2015. 6. 22.

Dong-Soo Kwon*

UnJe Yang, HyunYoung Lee, MinHo Hwang, DeokKyun Chung, DeokYu Gong, DongHo Lee

*Professor, Mechanical Engineering, KAIST

Director, Human-Robot Interaction Research Center

Director, Center for Future Medical Robotics

A Novel Surgical Pen-Type Master Device using Vibrotactile Feedback

JUNE 22-26, 2015NORTHWESTERN UNIVERSITY, EVANSTON IL

Korea Advanced Institute of Science and TechnologyKAIST, Daejeon, Republic of Korea

Established February 16, 1971

Type National

President Sung Mo Kang

Academic staff 1,140

Admin. Staff 322

Students 10,249

Undergraduates 4,047

Postgraduates 6,202

Doctoral students 2,311

Other students 1,187 co-terminal MS/PhD

Campus1,432,882 m2 (Daejeon)

413,346 m2 (Seoul)2

Telerobotics & Control LaboratoryMechanical Engineering, KAIST, 1995~

Professor Dong-Soo Kwon

Current Member

Research Professor

2

Alumni

Researchers 7ResearchAssociate

1

Ph. D. Students 14

Ph. D 22M.S. Students 9

Admin. Assistant 1M.S. 45

Human-Robot Interaction Haptics Medical Robotics

3

Interest of Cutaneous Feedback

Oak Ridge National Lab. Research Staff,1991~1995

4/84

• Robotic surgery minimize the invasiveness and provide the convenience with intelligence

< Conventional Surg. Instrument > < Modern Surg. Instrument > < Robotic Surg. Instrument >

InvasivenessInvasiveness

ConvenienceConvenience

Advancement of the Surgical Tools

Invasiveness & Convenience

5

Open Surgery Minimally Invasive Surgery

Non Invasive Surgery

Invasiveness

Advanced ToolAutomatic

Surgical ToolIntelligent

Surgical Tool

Intelligence

For Patients :

For Doctors :

Less pain, fast recovery

Convenient, no mistake

6

※ Investor Presentation Q3 2013, Intuitive Surgical

Medical Robot shows Rapid Progress in the GlobalMarket

7

Many Laparoscopy Robots are Being Developed toCompete with da Vinci System

Raven (Washington Univ., USA) ALF-X (Sofar S.p.A, Italy)

MiroSurge (DLR, Germany) Amadeus (Titan, Canada)da Vinci (Intuitive Surgical, USA)

Robin Heart (TUL, Poland) 8

Robin HeartTechnical University of Lodz, Poland

prof. Leszek PodsedkowskiegodaVinci-like slave console

Unique master console

ALF-XAdvanced Laparoscopy through Force-RefleCT(X)ion Sofar S.p.A, ItalyCart motion for positioningOnly 1 arm/cartCollision avoidableWide space necessary

Current Surgical Robot Systems

9

MiroSurgeDLR, GermanyMIRO: 7-DoF robot armNo RCM mechanismMICA: 2-DOF surgical instrument with force-torque sensing capabilities3kHz position control

AmadeusTitan Medical Inc., CanadaKUKA’s 7-DoF robot armFDA submission in late 2014Similar to da VinciRoute change to SPL (SPORT)

SPORT (Single Port Orifice Robotic Technology)

Current Surgical Robot Systems

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da Vinci(Intuitive Surgical)

NeuroArm(University of Calgary)

SPRINT(University of Nebraska

Medical Center)

• Master & Slave with same joint structure

• Joint by joint Mapping

• Neuro-Surgery System• 6-Dof Slave & Master• Position / Orientation

decoupled

• 6-Dof Slave & 7-DofMaster

• Position / Orientation decoupled

• Actuator joints

• 6-Dof Slave & Master• Position / Orientation

decoupled• Master base is

attached upon user

Robin heart shell(Poland)

Current Surgical Robot Systems master

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• 6-DoF input device• Position / Orientation joints are decoupled → Dexterous workspace ↑• Actuator joints : Gravity compensation (o) / Force Feedback (x)• Small link length → Small workspace → Clutch motion↑ → Stress ↑ ↑*• In case of using MIS environment, low intuitiveness

Geo-magic Touch (Senseable)

Phantom Premium (Senseable)

Omega. 7(Force Dimension)

Omega. 6(Force Dimension)

* Rassweiler, Jens, et al. "The role of laparoscopic radical prostatectomy in the era of robotic surgery." European Urology Supplements 9.3 (2010): 379-387.* Wauben, L. S. G. L., et al. "Application of ergonomic guidelines during minimally invasive surgery: a questionnaire survey of 284 surgeons." Surgical Endoscopy And Other Interventional Techniques 20.8 (2006): 1268-1274.

Current commercialized general purpose master device for surgical robot

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Conceptual Design of Our Surgical Robot System

Master System

Slave System

Base Platform

Positioning Arm

Active Robot Arm

Surgical Tool

[Base Platform]

[Active Robot Arm]

[Elbowed Surgical

Tool]

[PositioningArm]

[Master System]

[Operating Table]

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Open Surgery Laparoscopic Surgery(MIS) Single Port Surgery

Recovery Time 4~6 Weeks 1 Week Less than 1 WeekAesthetic Big scar Small scar Small or no scar

Pain Big Small Small

Open SurgeryLarge Incision

Laparoscopic surgery3~4 of small incisions

SPL(Single Port Laparoscopy)Single incision

Lapse of TimePast Present

: Single Port SurgerySPS is Becoming Popular as a New Domain

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• H-shaped integrated console base• Fixing position through brake, • Decreasing cost

• Elbow-equipped instrument• Minimizing of the movement of external robot arm • Providing Smooth surgical environment to operators

• Direct-driven robot arm• Avoiding collision• Increasing usability and accessibility• Decreasing cost

• Intuitive master system• Allowing natural control of slave system• Decreasing inertia and friction

We are Proposing a SPS Robot System

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Our SPS Robot System has 6 D.O.F surgical tool

Pitch

Roll

RCM (Trocar point)

Active arm (Robot arm)Total 2-DoF

Elbow : 1 DOF

Inner rotation : 1 DOFWrist : 2 DOF

Outer rotation : 1 DOF

Translation : 1 DOF

Surgical toolElbow type : 6-DoF

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We researches two types of master for SPS Robot System

Pen-type master6 D.O.F Link-type masterfor our SPS robot system 17

Less inertiaLarge workspace

Base : 2 DOF

Translation: 1 DOF

Rotation: 1 DOF

Wrist : 2 DOF

4 DOF (without grip)

Elbow : 1 DOF

Inner rotation : 1 DOF

Wrist : 2 DOF

Outer rotation : 1 DOF

Translation : 1 DOF

6 DOF (without grip)

Base : 2 DOF (Active arm)

[ Slave system ] [Link-type master device ]

Proposed Link-type master has 6 D.O.F

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Proposed Link-type master performed peg-transfer experiment

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Pen is the most friendly tool in human-life

• Light weight• Intuitive(easy to learn)• Low cost• Easy to set up• Use Vibrotactile

feedback to mimicking kinesthetic feedback

• Light weight• Friendly

(Short training time)• Kinesthetic feedback

is available• High accuracy• Difficult to set up in the

operating room • bulky• High cost• Long training time

• Impossible kinesthetic feedback

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<IMU Sensor><Vision Tracking>

<Haptuator>

<Tablet>

We suggest a pen-type master for robotic surgery

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We are trying to adapt vision tracking technology on a pen-type master

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We performed a knot-tying simulation to prove vibrotactile feedback can improve the surgical task.

<Suture(Prolene 5-0)>

Breaking Suture is the most occurring problem in Robotic Minimally Invasive Surgery.

The value of haptic feedback in conventional and robot-assisted minimal invasive surgery and virtual reality training: a current review, Surgical Endoscopy, vol. 23, no. 6, pp. 1180-1190, 2009 23

To verify a feasibility of pen-type master, we designed a simulator for knot-tying simulation

< Knot-Tying Simulator >

Load Cell

MotorSuture Pulling

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0 1 2 3 4 5 6 70

1

2

3

4

5

6

7

8

9

Time (sec)

Sut

ure

tens

ion

(N)

Without Vibrotactile Feedback

0 1 2 3 4 5 6 70

1

2

3

4

5

6

7

8

9With Vibrotactile Feedback

Time (sec)

Sut

ure

tens

ion

(N)

<Without vibrotactile feedback><With vibrotactile feedback>

The result shows that using vibrotactilefeedback can improvesuturing task.

With Vibration

WithoutVibration

In 3s

Over3s

In3s

Over3s

Not enoughforce 4 2

Adequatepoint 11 1 4

Break 2

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We compared the user's mission success rates with and without vibration feedback

For using a vibrotactile feedback, we need to sensing a force from a surgical tool

Adequatepoint

Adequatepoint

Not enoughforce

start startBreak

Grasping ForceSensor

(for grasper tip)

3-AxialForce Sensor

30

For using a force feedback, we are going to adapt disposable force sensor on our SPS system

- 3 axial force sensor• 3 axial manipulation force

- Torque sensor• Single axial grasping force

For using a force feedback, we are going to adapt disposable force sensor on our SPS system

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Design of Simple Structured Tactile Sensor for the Minimally Invasive Robotic Palpation, IEEE/ASME International Conference on Advanced Intelligent Mechatronics (AIM), pp. 1296-1299, 2013 Enhanced Tactile Sensor for the Minimally Invasive Robotic Palpation, IEEE/ASME International Conference on Advanced Intelligent Mechatronics (AIM), pp. 1375-1380, 2014Simple Structured Tactile Sensor for Tissue Recognition in Minimal Invasion Surgery, International Conference on Control, Automation and Systems, 2012

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<Conceptual design of robotic palpation tool in MIS>

<Sensor plate with the semiconductor type strain-gages>

<Sensor assembly for touch style robotic palpation>

<Output voltage/Load mass curve from 3rd beam>

For using a force feedback, we are going to adapt disposable force sensor on our SPS system

Discussions•Reliability/ Safety•Cost•Patient benefit•Surgeon benefit•Cutaneous pattern

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Thank you

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Acknowledgement to

Hyundai Heavy Industry Co.The University of Texas, Health Science Center, HoustonProf. Hyouk Ryeol Choi, SungKyunKwan UniversityDr. Jung Hoon Hwang, Korea Electronics Technology Institute

Dong-Soo Kwon (kwonds@kaist.ac.kr)