-4D: Embedding 4D Awareness into Vision-Language-Action Models for SpatioTemporally Coherent Robotic Manipulation
School of Computing, National University of Singapore（新加坡国立大学计算机学院）；School of Artificial Intelligence and Automation, Huazhong University of Science and Technology（华中科技大学人工智能与自动化学院）
Dynamic Interactive Relation Capturing via Scene Graph Learning for Robotic Surgical Report Generation
The Hong Kong University of Science and Technology (Guangzhou)（香港科技大学（广州））；University College London（伦敦大学学院）；The Hong Kong University of Science and Technology（香港科技大学）
Surgical-MambaLLM: Mamba2-enhanced Multimodal Large Language Model for VQLA in Robotic Surgery
Hong Kong University of Science and Technology (Guangzhou)（香港科学与技术大学（广州））；Imperial College London（帝国理工学院伦敦分校）；The Hong Kong University of Science and Technology（香港科学与技术大学）
Universitat Politècnica de Catalunya（加泰罗尼亚理工大学）；Fraunhofer Heinrich Hertz Institute（弗劳恩霍夫海因里希·赫兹研究所）
Providing force feedback as relevant information in current Robot-Assisted Minimally Invasive Surgery systems constitutes a technological challenge due to the constraints imposed by the surgical environment. In this context, Sensorless Force Estimation techniques represent a potential solution, enabling to sense the interaction forces between the surgical instruments and soft-tissues. Specifically, if visual feedback is available for observing soft-tissues' deformation, this feedback can be used to estimate the forces applied to these tissues. To this end, a force estimation model, based on Co…
Traditionally, cardiac surgery has been performed through a median sternotomy, which allows the surgeon generous access to the heart and surrounding great vessels. As a paradigm shift in the size and location of incisions occurs in cardiac surgery, new methods have been developed to allow the surgeon the same amount of dexterity and accessibility to the heart in confined spaces and in a less invasive manner. Initially, long instruments without pivot points were used, however, more recent robotic telemanipulation systems have been applied that allow for improved dexterity, enabling the surgeon …
The Hamlyn Centre for Robotic Surgery, IGHI, Imperial College London（伦敦帝国理工学院哈姆林机器人手术中心）；Dyson Robotics Laboratory, Imperial College London（伦敦帝国理工学院戴森机器人实验室）；OpenAI；Department of Surgery and Cancer, Imperial College London（伦敦帝国理工学院外科与癌症系）
Robotic surgery has become a powerful tool for performing minimally invasive procedures, providing advantages in dexterity, precision, and 3D vision, over traditional surgery. One popular robotic system is the da Vinci surgical platform, which allows preoperative information to be incorporated into live procedures using Augmented Reality (AR). Scene depth estimation is a prerequisite for AR, as accurate registration requires 3D correspondences between preoperative and intraoperative organ models. In the past decade, there has been much progress on depth estimation for surgical scenes, such as …
CHU de Nantes（南特大学医疗中心）；Laboratoire des Sciences du Numérique de Nantes UMR CNRS 6004（南特数字科学实验室（法国国家科学研究中心联合实验室 6004））；CNRS（法国国家科学研究中心）
In otolaryngologic surgery, endoscopy is increasingly used to provide a better view of hard-to-reach areas and to promote minimally invasive surgery. However, the need to manipulate the endoscope limits the surgeon's ability to operate with only one instrument at a time. Currently, several robotic systems are being developed, demonstrating the value of robotic assistance in microsurgery. The aim of this literature review is to present and classify current robotic systems that are used for otological and endonasal applications. For these solutions, an analysis of the functionalities in relation…
Digital Surgery Limited（数字手术有限公司）；University College London（伦敦大学学院）；Kasetsart University（泰国农业大学）
Robotic surgery and novel surgical instrumentation present great potentials towards safer, more accurate and consistent minimally invasive surgery. However, their adoption is dependent to the access to training facilities and extensive surgical training. Robotic instruments require different dexterity skills compared to open or laparoscopic. Surgeons, therefore, are required to invest significant time by attending extensive training programs. Contrary, hands on experiences represent an additional operational cost for hospitals as the availability of robotic systems for training purposes is lim…
Johns Hopkins University（约翰斯·霍普金斯大学）；Children’s National Hospital（国立儿童医院）
Autonomous robotic surgery has the potential to provide efficacy, safety, and consistency independent of individual surgeons skill and experience. Autonomous soft-tissue surgery in unstructured and deformable environments is especially challenging as it necessitates intricate imaging, tissue tracking and surgical planning techniques, as well as a precise execution via highly adaptable control strategies. In the laparoscopic setting, soft-tissue surgery is even more challenging due to the need for high maneuverability and repeatability under motion and vision constraints. We demonstrate the fir…
The Chinese University of Hong Kong（香港中文大学）；The Johns Hopkins University（约翰斯·霍普金斯大学）
Robot-assisted surgery has become progressively more and more popular due to its clinical advantages. In the meanwhile, the artificial intelligence and augmented reality in robotic surgery are developing rapidly and receive lots of attention. However, current methods have not discussed the coherent integration of AI and AR in robotic surgery. In this paper, we develop a novel system by seamlessly merging artificial intelligence module and augmented reality visualization to automatically generate the surgical guidance for robotic surgery education. Specifically, we first leverage reinforcement …
University of California San Diego（加利福尼亚大学圣地亚哥分校）；Kyung Hee University（庆熙大学）
Innovations from surgical robotic research rarely translates to live surgery due to the significant difference between the lab and a live environment. Live environments require considerations that are often overlooked during early stages of research such as surgical staff, surgical procedure, and the challenges of working with live tissue. One such example is the da Vinci Research Kit (dVRK) which is used by over 40 robotics research groups and represents an open-sourced version of the da Vinci Surgical System. Despite dVRK being available for nearly a decade and the ideal candidate for transl…
Shantou University（汕头大学）；The First Affiliated Hospital of Medical College of Shantou University（汕头大学医学院第一附属医院）
This paper presents the development and experimental evaluation of a surgical robotic system for total hip arthroplasty (THA). Although existing robotic systems used in joint replacement surgery have achieved some progresses, the robot arm must be situated accurately at the target position during operation, which depends significantly on the experience of the surgeon. In addition, handheld acetabulum reamers typically exhibit uneven strength and grinding file. Moreover, the lack of techniques to real-time measure femoral neck length may lead to poor outcomes. To tackle these challenges, we pro…
Primary Experimental Feedback on a Co-manipulated Robotic System for Assisted Cervical Surgery
Pprime Institute（Pprime研究所）；University of Poitiers（普瓦捷大学）；CNRS（法国国家科学研究中心）；ISAE-ENSMA（法国高等航空航天学院-国立高等机械与航空技术学院）；Centre Hospitalier Universitaire (CHU)（大学教学医院（CHU））；National Central University（国立中央大学）；National Engineering School of Sousse（苏塞国立工程师学院）；University of Sousse（苏塞大学）
NUS (Suzhou) Research Institute (NUSRI)（新加坡国立大学（苏州）研究院（NUSRI））
Gastrointestinal endoscopic surgery (GES) has high requirements for instruments' size and distal dexterity, because of the narrow endoscopic channel and long, tortuous human gastrointestinal tract. This paper utilized Nickel-Titanium (NiTi) wires to develop a miniature 3-DoF (pitch-yaw-translation) flexible parallel robotic wrist (FPRW). Additionally, we assembled an electric knife on the wrist's connection interface and then teleoperated it to perform an endoscopic submucosal dissection (ESD) on porcine stomachs. The effective performance in each ESD workflow proves that the designed FPRW has…
Imperial College London（伦敦帝国理工学院）；University of Bristol（布里斯托尔大学）
In recent decades, the tremendous benefits surgical robots have brought to surgeons and patients have been witnessed. With the dexterous operation and the great precision, surgical robots can offer patients less recovery time and less hospital stay. However, the controls for current surgical robots in practical usage are fully carried out by surgeons via teleoperation. During the surgery process, there exists a lot of repetitive but simple manipulation, which can cause unnecessary fatigue to the surgeons. In this paper, we proposed a deep reinforcement learning-based semi-autonomous control fr…
Image-to-Force Estimation for Soft Tissue Interaction in Robotic-Assisted Surgery Using Structured Light
School of Electronic Information Engineering, Tongji University（同济大学电子与信息工程学院）；MicroPort MedBot (Group) Company Ltd.（微创医疗机器人（集团）股份有限公司）；College of Engineering, Peking University（北京大学工学院）；City University of Hong Kong（香港城市大学）
University of California San Diego（加州大学圣地亚哥分校）；University of New Mexico（新墨西哥大学）
Automating the process of manipulating and delivering sutures during robotic surgery is a prominent problem at the frontier of surgical robotics, as automating this task can significantly reduce surgeons' fatigue during tele-operated surgery and allow them to spend more time addressing higher-level clinical decision making. Accomplishing autonomous suturing and suture manipulation in the real world requires accurate suture thread localization and reconstruction, the process of creating a 3D shape representation of suture thread from 2D stereo camera surgical image pairs. This is a very challen…
NUS Graduate School for Integrative Sciences and Engineering (NGS)（新加坡国立大学综合科学与工程研究生院（NGS））；National University of Singapore（新加坡国立大学）；University of Moratuwa（莫拉图瓦大学）；NIT Trichy（印度国立理工学院蒂鲁吉拉伯利分校）
Robot-assisted surgery is an emerging technology which has undergone rapid growth with the development of robotics and imaging systems. Innovations in vision, haptics and accurate movements of robot arms have enabled surgeons to perform precise minimally invasive surgeries. Real-time semantic segmentation of the robotic instruments and tissues is a crucial step in robot-assisted surgery. Accurate and efficient segmentation of the surgical scene not only aids in the identification and tracking of instruments but also provided contextual information about the different tissues and instruments be…
National University of Singapore（新加坡国立大学）；NUSRI Suzhou China（新加坡国立大学苏州研究院）；The Chinese University of Hong Kong（香港中文大学）；Imperial College London（伦敦帝国理工学院）；Duke-NUS Medical School（杜克-新加坡国立大学医学院）
Generating a surgical report in robot-assisted surgery, in the form of natural language expression of surgical scene understanding, can play a significant role in document entry tasks, surgical training, and post-operative analysis. Despite the state-of-the-art accuracy of the deep learning algorithm, the deployment performance often drops when applied to the Target Domain (TD) data. For this purpose, we develop a multi-layer transformer-based model with the gradient reversal adversarial learning to generate a caption for the multi-domain surgical images that can describe the semantic relation…
LIRMM, University of Montpellier, CNRS（蒙彼利埃大学法国国家科学研究中心LIRMM实验室）；Stanford University（斯坦福大学）
The current generation of surgeons requires extensive training in teleoperation to develop specific dexterous skills, which are independent of medical knowledge. Training curricula progress from manipulation tasks to simulated surgical tasks but are limited in time. To tackle this, we propose to integrate surgical robotic training together with Haptic Feedback (HF) to improve skill acquisition. This paper present the initial but promising results of our haptic device designed to support in the training of surgical gestures. Our ongoing work is related to integrate the HF in the RAVEN II platfo…
School of Mechanical and Aerospace Engineering（机械与航空航天工程学院）
The human-machine interface is of critical importance for master-slave control of the robotic system for surgery, in which current systems offer the control or two robotic arms teleoperated by the surgeon's hands. To relax the need for surgical assistants and augment dexterity in surgery, it has been recently proposed to use a robot like a third arm that can be controlled seamlessly, independently from the natural arms, and work together with them. This report will develop and investigate this concept by implementing foot control of a robotic surgical arm. A novel passive haptic foot-machine i…
Autonomous robotic surgery requires deliberation, i.e. the ability to plan and execute a task adapting to uncertain and dynamic environments. Uncertainty in the surgical domain is mainly related to the partial pre-operative knowledge about patient-specific anatomical properties. In this paper, we introduce a logic-based framework for surgical tasks with deliberative functions of monitoring and learning. The DEliberative Framework for Robot-Assisted Surgery (DEFRAS) estimates a pre-operative patient-specific plan, and executes it while continuously measuring the applied force obtained from a bi…
Despite the immense technology advancement in the surgeries the criteria of assessing the surgical skills still remains based on subjective standards. With the advent of robotic-assisted surgery, new opportunities for objective and autonomous skill assessment is introduced. Previous works in this area are mostly based on structured-based method such as Hidden Markov Model (HMM) which need enormous pre-processing. In this study, in contrast with them, we develop a new shaped-based framework for automatically skill assessment and personalized surgical training with minimum parameter tuning. Our …
