Gruijthuijsen Caspar, Garcia-Peraza-Herrera Luis C, Borghesan Gianni, Reynaerts Dominiek, Deprest Jan, Ourselin Sebastien, Vercauteren Tom, Vander Poorten Emmanuel
Department of Mechanical Engineering, KU Leuven, Leuven, Belgium.
Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom.
Front Robot AI. 2022 Apr 11;9:832208. doi: 10.3389/frobt.2022.832208. eCollection 2022.
Many keyhole interventions rely on bi-manual handling of surgical instruments, forcing the main surgeon to rely on a second surgeon to act as a camera assistant. In addition to the burden of excessively involving surgical staff, this may lead to reduced image stability, increased task completion time and sometimes errors due to the monotony of the task. Robotic endoscope holders, controlled by a set of basic instructions, have been proposed as an alternative, but their unnatural handling may increase the cognitive load of the (solo) surgeon, which hinders their clinical acceptance. More seamless integration in the surgical workflow would be achieved if robotic endoscope holders collaborated with the operating surgeon semantically rich instructions that closely resemble instructions that would otherwise be issued to a human camera assistant, such as "focus on my right-hand instrument." As a proof of concept, this paper presents a novel system that paves the way towards a synergistic interaction between surgeons and robotic endoscope holders. The proposed platform allows the surgeon to perform a bimanual coordination and navigation task, while a robotic arm autonomously performs the endoscope positioning tasks. Within our system, we propose a novel tooltip localization method based on surgical tool segmentation and a novel visual servoing approach that ensures smooth and appropriate motion of the endoscope camera. We validate our vision pipeline and run a user study of this system. The clinical relevance of the study is ensured through the use of a laparoscopic exercise validated by the European Academy of Gynaecological Surgery which involves bi-manual coordination and navigation. Successful application of our proposed system provides a promising starting point towards broader clinical adoption of robotic endoscope holders.
许多微创手术依赖于外科手术器械的双手操作，这迫使主刀医生依赖另一位医生作为摄像助手。除了过度占用手术人员的负担外，这可能会导致图像稳定性降低、任务完成时间增加，有时还会因任务单调而出现错误。有人提出使用由一组基本指令控制的机器人内窥镜固定器作为替代方案，但它们不自然的操作可能会增加（单人）外科医生的认知负担，从而阻碍其临床应用。如果机器人内窥镜固定器能够与手术医生协作，以类似于原本会发给人类摄像助手的语义丰富的指令（例如“聚焦于我的右手器械”）进行操作，那么在手术工作流程中就能实现更无缝的集成。作为概念验证，本文提出了一种新颖的系统，为外科医生与机器人内窥镜固定器之间的协同交互铺平了道路。所提出的平台允许外科医生执行双手协调和导航任务，而机器人手臂则自主执行内窥镜定位任务。在我们的系统中，我们提出了一种基于手术工具分割的新颖工具提示定位方法和一种新颖的视觉伺服方法，以确保内窥镜摄像头的平稳且适当的运动。我们验证了我们的视觉管道并对该系统进行了用户研究。通过使用由欧洲妇科外科学院验证的涉及双手协调和导航的腹腔镜练习，确保了该研究的临床相关性。我们提出的系统的成功应用为机器人内窥镜固定器在更广泛的临床应用中提供了一个有希望的起点。
