A Virtual Fixture Design for Teleoperated Vitreoretinal Surgery

Abstract

Epiretinal Membrane Peeling (EMP) is a common vitreoretinal surgery in clinic. Over the past twenty years, telerobotics has been developed to assist retinal surgeons. Robot-assisted surgery can aid the surgeon by motion scaling and filtering out natural hand tremor. However, the additive precision has yet to relieve the surgeon from the burdensome task entirely, and teleoperation comes with a downside of extending execution time.

One of the complicating factors in robot-assisted EMP surgery is the limited depth perception afforded by the binocular microscope, which increases the risk of inadvertent contact of the surgical tool with the retina. Recently, PRECEYES has introduced an intraoperative sensor that measures the distance to the surface of the retina to their surgical system. The master device is capable of force feedback, which can be employed to transmit distance information to the surgeon without extra burden to the already visually overwhelmed task.

This study aims to design and evaluate haptic assistance for teleoperated EMP based on noisy distance sensor. Sixteen subjects with non-medical background participated in the human factors experiment performing a simulated vitreoretinal surgery by using a 3-DoF haptic master device controlling a simulated slave robot. All subjects performed two experimental conditions (with and without haptic assistance) in a balanced order. The experimental result shows that, with haptic assistance, the overall puncture rate reduces from 9.6% to 2.8% and peeling forces are stabilized significantly. Which indicates that the proposed method utilizes distance information in a promising way, thus reducing the difficulty of the teleoperated task.