Force Sensing in Robot-assisted Keyhole Endoscopy: A Systematic Survey

Instrument-tissue interaction forces in Minimally Invasive Surgery (MIS) provide valuable information that can be used to provide haptic perception, monitor tissue trauma, develop training guidelines, and evaluate the skill level of novice and expert surgeons.Force and tactile sensing is lost in many Robot-Assisted Surgery (RAS) systems. Therefore, many researchers have focused on recovering this information through sensing systems and estimation algorithms. This article provides a comprehensive systematic review of the current force sensing research aimed at RAS and, more generally, keyhole endoscopy, in which instruments enter the body through small incisions. Articles published between January 2011 and May 2020 are considered, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The literature search resulted in 110 papers on different force estimation algorithms and sensing technologies, sensor design specifications, and fabrication techniques.

Multi-Axis Force Sensing in Robotic Minimally Invasive Surgery With No Instrument Modification

This paper presents a novel multi-axis force-sensing approach in robotic minimally invasive surgery with no modification to the surgical instrument. Thus, it is adaptable to different surgical instruments. A novel 6-axis optical force sensor, with local signal conditioning and digital electronics, was mounted onto the proximal shaft of a da Vinci EndoWrist instrument. A new cannula design comprising an inner tube and an outer tube was proposed. The inner tube is attached to the cannula interface to the robot base through a compliant leaf spring with adjustable stiffness. It allows bending of the instrument shaft due to the tip forces. The outer tube mechanically filters out the body forces from affecting the instrument bending behavior. A mathematical model of the sensing principle was developed and used for model-based calibration. A data-driven calibration based on a shallow neural network architecture comprising a single 5-nodes hidden layer and a 5x1 output layer is discussed. Extensive testing was conducted to validate that the sensor can successfully measure the lateral forces and moments and the axial torque applied to the instruments distal end within the desired resolution, accuracy, and range requirements.