The 10 mm incisions used in minimally invasive cancer surgery prevent the direct palpation of internal organs, making intraoperative tumor localization difficult. A tactile sensing instrument (TSI), which uses a commercially available sensor to measure distributed pressure profiles along the contacting surface, has been developed to facilitate remote tissue palpation. The objective of this research is to assess the feasibility of using the TSI under robotic control to reliably locate underlying tumors while reducing collateral tissue trauma. The performance of humans and a robot using the TSI to locate tumor phantoms embedded into ex vivo bovine livers is compared. An augmented hybrid impedance control scheme has been implemented on a Mitsubishi PA10-7C to perform the force/position control used in the trials. The results show that using the TSI under robotic control realizes an average 35% decrease in the maximum forces applied and a 50% increase in tumor detection accuracy when compared to manual manipulation of the same instrument. This demonstrates that the detection of tumors using tactile sensing is highly dependent on how consistently the forces on the tactile sensing area are applied, and that robotic assistance can be of great benefit when trying to localize tumors in minimally invasive surgery.
American Cancer Society (2007a). Cancer Facts and Figures 2007, No. 500807. Atlanta, GA , American Cancer Society Inc. http://www.cancer.org.
2.
American Cancer Society (2007b). Global Cancer Facts and Figures 2007, No. 861807. Atlanta, GA, American Cancer Society Inc. http://www.cancer.org.
3.
Beasley, R.A. and Howe, R.D. ( 2002). Tactile tracking of arteries in robotic surgery . Proceedings of the IEEE International Conference on Robotics and Automation, Vol. 4, Washington, DC, pp. 3801-3806.
4.
Berkelman, P.J. et al. (2003). A miniature microsurgical instrument tip force sensor for enhanced force feedback during robot-assisted manipulation. IEEE Transactions on Robotics and Automation, 19(5): 917-922.
5.
Bicchi, A. et al. (1996). A sensor-based minimally invasive surgery tool for detecting tissue elastic properties. Proceedings of the IEEE International Conference on Robotics and Automation, Vol. 1, Minneapolis, MN, pp. 884-888.
6.
Dargahi, J. ( 2004). An integrated force-position tactile sensor for improving diagnostic and therapeutic endoscopic surgery. Bio-Medical Materials and Engineering, 14(2): 151-166.
7.
Dargahi, J., Payandeh, S. and Parameswaran, M. ( 1999). A micromachined piezoelectric teeth-like laparoscopic tactile sensor: theory, fabrication and experiments. Proceedings of the IEEE International Conference on Robotics and Automation , Detroit, MI, pp. 299-304.
8.
Dario, P. and Bergamasco, M. ( 1988). An advanced robot system for automated diagnostic tasks through palpation. IEEE Transactions on Biomedical Engineering , 35(2): 118- 126.
9.
Davidson, M. ( 2002). The interpretation of diagnostic tests: a primer for physiotherapists. Australian Journal of Physiotherapy , 48: 227-232.
10.
De, S. et al. (2007). Assessment of tissue damage due to mechanical stress. The International Journal of Robotics Research, 26(11-12): 1159-1171.
11.
Dubois, P. ( 2002). In vivo measurement of surgical gestures. IEEE Transactions on Biomedical Engineering, 49(1): 49- 54.
12.
Eltaib, M.E.H. and Hewit, J.R. ( 2003). Tactile sensing technology for minimal access surgery - a review. Mechatronics, 13: 1163-1177.
13.
Fearing, R.S. ( 1990). Tactile sensing mechanisms. The International Journal of Robotics Research, 9(3): 3-23.
14.
Feller, R.L. et al. (2004). The effect of force feedback on remote palpation . Proceedings of the IEEE International Conference on Robotics and Automation, New Orleans, LA, pp. 782-788.
15.
Hannaford, B. et al. (1998). Computerized endoscopic surgical grasper. Proceedings of Medicine Meets Virtual Reality 6, San Diego, CA, pp. 111-117.
16.
Howe, R.D. et al. (1995). Remote palpation technology. Engineering in Medicine and Biology Magazine, 14(3): 318- 323.
17.
LeBlanc, J.K., DeWitt, J. and Sherman, S. ( 2007). Endoscopic ultrasound: how does it aid the surgeon ? Advances in Surgery, 41: 17-50.
18.
McCreery, G.L. et al. (2008). Feasibility of locating tumors in lung via kinesthetic feedback. International Journal of Medical Robotics and Computer Assisted Surgery, published online, DOI: 10.1002/rcs.169.
19.
Miller, A.P. et al. (2007). Tactile imaging system for localizing lung nodules during video assisted thoracoscopic surgery. Proceedings of the IEEE International Conference on Robotics and Automation , Rome, Italy, pp. 2996- 3001.
20.
Ottermo, M.V. et al. (2006). The role of tactile feedback in laparoscopic surgery. Surgical Laparoscopy Endoscopy and Percutaneous Techniques , 16(6): 390-400.
21.
Patel, R.V. and Shadpey, F. ( 2005). Control of redundant robot manipulators: theory and experiments . Lecture Notes in Control and Information Sciences, Vol. 315. Heidelberg, Springer.
22.
Patel, R.V. et al. (2008). A robust position and force control strategy for 7-DOF redundant manipulators. IEEE Transactions on Mechatronics , accepted.
23.
Peine, W.J., Son, J.S. and Howe, R.D. ( 1994). A palpation system for artery localization in laparoscopic surgery. Proceedings of the 1st International Symposium on Medical Robotics and Computer Assisted Surgery, Pittsburgh, PA.
24.
Perri, M.T. et al. (2008). A new tactile imaging device to aid with localizing lung tumours during thoracoscopic surgery. Proceedings of the International Conference on Computer Assisted Radiology and Surgery (CARS), 22nd International Congress Series, Barcelona, Spain.
25.
Rosen, J. and Hannaford, B. ( 2001). Markov modeling of minimally invasive surgery based on tool/tissue interaction and force/torque signatures for evaluating surgical skills. IEEE transactions on Biomedical Engineering , 48(5): 579-591.
26.
Rosen, J. et al. (1999). Force controlled and teleoperated endoscopic grasper for minimally invasive surgery - experimental performance evaluation . IEEE Transactions on Biomedical Engineering, 46(10): 1212-1221.
27.
Schostek, S. et al. (2006). Artificial tactile sensing in minimally invasive surgery - a new technical approach. Minimally Invasive Therapy and Allied Technologies, 15(5): 296-304.
28.
Seraji, H., Long, M.K. and Lee, T.S. ( 1993). Motion control of 7-DOF arms: the configuration control approach. IEEE Transactions on Robotics and Automation , 9(2): 125-139.
29.
Shimachi, S., Fujiwara, Y. and Hakozaki, Y. ( 2004). New sensing method of force acting on instrument for laparoscopic robot surgery. Proceedings of the International Conference on Computer Assisted Radiology and Surgery (CARS), International Congress Series Vol. 1268, Chicago, IL, pp. 775-780.
30.
Singh, H., Sedaghati, R. and Dargahi, J. ( 2003). Experimental and finite element analysis of an endoscopic tooth-like tactile sensor. Sensors, 1: 259-264.
31.
Singh, P. et al. (2007). EUS for detection of the hepatocellular carcinoma: results of a prospective study. Gastrointestinal Endoscopy , 66(2): 265-273.
32.
Takashima, K. et al. (2005). An endoscopic tactile sensor for low invasive surgery. Sensors and Actuators A, 119: 372- 383.
33.
Tavakoli, M., Patel, R.V. and Moallem, M. ( 2005). Haptic interaction in robot-assisted endoscopic surgery: a sensorized end-effector. International Journal of Medical Robotics and Computer Assisted Surgery, 1(2): 53-63.
34.
Tavakoli, M. et al. (2006a). Multi-sensory force/deformation cues for stiffness characterization in soft-tissue palpation. Proceedings of the IEEE International Conference of the Engineering in Medicine and Biology Society, New York, pp. 847-840.
35.
Tavakoli, M. et al. (2006b). Tool/tissue interaction feedback modalities in robot-assisted lump localization. Proceedings of the IEEE International Conference of the Engineering in Medicine and Biology Society, New York, pp. 3854- 3857.
36.
Tholey, G., Desai, J.P. and Castellanos, A.E. ( 2005). Force feedback plays a significant role in minimally invasive surgery: results and analysis. Annals of Surgery , 241(1): 102-109.
37.
Tholey, G. et al. (2004). Design, development, and testing of an automated laparoscopic grasper with 3-D force measurement capability. Proceedings of the International Conference on Noise and Vibration Engineering (ISMA 2004), Cotin, S. and Metaxas, M. (eds), Leuven, Belgium, pp. 38- 48.
38.
Trejos, A.L. et al. (2008). Experimental evaluation of robot-assisted tactile sensing for minimally invasive surgery. Proceedings of the 2nd IEEE RAS/EMBS International Conference on Biomedical Robotics and Biomechatronics (BioRob 2008), October 19-22, Scottsdale, AZ, pp. 971-976.
39.
Van Meer, F. et al. (2004). Si-micromachined 2D force sensor for a laparoscopic instrument. Proceedings of the International Conference on Computer Assisted Radiology and Surgery (CARS), International Congress Series, Vol. 1268, Chicago, IL, p. 1334.
40.
Wellman, P. and Howe, R.D. ( 1997). Modeling probe and tissue interaction for tumor feature extraction. Proceedings of the 1997 ASME Summer Bioengineering Conference, Sun River, OR.
41.
Wellman, P.S. and Howe, R.D. ( 1999). Extracting features from tactile maps. Proceedings of the 2nd International Conference on Medical Image Computing and Computer-Assisted Intervention, Cambridge, UK. Berlin, Springer, pp. 1133-1142.
