Surgery, American University of Beirut, Beirut, Lebanon.
Department of Mechanical Engineering, Imperial College London, London, United Kingdom of Great Britain and Northern Ireland.
J Med Eng Technol. 2020 Jul;44(5):247-254. doi: 10.1080/03091902.2020.1772391. Epub 2020 Jun 23.
During traditional surgery, the surgeons' hands are in direct contact with organs, and surgeons rely on the sense of touch to perform surgery. In teleoperated robotic systems, all physical connections between the surgeon and both the robot and patient, are absent. The surgeon must estimate the force exerted on organs, based only on visual deformation of tissues he is pulling, pushing, gripping, or suturing. It is hard to imagine how to operate with no haptic sensations, and it is surprising that commercially available robots didn't include until now any Haptic Feedback, despite reports about tissue injury, and inability to perform complex manipulation. The sense of touch must be created by stimuli sensed by the surgeon. Haptic sensors are required to collect and send haptic information, and display them on the operator's side, creating telepresence, known as transparency. Multiple ways have been developed to improve transparency through force feedback and tactile feedback. However, this interferes with the stability of the closed-loop controlling interactions between master, robot and remote environment. Cutaneous feedback is more stable and less transparent; force feedback is more transparent and less stable. Thus, multimodal platforms of haptic feedback would try to find the best trade-off between both modalities.
在传统手术中，外科医生的手直接接触器官，并且依靠触觉进行手术。在远程操作机器人系统中，外科医生与机器人和患者之间的所有物理连接都不存在。外科医生必须仅根据他正在拉动、推动、夹持或缝合的组织的视觉变形来估计施加在器官上的力。很难想象在没有触觉的情况下如何进行操作，令人惊讶的是，尽管有关于组织损伤和无法进行复杂操作的报道，但直到现在，商业上可用的机器人都没有包括任何触觉反馈。触觉必须通过外科医生感知的刺激来产生。触觉传感器用于收集和发送触觉信息，并在操作员一侧显示，从而产生远程呈现，即透明度。已经开发出多种方法来通过力反馈和触觉反馈来提高透明度。然而，这会干扰主手、机器人和远程环境之间的闭环控制交互的稳定性。皮肤反馈更稳定但透明度更低；力反馈更透明但稳定性更低。因此，触觉反馈的多模态平台将试图在两种模式之间找到最佳折衷。
