Objective: We aim to investigate long-term robotic surgical skill acquisition among surgical residents and the effects of training intervals and fatigue on performance. Methods: For six months, surgical residents participated in three training sessions once a month, surrounding a single 26-hour hospital shift. In each shift, they participated in training sessions scheduled before, during, and after the shift. In each training session, they performed three dry-lab training tasks: Ring Tower Transfer, Knot-Tying, and Suturing. We collected a comprehensive dataset, including videos synchronized with kinematic data, activity tracking, and scans of the suturing pads. Results: We collected a dataset of 972 trials performed by 18 residents of different surgical specializations. Participants demonstrated consistent performance improvement across all tasks. In addition, we found variations in between-shift learning and forgetting across metrics and tasks, and hints for possible effects of fatigue. Conclusion: The findings from our first analysis shed light on the long-term learning processes of robotic surgical skills with extended intervals and varying levels of fatigue. Significance: This study lays the groundwork for future research aimed at optimizing training protocols and enhancing AI applications in surgery, ultimately contributing to improved patient outcomes. The dataset will be made available upon acceptance of our journal submission.
SurgiSR4K: A High-Resolution Endoscopic Video Dataset for Robotic-Assisted Minimally Invasive Procedures
Intuitive Surgical, Inc.（Intuitive Surgical公司）；Johns Hopkins Medicine Neurosurgery（约翰霍普金斯医学神经外科）；Johns Hopkins University Electrical and Computer Engineering（约翰霍普金斯大学电气与计算机工程）；University of British Columbia Electrical and Computer Engineering（不列颠哥伦比亚大学电气与计算机工程）；Wilford & Kate Bailey Small Animal Teaching Hospital（威尔福德与凯蒂·贝利小动物教学医院）
The Quiet Eye Phenomenon in Minimally Invasive Surgery
Stanford University（斯坦福大学）；University of British Columbia（不列颠哥伦比亚大学）；Intuitive Surgical（直觉外科公司）；Johns Hopkins University School of Medicine（约翰斯·霍普金斯大学医学院）；Johns Hopkins University（约翰斯·霍普金斯大学）
MISTac: A Vision-Based Tactile Sensor for Minimally Invasive Surgery
TUD Dresden University of Technology（德累斯顿工业大学）；Stanford University（斯坦福大学）；University Hospital Carl Gustav Carus（卡尔·古斯塔夫·卡鲁斯大学医院）；Centre for Tactile Internet with Human-in-the-Loop (CeTI)（以人为中心的触觉互联网中心）；National Center for Tumor Diseases (NCT)（国家肿瘤疾病中心）；DKFZ（德国癌症研究中心）；Helmholtz-Zentrum Dresden-Rossendorf (HZDR)（德累斯顿-罗森多夫亥姆霍兹中心）；Karlsruhe Institute of Technology (KIT)（卡尔斯鲁厄理工学院）
Design Analysis of an Innovative Parallel Robot for Minimally Invasive Pancreatic Surgery
Technical University of Cluj-Napoca（克卢日-纳波卡技术大学）；Technical Sciences Academy of Romania（罗马尼亚技术科学院）；École Centrale Nantes（南特中央理工学校）；Nantes Université（南特大学）；CNRS（法国国家科学研究中心）
Integrating mobile robots into human society involves the fundamental problem of navigation in crowds. This problem has been studied by considering the behaviour of humans at the level of individuals, but this representation limits the computational efficiency of motion planning algorithms. We explore the idea of representing a crowd as a flow field, and propose a formal definition of path quality based on the concept of invasiveness; a robot should attempt to navigate in a way that is minimally invasive to humans in its environment. We develop an algorithmic framework for path planning based …
The control architecture of a spherical robot for Minimally Invasive Surgery
CESTER, Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca（克卢日-纳波卡技术大学工业机器人仿真与测试研究中心）；Technical Sciences Academy of Romania（罗马尼亚技术科学院）；École Centrale Nantes（南特中央理工大学）；Nantes Université（南特大学）；CNRS（法国国家科学研究中心）；LS2N, UMR 6004（南特数字科学实验室）
Emerging paradigms furthering the reach of medical technology deeper into human anatomy present unique modeling, control and sensing problems. This paper discusses a brief history of medical robotics leading to the current trend of minimally invasive intervention and diagnostics in confined spaces. Robotics for natural orifice and single port access surgery, capsule and magnetically actuated robotics and microrobotics are discussed with the aim of elucidating the state of the art. Works on modeling, sensing and control of mechanical architectures of robots for natural orifice and single port a…
The surgical paradigm of Minimally Invasive Surgery (MIS) has been a key driver to the adoption of robotic surgical assistance. Progress in the last three decades has led to a gradual transition from manual laparoscopic surgery with rigid instruments to robot-assisted surgery. In the last decade, the increasing demand for new surgical paradigms to enable access into the anatomy without skin incision (intraluminal surgery) or with a single skin incision (Single Port Access surgery - SPA) has led researchers to investigate snake-like flexible surgical devices. In this chapter, we first present a…
Accuracy and repeatability of a parallel robot for personalised minimally invasive surgery
CESTER, Technical University of Cluj-Napoca（克卢日-纳波卡技术大学 CESTER）；École Centrale Nantes, Nantes Université, CNRS, LS2N（南特中央理工大学、南特大学、法国国家科学研究中心、LS2N）；Technical Sciences Academy of Romania（罗马尼亚技术科学院）
University of British Columbia（不列颠哥伦比亚大学）；Zipline International（Zipline International公司）；Johns Hopkins University（约翰斯·霍普金斯大学）
We propose a new method for six-degree-of-freedom (6-DoF) autonomous camera movement for minimally invasive surgery, which, unlike previous methods, takes into account both the position and orientation information from structures in the surgical scene. In addition to locating the camera for a good view of the manipulated object, our autonomous camera takes into account workspace constraints, including the horizon and safety constraints. We developed a simulation environment to test our method on the "wire chaser" surgical training task from validated training curricula in conventional laparosc…
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 …
Kinematic analysis of a parallel robot for minimally invasive surgery
CESTER, Technical University of Cluj-Napoca（克卢日-纳波卡技术大学 CESTER）；École Centrale Nantes, Nantes Université, CNRS, LS2N, UMR 6004（南特中央理工大学、南特大学、法国国家科学研究中心、LS2N实验室、UMR 6004）；Technical Sciences Academy of Romania（罗马尼亚技术科学院）
Case Western Reserve University（凯斯西储大学）；Stanford University（斯坦福大学）
Effective force modulation during tissue manipulation is important for ensuring safe robot-assisted minimally invasive surgery (RMIS). Strict requirements for in-vivo distal force sensing have led to prior sensor designs that trade off ease of manufacture and integration against force measurement accuracy along the tool axis. These limitations have made collecting high-quality 3-degree-of-freedom (3-DoF) bimanual force data in RMIS inaccessible to researchers. We present a modular and manufacturable 3-DoF force sensor that integrates easily with an existing RMIS tool. We achieve this by relaxi…
Advancing Minimally Invasive Precision Surgery in Large Open Cavities with Robotic Flexible Endoscopy
Multi-Scale Robotics Lab, ETH Zurich（ETH Zurich 多尺度机器人实验室）；Center for Preclinical Development, University Hospital Zurich, University of Zurich（苏黎世大学医院预临床发展中心，苏黎世大学）；Department of Obstetrics, University Hospital of Zurich（苏黎世大学医院妇产科）；The Zurich Center for Fetal Diagnosis and Therapy, University of Zurich（苏黎世大学胎儿诊断与治疗中心）；Department of Pediatric Surgery, University Children’s Hospital Zurich（苏黎世大学儿童医院小儿外科部门）
Minimally invasive surgery (MIS) offers several advantages including minimum tissue injury and blood loss, and quick recovery time, however, it imposes some limitations on surgeons ability. Among others such as lack of tactile or haptic feedback, poor visualization of the surgical site is one of the most acknowledged factors that exhibits several surgical drawbacks including unintentional tissue damage. To the context of robot assisted surgery, lack of frame contextual details makes vision task challenging when it comes to tracking tissue and tools, segmenting scene, and estimating pose and de…
A convoy of magnetic millirobots transports endoscopic instruments for minimally-invasive surgery
University of Stuttgart（斯图加特大学）；Xiangya Hospital, Central South University（中南大学湘雅医院）；International Joint Research Center of Minimally Invasive Endoscopic Technology Equipment & Standards（微创内镜技术装备与标准国际联合研究中心）；German Cancer Research Center (DKFZ)（德国癌症研究中心）；University of Heidelberg（海德堡大学）；Technical University Dresden（德累斯顿工业大学）
MiniTac: An Ultra-Compact 8 mm Vision-Based Tactile Sensor for Enhanced Palpation in Robot-Assisted Minimally Invasive Surgery
State Key Laboratory of General Artificial Intelligence（国家关键人工智能实验室）；Beijing Institute for General Artificial Intelligence（北京通用人工智能研究院）；Institute for Artificial Intelligence（人工智能学院）；Shenyang Institute of Automation（沈阳自动化研究所）；Chinese Academy of Sciences（中国科学院）；PLA General Hospital（中国人民解放军总医院）
We investigate grasping of rigid objects in unilateral robot-assisted minimally invasive surgery (RAMIS) in this paper. We define a human-centered transparency that quantifies natural action and perception in RAMIS. We demonstrate this human-centered transparency analysis for different values of gripper scaling - the scaling between the grasp aperture of the surgeon-side manipulator and the aperture of the surgical instrument grasper. Thirty-one participants performed teleoperated grasping and perceptual assessment of rigid objects in one of three gripper scaling conditions (fine, normal, and …
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…
University of Technology, Sydney（悉尼科技大学）；Centre for Autonomous Systems（自主系统中心）
In minimal invasive surgery, it is important to rebuild and visualize the latest deformed shape of soft-tissue surfaces to mitigate tissue damages. This paper proposes an innovative Simultaneous Localization and Mapping (SLAM) algorithm for deformable dense reconstruction of surfaces using a sequence of images from a stereoscope. We introduce a warping field based on the Embedded Deformation (ED) nodes with 3D shapes recovered from consecutive pairs of stereo images. The warping field is estimated by deforming the last updated model to the current live model. Our SLAM system can: (1) Increment…
Armstrong Atlantic State University（阿姆斯特朗大西洋州立大学）；Ovidius University（奥维迪乌斯大学）
Recent advances in haptic hardware and software technology have generated interest in novel, multimodal interfaces based on the sense of touch. Such interfaces have the potential to revolutionize the way we think about human computer interaction and open new possibilities for simulation and training in a variety of fields. In this paper we review several frameworks, APIs and toolkits for haptic user interface development. We explore these software components focusing on minimally invasive surgical simulation systems. In the area of medical diagnosis, there is a strong need to determine mechani…
Leibniz Universität Hannover（莱布尼茨汉诺威大学）；Hamburg University of Technology（汉堡工业大学）
Purpose: The facial recess is a delicate structure that must be protected in minimally invasive cochlear implant surgery. Current research estimates the drill trajectory by using endoscopy of the unique mastoid patterns. However, missing depth information limits available features for a registration to preoperative CT data. Therefore, this paper evaluates OCT for enhanced imaging of drill holes in mastoid bone and compares OCT data to original endoscopic images. Methods: A catheter-based OCT probe is inserted into a drill trajectory of a mastoid phantom in a translation-rotation manner to acqu…
MVP-Tac: A Miniaturized Dual-Modal Vision and Photoelastic Tactile Sensor for Robot-Assisted Minimally Invasive Surgery
Elmore Family School of Electrical and Computer Engineering, Purdue University（普渡大学埃尔莫尔电气与计算机工程学院）；Edwardson School of Industrial Engineering, Purdue University（普渡大学爱德华森工业工程学院）；School of Mechanical Engineering, Purdue University（普渡大学机械工程学院）；Robotics Engineering Technology, Purdue University（普渡大学机器人工程技术学院）；Department of Civil Engineering, Stony Brook University（石溪大学土木工程系）；Department of Mechanical Engineering, Michigan State University（密歇根州立大学机械工程系）
Bioinspired Kirigami Capsule Robot for Minimally Invasive Gastrointestinal Biopsy
Department of Electronic Engineering, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China, and CUHK Shenzhen Research Institute, CUHK-SZRI, Shenzhen, China（电子工程系，香港中文大学（深圳）研究学院，香港中文大学（深圳）研究学院，深圳，中国）；Department of Mechanical Engineering and Automation, Northeastern University, Shenyang 110819, China（机械工程与自动化系，东北大学，沈阳110819，中国）；Department of Medicine and Therapeutics and Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong（医学与治疗系及消化疾病研究所，香港中文大学，香港）
Body-mounted MR-conditional Robot for Minimally Invasive Liver Intervention
Institute of Robotics and Intelligent Machines, Georgia Institute of Technology（佐治亚理工学院机器人与智能机器研究所）；Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center（范德堡大学医学中心范德堡大学影像科学研究所）；Emory University（埃默里大学）；Mayo Clinic（梅奥诊所）；Department of Biomedical Engineering, Georgia Institute of Technology/Emory University（佐治亚理工学院/埃默里大学生物医学工程系）
Towards AI-enhanced control: a numerical technique for trajectory smoothing of a parallel robot for pancreatic surgery
CESTER, Technical University of Cluj-Napoca（克卢日-纳波卡技术大学CESTER）；École Centrale Nantes, Nantes Université（南特中央理工学院，南特大学）；CNRS（法国国家科学研究中心）；Technical Sciences Academy of Romania（罗马尼亚技术科学院）
The CYCLOPS is a cable-driven parallel mechanism used for minimally invasive applications, with the ability to be customised to different surgical needs; allowing it to be made procedure- and patient-specific. For adequate optimisation, however, appropriate data on clinical constraints and task-space is required. Whereas the former can be provided through preoperative planning and imaging, the latter remains a problem, primarily for highly dexterous MIS systems. The current work focuses on the development of a task-space optimisation method for the CYCLOPS system and the development of a data …
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…
This work proves that semantic segmentation on minimally invasive surgical instruments can be improved by using training data that has been augmented through domain adaptation. The benefit of this method is twofold. Firstly, it suppresses the need of manually labeling thousands of images by transforming synthetic data into realistic-looking data. To achieve this, a CycleGAN model is used, which transforms a source dataset to approximate the domain distribution of a target dataset. Secondly, this newly generated data with perfect labels is utilized to train a semantic segmentation neural networ…
Automatic Tissue Traction Using Miniature Force-Sensing Forceps for Minimally Invasive Surgery
University of New South Wales（新南威尔士大学）；School of Mechanical & Manufacturing Engineering（机械与制造工程学院）；School of Electrical Engineering and Telecommunications（电气工程与电信学院）；Harbin Institute of Technology（哈尔滨工业大学）；School of Biomedical Engineering and Digital Health（生物医学工程与数字健康学院）
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…
Ben-Gurion University of the Negev（内盖夫本-古里安大学）；California Institute of Technology（加州理工学院）；University of Southern California（南加州大学）；Soroka Medical Center（索罗卡医疗中心）
Teleoperated robot-assisted minimally-invasive surgery (RAMIS) offers many advantages over open surgery. However, there are still no guidelines for training skills in RAMIS. Motor learning theories have the potential to improve the design of RAMIS training but they are based on simple movements that do not resemble the complex movements required in surgery. To fill this gap, we designed an experiment to investigate the effect of time-dependent force perturbations on the learning of a pattern-cutting surgical task. Thirty participants took part in the experiment: (1) a control group that traine…
SurgCalib: Gaussian Splatting-Based Hand-Eye Calibration for Robot-Assisted Minimally Invasive Surgery
Robotics and Control Laboratory, University of British Columbia（机器人与控制实验室，不列颠哥伦比亚大学）；Department of Biomedical Engineering, National University of Singapore（生物医学工程系，新加坡国立大学）；Division of Otolaryngology – Head and Neck Surgery, University of British Columbia（耳鼻喉科–头颈外科部，不列颠哥伦比亚大学）
Cyber-physical systems for robotic surgery have enabled minimally invasive procedures with increased precision and shorter hospitalization. However, with increasing complexity and connectivity of software and major involvement of human operators in the supervision of surgical robots, there remain significant challenges in ensuring patient safety. This paper presents a safety monitoring system that, given the knowledge of the surgical task being performed by the surgeon, can detect safety-critical events in real-time. Our approach integrates a surgical gesture classifier that infers the operati…
University of Verona（维罗纳大学）；Universitat Politècnica de Catalunya（加泰罗尼亚理工大学）
Deep Reinforcement Learning (DRL) is a viable solution for automating repetitive surgical subtasks due to its ability to learn complex behaviours in a dynamic environment. This task automation could lead to reduced surgeon's cognitive workload, increased precision in critical aspects of the surgery, and fewer patient-related complications. However, current DRL methods do not guarantee any safety criteria as they maximise cumulative rewards without considering the risks associated with the actions performed. Due to this limitation, the application of DRL in the safety-critical paradigm of robot…
Gastrointestinal (GI) cancers account for 1.5 million deaths worldwide. Endoscopic Submucosal Dissection (ESD) is an advanced therapeutic endoscopy technique with superior clinical outcome due to the minimally invasive and en bloc removal of tumours. In the western world, ESD is seldom carried out, due to its complex and challenging nature. Various surgical systems are being developed to make this therapy accessible, however, these solutions have shown limited operational workspace, dexterity, or low force exertion capabilities. The current paper shows the ESD CYCLOPS system, a bimanual surgic…
Robotic-assisted minimally invasive surgery (MIS) has enabled procedures with increased precision and dexterity, but surgical robots are still open loop and require surgeons to work with a tele-operation console providing only limited visual feedback. In this setting, mechanical failures, software faults, or human errors might lead to adverse events resulting in patient complications or fatalities. We argue that impending adverse events could be detected and mitigated by applying context-specific safety constraints on the motions of the robot. We present a context-aware safety monitoring syste…
