IEEE Robotics & Automation Magazine - June 2017 - 61
silicone rubber balls simulating tumors [20]. The simulated
tumors are 6 mm in diameter and 4 mm deep. In Figure 10(c)
and (g), the ultrasound image clearly shows the embedded
tumor as a speckled white ball. In Figure 10(d) and (h), the
tumor shows up as a green-red spot on the tactile pressure
map. The tests verified that the active sensor can be switched
in under 3 s by rolling the end effector on the spot.
Next, the instrument was tested on an ex vivo porcine liver
sample with an embedded 10-mm simulated agar tumor at a
depth of 5 mm, as described in [13]. In Figure 10(e) and (i),
the tumor shows up as a dark spot on the ultrasound image
that has been highlighted with a red ellipse. Here, it can be
seen that it is not very easy to identify a tumor in real tissue
using ultrasound alone. This is where the benefit of including
a tactile sensor can clearly be seen. In Figure 10(f) and (j), the
tactile map clearly shows that the suspected area has a stiff
lump, confirming the presence of a tumor. The data collected
from the external force sensor showed that a force of about
5-6 N was sufficient to consistently locate the tumor in both
tactile and ultrasound modes. At the conclusion of the tests,
there was no visible damage to the tissue sample.
Conclusions and Future Work
Tactile sensors have the potential to overcome a major drawback of RAMIS and to allow the use of RAMIS in more cases.
The novel palpation instrument presented in this article is
compatible with the da Vinci robot and combines tactile sensing and ultrasound imaging in a single instrument with three
internal DoF. It is hypothesized that fusing data from these
two sensing modalities can significantly improve tumor localization accuracy [7]. A prototype that very closely resembles
the designed instrument was constructed to test and demonstrate its functionality.
The control system was verified by observing the proper
operation of the prototype. The prototype was used to demonstrate that the design allows for easy replacement of the tactile
sensor and for movement through the desired range of motion.
A visualization setup was developed to provide tactile and
ultrasound feedback through the da Vinci master console, and
this has proven to work well in the tests. Preliminary tests with
silicone phantoms and ex vivo tissue samples show promising
results. Further testing is required to establish a quantitative
measure of the improvement in tumor localization provided by
this instrument. This instrument is the first of its kind, and the
positive results obtained so far encourage further work.
In the future, the instrument will be evaluated in various
ex vivo and in situ tests to determine the size, depth, and stiffness of tumors that can be reliably detected. Better techniques
to reliably seal the sensors and electrical contacts from body
fluids will be developed and tested. The end effector and wrist
would most likely be enclosed in a thin, disposable rubber
sleeve during use. The effects of these sealing techniques on
sensor performance will be investigated as well. Furthermore,
the effectiveness of the chemical sterilization techniques will
be assessed, while also ensuring that they do not damage the
ultrasound transducer or the instrument.
Endoscope
Master
Console
Robot
Arms
Palpation
Instrument
Sample
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(i)
(h)
(j)
Figure 10. The preliminary palpation performance testing of the
instrument. The setup: (a) the master console and (b) the da
Vinci Classic robot with the instrument mounted. The results of
the palpation experiment as seen through the da Vinci master
console: (c) and (d) using a clear silicone phantom with 6-mm
simulated silicone tumors at a 4-mm depth; (e) and (f ) using a
porcine liver sample with a 10-mm simulated agar tumor at a
5-mm depth; (c) and (e) ultrasound mode (with different depth
settings); (d ) and (f ) tactile mode; (g)-( j) closeup views of the
ultrasound [(g) and (i)] and tactile [(h) and ( j)] images.
A 6-DoF fiber-optic force/torque sensor is also under
development for the instrument. This sensor would be located between the wrist and the end effector to circumvent the
drive cable tension, thereby allowing it to measure the palpation forces with the greatest degree of accuracy. Once this sensor is implemented, physical force reflection can be provided
to the surgeon via the da Vinci master console to improve the
safety and repeatability of the palpation procedure. It will also
June 2017
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