Autonomous Field-of-View Adjustment Using Adaptive Kinematic Constrained Control with Robot-Held Microscopic Camera Feedback

Robotic systems for manipulation in millimeter scale often use a camera with high magnification for visual feedback of the target region. However, the limited field-of-view (FoV) of the microscopic camera necessitates camera motion to capture a broader workspace environment. In this work, we propose an autonomous robotic control method to constrain a robot-held camera within a designated FoV. Furthermore, we model the camera extrinsics as part of the kinematic model and use camera measurements coupled with a U-Net based tool tracking to adapt the complete robotic model during task execution. As a proof-of-concept demonstration, the proposed framework was evaluated in a bi-manual setup, where the microscopic camera was controlled to view a tool moving in a pre-defined trajectory. The proposed method allowed the camera to stay 99.5% of the time within the real FoV, compared to 48.1% without the proposed adaptive control.

Why is the winner the best?

International benchmarking competitions have become fundamental for the comparative performance assessment of image analysis methods. However, little attention has been given to investigating what can be learnt from these competitions. Do they really generate scientific progress? What are common and successful participation strategies? What makes a solution superior to a competing method? To address this gap in the literature, we performed a multi-center study with all 80 competitions that were conducted in the scope of IEEE ISBI 2021 and MICCAI 2021. Statistical analyses performed based on comprehensive descriptions of the submitted algorithms linked to their rank as well as the underlying participation strategies revealed common characteristics of winning solutions. These typically include the use of multi-task learning (63%) and/or multi-stage pipelines (61%), and a focus on augmentation (100%), image preprocessing (97%), data curation (79%), and postprocessing (66%). The "typical" lead of a winning team is a computer scientist with a doctoral degree, five years of experience in biomedical image analysis, and four years of experience in deep learning. Two core general development strategies stood out for highly-ranked teams: the reflection of the metrics in the method design and the focus on analyzing and handling failure cases. According to the organizers, 43% of the winning algorithms exceeded the state of the art but only 11% completely solved the respective domain problem. The insights of our study could help researchers (1) improve algorithm development strategies when approaching new problems, and (2) focus on open research questions revealed by this work.

Autonomous Robotic Drilling System for Mice Cranial Window Creation: An Evaluation with an Egg Model

Robotic assistance for experimental manipulation in the life sciences is expected to enable precise manipulation of valuable samples, regardless of the skill of the scientist. Experimental specimens in the life sciences are subject to individual variability and deformation, and therefore require autonomous robotic control. As an example, we are studying the installation of a cranial window in a mouse. This operation requires the removal of the skull, which is approximately 300 um thick, to cut it into a circular shape 8 mm in diameter, but the shape of the mouse skull varies depending on the strain of mouse, sex and week of age. The thickness of the skull is not uniform, with some areas being thin and others thicker. It is also difficult to ensure that the skulls of the mice are kept in the same position for each operation. It is not realistically possible to measure all these features and pre-program a robotic trajectory for individual mice. The paper therefore proposes an autonomous robotic drilling method. The proposed method consists of drilling trajectory planning and image-based task completion level recognition. The trajectory planning adjusts the z-position of the drill according to the task completion level at each discrete point, and forms the 3D drilling path via constrained cubic spline interpolation while avoiding overshoot. The task completion level recognition uses a DSSD-inspired deep learning model to estimate the task completion level of each discrete point. Since an egg has similar characteristics to a mouse skull in terms of shape, thickness and mechanical properties, removing the egg shell without damaging the membrane underneath was chosen as the simulation task. The proposed method was evaluated using a 6-DOF robotic arm holding a drill and achieved a success rate of 80% out of 20 trials.

Vitreoretinal Surgical Robotic System with Autonomous Orbital Manipulation using Vector-Field Inequalities

Vitreoretinal surgery pertains to the treatment of delicate tissues on the fundus of the eye using thin instruments. Surgeons frequently rotate the eye during surgery, which is called orbital manipulation, to observe regions around the fundus without moving the patient. In this paper, we propose the autonomous orbital manipulation of the eye in robot-assisted vitreoretinal surgery with our tele-operated surgical system. In a simulation study, we preliminarily investigated the increase in the manipulability of our system using orbital manipulation. Furthermore, we demonstrated the feasibility of our method in experiments with a physical robot and a realistic eye model, showing an increase in the view-able area of the fundus when compared to a conventional technique. Source code and minimal example available at https://github.com/mmmarinho/icra2023_orbitalmanipulation.

PEg TRAnsfer Workflow recognition challenge report: Does multi-modal data improve recognition?

This paper presents the design and results of the "PEg TRAnsfert Workflow recognition" (PETRAW) challenge whose objective was to develop surgical workflow recognition methods based on one or several modalities, among video, kinematic, and segmentation data, in order to study their added value. The PETRAW challenge provided a data set of 150 peg transfer sequences performed on a virtual simulator. This data set was composed of videos, kinematics, semantic segmentation, and workflow annotations which described the sequences at three different granularity levels: phase, step, and activity. Five tasks were proposed to the participants: three of them were related to the recognition of all granularities with one of the available modalities, while the others addressed the recognition with a combination of modalities. Average application-dependent balanced accuracy (AD-Accuracy) was used as evaluation metric to take unbalanced classes into account and because it is more clinically relevant than a frame-by-frame score. Seven teams participated in at least one task and four of them in all tasks. Best results are obtained with the use of the video and the kinematics data with an AD-Accuracy between 93% and 90% for the four teams who participated in all tasks. The improvement between video/kinematic-based methods and the uni-modality ones was significant for all of the teams. However, the difference in testing execution time between the video/kinematic-based and the kinematic-based methods has to be taken into consideration. Is it relevant to spend 20 to 200 times more computing time for less than 3% of improvement? The PETRAW data set is publicly available at www.synapse.org/PETRAW to encourage further research in surgical workflow recognition.

Autonomous Coordinated Control of the Light Guide for Positioning in Vitreoretinal Surgery

Vitreoretinal surgery is challenging even for expert surgeons owing to the delicate target tissues and the diminutive 7-mm-diameter workspace in the retina. In addition to improved dexterity and accuracy, robot assistance allows for (partial) task automation. In this work, we propose a strategy to automate the motion of the light guide with respect to the surgical instrument. This automation allows the instrument's shadow to always be inside the microscopic view, which is an important cue for the accurate positioning of the instrument in the retina. We show simulations and experiments demonstrating that the proposed strategy is effective in a 700-point grid in the retina of a surgical phantom.

MIcro-Surgical Anastomose Workflow recognition challenge report

The "MIcro-Surgical Anastomose Workflow recognition on training sessions" (MISAW) challenge provided a data set of 27 sequences of micro-surgical anastomosis on artificial blood vessels. This data set was composed of videos, kinematics, and workflow annotations described at three different granularity levels: phase, step, and activity. The participants were given the option to use kinematic data and videos to develop workflow recognition models. Four tasks were proposed to the participants: three of them were related to the recognition of surgical workflow at three different granularity levels, while the last one addressed the recognition of all granularity levels in the same model. One ranking was made for each task. We used the average application-dependent balanced accuracy (AD-Accuracy) as the evaluation metric. This takes unbalanced classes into account and it is more clinically relevant than a frame-by-frame score. Six teams, including a non-competing team, participated in at least one task. All models employed deep learning models, such as CNN or RNN. The best models achieved more than 95% AD-Accuracy for phase recognition, 80% for step recognition, 60% for activity recognition, and 75% for all granularity levels. For high levels of granularity (i.e., phases and steps), the best models had a recognition rate that may be sufficient for applications such as prediction of remaining surgical time or resource management. However, for activities, the recognition rate was still low for applications that can be employed clinically. The MISAW data set is publicly available to encourage further research in surgical workflow recognition. It can be found at www.synapse.org/MISAW

MBAPose: Mask and Bounding-Box Aware Pose Estimation of Surgical Instruments with Photorealistic Domain Randomization

Surgical robots are controlled using a priori models based on robots' geometric parameters, which are calibrated before the surgical procedure. One of the challenges in using robots in real surgical settings is that parameters change over time, consequently deteriorating control accuracy. In this context, our group has been investigating online calibration strategies without added sensors. In one step toward that goal, we have developed an algorithm to estimate the pose of the instruments' shafts in endoscopic images. In this study, we build upon that earlier work and propose a new framework to more precisely estimate the pose of a rigid surgical instrument. Our strategy is based on a novel pose estimation model called MBAPose and the use of synthetic training data. Our experiments demonstrated an improvement of 21 % for translation error and 26 % for orientation error on synthetic test data with respect to our previous work. Results with real test data provide a baseline for further research.

SmartArm: Suturing Feasibility of a Surgical Robotic System on a Neonatal Chest Model

Commercially available surgical-robot technology currently addresses many surgical scenarios for adult patients. This same technology cannot be used to the benefit of neonate patients given the considerably smaller workspace. Medically relevant procedures regarding neonate patients include minimally invasive surgery to repair congenital esophagus disorders, which entail the suturing of the fragile esophagus within the narrow neonate cavity. In this work, we explore the use of the SmartArm robotic system in a feasibility study using a neonate chest and esophagus model. We show that a medically inexperienced operator can perform two-throw knots inside the neonate chest model using the robotic system.

Single-Shot Pose Estimation of Surgical Robot Instruments' Shafts from Monocular Endoscopic Images

Surgical robots are used to perform minimally invasive surgery and alleviate much of the burden imposed on surgeons. Our group has developed a surgical robot to aid in the removal of tumors at the base of the skull via access through the nostrils. To avoid injuring the patients, a collision-avoidance algorithm that depends on having an accurate model for the poses of the instruments' shafts is used. Given that the model's parameters can change over time owing to interactions between instruments and other disturbances, the online estimation of the poses of the instrument's shaft is essential. In this work, we propose a new method to estimate the pose of the surgical instruments' shafts using a monocular endoscope. Our method is based on the use of an automatically annotated training dataset and an improved pose-estimation deep-learning architecture. In preliminary experiments, we show that our method can surpass state of the art vision-based marker-less pose estimation techniques (providing an error decrease of 55% in position estimation, 64% in pitch, and 69% in yaw) by using artificial images.