Telemanipulation in minimally invasive
surgery
Minimally
invasive surgery (MIS) challenges the surgeon’s skills due to his
separation from the operation area which can be reached by long
instruments only. To overcome the drawbacks of conventional MIS
telepresence and telemanipulation techniques play an important role: In
case of minimally invasive robotic surgery (MIRS) the instruments are not
directly manipulated anymore. Instead of this they are remotely commanded
by the surgeon who sits in front of a console while the instruments
themselves are moved by specialized robotic arms. The surgeon regains
direct virtual access to the operating field.
Our telesurgery scenario consists of a teleoperator and an operator
console. The teleoperator is made up of two Aesop robots (from Computer
Motion Inc.). One of the robots carries a surgical instrument which is
equipped with a miniaturized force/torque sensor (developed at the
Institute of Robotics and Mechatronics, see here), the other one carries
the laparoscope. Both the stereo video and the measured forces are
displayed at the operator console. So the user cannot only see but also
feel what he is doing. A PHANToM (from Sensabe Technologies Inc.) is used
as force display. This setup was used recently to perform an experimental
psychological evaluation in order to gain a deeper insight into the role
of force feedback for robot assisted interventions. If no haptic input
device is available the force information can also be displayed visually
(augmented reality).
The Aesop robots will be replaced in the near future by the surgical
robots developed at the institute (see here) carrying actuated and
sensorized instruments (see here). This way, full dexterity (6 DoF) is
achieved inside the patient and both manipulation and grasping forces can
be measured. Furthermore, the PHANToM will be equipped with a grasping
force master in order to display not only the manipulation forces but also
the gripping forces to the user.