Telerobotic Surgery With Autonomous Physiological Motion Compensation

Looking to the history of medicine, we can clearly identify a major breakthrough supported by imaging technologies to reveal, diagnose and examine diseases (e.g., magnetic resonance, echography, positron emission tomography, X-rays, computed axial tomography and electron microscopy). Although surgical procedures have benefited from these technologies, no breakthrough happened in surgical manipulation tasks. Almost all surgeons manipulate medical instruments directly by hand without resorting to sophisticated instruments. Due to the intrinsic nature of human arms, only dexterous and virtuous surgeons can accomplish surgical tasks with superior performance in the presence of several difficulties such as soft tissue interaction, complex geometry, time consuming procedures linked to surgeon discomfort, precise motion control, accurate force control during insertion while penetrating tissues with different stiffnesses, loss of internal mobility due to kinematic constraints, restricted workspace, and sometimes, on top of all this, physiological motion disturbances. Surgical robotics has potential to solve most of these issues, being probably the emerging breakthrough that is missing in surgery. The main goal of this project is to design a control architecture for telerobotic surgery with haptic feedback, which automatically compensates physiological motions not known in advance. Beating-heart surgeries are the main target applications, due to precise force and motion control requirements (e.g., heart biopsy and anastomosis for coronary artery bypass grafting) under relatively strong and partially structured physiological motions. Laboratory logistics associated to heart manipulation on living beings is a key problem to develop mature robotic solutions. Therefore, we propose a realistic scenario without living beings in the workspace, where an industrial robot equipped with ex-vivo tissues/organs at the end-effector generates physiological motions using offline data (e.g., electrocardiogram). A second medical robot will perform telesurgery tasks on the moving ex-vivo tissues, providing haptic feedback. It should be pointed out that no commercial robotic system performs beating-heart surgeries. Merging autonomous motion compensation techniques with robot task motion and haptic feedback is a major scientific challenge that we want to tackle. The project has five main tasks. Task 1 is for installation and configuration of the industrial robot. In Task 2, the generation of physiological motions on the industrial robot along time varying directions will be done. Task 3 addresses motion estimation techniques using vision and force sensors located on the medical robot. The goal of Task 4 is to design a control architecture for haptic telesurgery with autonomous physiological motion compensation. In Task 5, experimental tests will be done for knot tying and needle insertion with controlled depth, in the presence of heart and breathing motions. We will invite surgeons from the Hospitals of Coimbra University to perform these tasks.