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. 2021 Jun:2021:10.1109/icra48506.2021.9562040.
doi: 10.1109/icra48506.2021.9562040. Epub 2021 Oct 18.

An Integrated High-dexterity Cooperative Robotic Assistant for Intraocular Micromanipulation

Makoto Jinno  1 , Gang Li  2 , Niravkumar Patel  2 , Iulian Iordachita  2
Affiliations

An Integrated High-dexterity Cooperative Robotic Assistant for Intraocular Micromanipulation

Makoto Jinno et al. IEEE Int Conf Robot Autom. 2021 Jun.

Abstract

Retinal surgeons are required to manipulate multiple surgical instruments in a confined intraocular space, while the instruments are constrained at the small incisions made on the sclera. Furthermore, physiological hand tremor can affect the precision of the instrument motion. The Steady-Hand Eye Robot (SHER), developed in our previous study, enables tremor-free tool manipulation by employing a cooperative control scheme whereby the surgeon and robot can co-manipulate the surgical instruments. Although SHER enables precise and tremor-free manipulation of surgical tools, its straight and rigid structure imposes certain limitations, as it can only approach a target on the retina from one direction. As a result, the instrument could potentially collide with the eye lens when attempting to access the anterior portion of the retina. In addition, it can be difficult to approach a target on the retina from a suitable direction when accessing its anterior portion for procedures such as vein cannulation or membrane peeling. Snake-like robots offer greater dexterity and allow access to a target on the retina from suitable directions, depending on the clinical task at hand. In this study, we present an integrated, high-dexterity, cooperative robotic assistant for intraocular micromanipulation. This robotic assistant comprises an improved integrated robotic intraocular snake (I2RIS) with a user interface (a tactile switch or joystick unit) for the manipulation of the snake-like distal end and the SHER, with a detachable end-effector to which the I2RIS can be attached. The integrated system was evaluated through a set of experiments wherein subjects were requested to touch or insert into randomly-assigned targets. The results indicate that the high-dexterity robotic assistant can touch or insert the tip into the same target from multiple directions, with no significant increase in task completion time for either user interface.

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Figures

Figure 1.
Figure 1.
System overview of the integrated robotic assistant consisting of the new I2RIS with the user interface and SHER: (a) overview; (b) holding the I2RIS with the user interface visible; (c) dexterous distal unit. As a surgeon manipulates a tool position by holding the I2RIS, the dexterous distal tip can approach a target from various directions using the I2RIS user interface.
Figure 2.
Figure 2.
Conceptual design of the dexterous distal unit of the IRIS: The unit is composed of 12 disk-like elements, providing 2-DOF bending joints actuated by four wires: (a) overview; (b) three-view drawing of an element (dimensions in mm) [19].
Figure 3.
Figure 3.
Control scheme of the integrated system of the SHER and I2RIS with user interface.
Figure 4.
Figure 4.
Conceptual design of the detachable I2RIS: (a) mechnical interface of the SHER for the attachment of the I2RIS and various types of surgical tools prior to attachment; (b) I2RIS integrated with the SHER following attachment.
Figure 5.
Figure 5.
User interface design of the I2RIS: (a) installation of the user interface to the I2RIS and its coordinate system; (b) tactile switch unit; (c) joystick unit; motor velocity control methods of (d) the tactile switch; and (e) the joystick.
Figure 6.
Figure 6.
Overview and detailed dimensions of the eye model for the pointing tasks: (a) overview; (b) detailed dimensions of the eye model in the top and front view, and the point number. Dimensions are in mm.
Figure 7.
Figure 7.
The task was to point to the number eight from varying directions using the bending function after passing through the sclerotomy point: (a) x-z plane view; (b) x-y plane view.
Figure 8.
Figure 8.
Pointing task time: (a) total time of the pointing task; (b) average time of each pointing task.
Figure 9.
Figure 9.
SHER tip position trajectory and orientation of the pointing task: (a) x-y plane; (b) x-z plane; (c) y-z plane; (d) box plot of displacement distribution; (e) orientation; (f) box plot of orientation distribution; (g) definition of the SHER tip position. The motion areas of the tactile switch and joystick were smaller than the straight I2RIS.
Figure 10.
Figure 10.
Box plot of the pointing task experiments; the task times were four random points and the home position pointing time, with data from ten trials.
Figure 11.
Figure 11.
Overview and detailed dimensions of the eye model for the insertion tasks: (a) overview; (b) detailed dimensions of the eye model from top and front views and the point number. (Dimensions are in mm).
Figure 12.
Figure 12.
Box plot of the insertion task experiments by Subject 1; the task times were four random point insertion times. Data from 10 trials.
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References

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