Royal Society/Wolfson Foundation Medical Image Computing Laboratory, Imperial College London, London, United Kingdom.
Med Image Anal. 2012 Apr;16(3):612-31. doi: 10.1016/j.media.2010.07.007. Epub 2010 Aug 1.
The success of MIS is coupled with an increasing demand on surgeons' manual dexterity and visuomotor coordination due to the complexity of instrument manipulations. The use of master-slave surgical robots has avoided many of the drawbacks of MIS, but at the same time, has increased the physical separation between the surgeon and the patient. Tissue deformation combined with restricted workspace and visibility of an already cluttered environment can raise critical issues related to surgical precision and safety. Reconnecting the essential visuomotor sensory feedback is important for the safe practice of robot-assisted MIS procedures. This paper introduces a novel gaze-contingent framework for real-time haptic feedback and virtual fixtures by transforming visual sensory information into physical constraints that can interact with the motor sensory channel. We demonstrate how motor tracking of deforming tissue can be made more effective and accurate through the concept of Gaze-Contingent Motor Channelling. The method is also extended to 3D by introducing the concept of Gaze-Contingent Haptic Constraints where eye gaze is used to dynamically prescribe and update safety boundaries during robot-assisted MIS without prior knowledge of the soft-tissue morphology. Initial validation results on both simulated and robot assisted phantom procedures demonstrate the potential clinical value of the technique. In order to assess the associated cognitive demand of the proposed concepts, functional Near-Infrared Spectroscopy is used and preliminary results are discussed.
微创手术的成功要求外科医生具备更高的手眼协调能力，因为手术器械的操作非常复杂。主从式手术机器人的应用虽然避免了微创手术的许多缺点，但同时也增加了外科医生和患者之间的身体距离。组织变形、有限的工作空间以及已经混乱的环境视野都会对手术精度和安全性产生重大影响。重新建立必要的视动感觉反馈对于安全实施机器人辅助微创手术至关重要。本文提出了一种新的基于注视的实时触觉反馈和虚拟固定框架，通过将视觉感觉信息转化为与运动感觉通道相互作用的物理约束，实现了这一目标。我们通过注视相关运动导向的概念展示了如何通过跟踪变形组织来提高运动跟踪的有效性和准确性。该方法还通过引入注视相关触觉约束的概念扩展到了 3D 领域，该概念使用眼睛注视在机器人辅助微创手术期间动态规定和更新安全边界，而无需事先了解软组织形态。在模拟和机器人辅助的体模手术上的初步验证结果证明了该技术的潜在临床价值。为了评估所提出概念的相关认知需求，使用了功能性近红外光谱技术，并讨论了初步结果。
