Safety Operation Consciousness Realization of a MR Fluids Novel … · 2016-02-04 · Takashi...

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This article has been accepted for publication in a future issue of this journal, but has not been fully edited. Content may change prior to final publication. Citation information: DOI 10.1109/TMECH.2015.2489219, IEEE/ASMETransactions on Mechatronics

Abstract: In catheter minimally invasive neuro surgery

(CMINS), catheter tip collision with the blood vessel detection

during the surgery practice is important. Moreover, successful

CMINS is depended on the discrimination of collision by skilled

surgeon in direct operation. However, in the context of

teleoperated scenario, the surgeon was physically separated.

Therefore, lacking of haptic sensation is a major challenge for

telesurgery scenario. A human operator-centered haptic

interface is adopted to address this problem. In this paper,

teleoperated robotic assisted surgery and psychophysics based

safety operation consciousness theory was presented. Morevoer,

a human operator-centered haptic interface design concept is

firstly introduced into actuator choice and design. A semi-active

haptic interface was designed and fabricated through taking full

advantage of MR fluids. Furthermore, a mechanical model

(force/ torque model) was established. In addition, in case of no

collision, transparency of teleoperated system was realized, in

case of collision, psychophysics based collision discrimination

control scheme was firstly presented to provide safety operation

consciousness. Experiments demonstrate the usability of the

designed haptic interface and correctness of the safety operation

consciousness control scheme.

Index Terms: Telesurgery, Catheter Minimally Invasive

Neuro Surgery (CMINS), Haptic interface,

Magneto-Rheological Fluids (MRFs), Transparency, Safety

operating consciousness

I. INTRODUCTION

There is a fast growing acceptance of minimally invasive surgery (MIS), in which special slender instruments are inserted through small skin incisions with the least possible damage to healthy organs and tissues. This kind of technology, a revolutionized the concept of surgery, has some advantages

X. Yin is with the Graduate School of Engineering, Kagawa University,

Hayashi-cho, Takamatsu, 761-0396, Japan. (e-mail: [email protected])

S. Guo is with Key Laboratory of Convergence Medical Engineering System and Healthcare Technology, Ministry of Industry and Information

Technology, Beijing Institute of Technology, Beijing 100081, China, and

also with the Intelligent Mechanical Systems Engineering Department, Kagawa University,Takamatsu 761-0396, Japan (e-mail:

[email protected])

N. Xiao is with Key Laboratory of Convergence Medical Engineering System and Healthcare Technology, Ministry of Industry and Information

Technology, Beijing Institute of Technology, Beijing 100081, China

(e-mail:[email protected]) Takashi Tamiya is with the Department of Neurological Surgery Faculty

of Medicine, Kagawa University, Takamatsu 761-0396, Japan (Email:

[email protected])

H. Hirata and H. Ishihara are with the Intelligent Mechanical Systems

Engineering Department, Kagawa University, Takamatsu 761-0396, Japan

(e-mail: [email protected]; [email protected]).

such as the reduction of surgical trauma, recovery time, postoperative pain, infections risks and costs as well as improvement in cosmetics, which plays an important role in modern medical technology [1]. However, some potential challenges also have been introduced in. These include the loss of touch feedback, 3 dimensional vision, poor dynamic of operation, and poor ergonomics of the tool. Some of these limitations in MIS have been solved by introducing robotic assisted manipulator. Recently, along with engineering and control technology development, teleoperated robot assisted MIS is also adopted to address the some problems like, preventing the surgeon from being X-ray radiation, and providing the comfortable operating environment to the surgeon as well as providing surgery assistant to remote rural areas medical center due to lacking experienced surgeon.

Some of teleoperated robot assisted MIS systems have been developed, which consist of human operator, master interface, communication and control channel, remote salve manipulator and patient. In these systems, there is a need information exchange between the human operator and the remote manipulator, which can be described as the form of either position (velocity) or force [2]. Ideal teleoperated scenario can be viewed as physically extension of the human body. The human-centered haptic interface should possess characteristics of reproducing interaction force between the remote environment and the end effector of slave robot assisted manipulator to provide haptic sensation, on the other hand, measuring the movement situation of the operator’s hand during the surgical process to command the slave manipulator.

In order to realize the ‘immersive’ operation scenario, the haptic interface used for a master console is introduced in teleoperated robot assisted MIS. It has a distinct characteristic from other display devices because it is bi-directional, i.e. capable of both reading and writing input to and from a human operator [3]. Haptic interface was introduced in various areas, such as entertainment [4], surgical training and education [5], aeronautics industry [6] and medical application [7]-[8]. In these applications, it is an excitement research area to utilize haptic technology in medical robotic assisted teleoperated surgery, which includes surgical simulators [9], haptic operation macro and micro robots for MIS as well as remote diagnosis for telemedicine.

Neurosurgery therapy is the usage of catheter to give physician direct access to the infected area via vascular system. Some achievements have been achieved in this area. For example, the current available commercial products- da Vinci surgical system [10] offers a great advantage in precision and dexterity to laparoscopic surgeons. However, it

Safety Operation Consciousness Realization of a MR Fluids-based

Novel Haptic Interface for teleoperated Catheter Minimally

Invasive Neuro Surgery

Xuanchun Yin, Shuxiang Guo, Senior Member, IEEE, Nan Xiao, Member, IEEE, Takashi Tamiya, Hideyuki Hirata and Hidenori Ishihara

mailto:[email protected]





is a major drawback that it makes the operator blurred to intuitive sensation because of lacking true tactile feedback during tissue manipulation. Compared with existed commercial products, some fundamental research has been carried out in universities. Such as: a catheter manipulation training system was presented by Fukuda, T. et al. [11], which is based on quantitative measurement of catheter insertion and rotation. A robot assisted cardiac catheter operating system for heart surgery was proposed by Kesner, S. B., and Howe, R. D. [12]. Based on literatures analysis and practice application, to ensure the surgery successfully in the context of telesurgery, it is significant important to measure the interaction force between the end-effector of the slave manipulator and the tissue and fed back to the master manipulator as well as displaying to the human operator.

The main challenges in the teleoperated robot assisted minimally invasive surgery are: interaction force measurement between the end effector of robotic slave manipulator and the environment, and lack of haptic sensation for providing to the human operator. In the area of robot assisted catheter minimally invasive surgery, interaction force measurement method has been proposed by our group, for example: Guo.et al. presented a sensor-based interaction force measurement system: a force-torque sensor mounted directly on the wrist of the robot can be used to measure proximal forces during catheter insertion [13]. A miniature force sensor was mounted on the catheter tip and distal force was transmitted to the operator through a haptic device-Phantom [14]. However, the force sensor attached on the end-effector was inserted in the patient, which may cause infections due to the sterilizability difficulty. In addition, due to the constraint on incision size in MIS, the diameter of the portion of the end-effector that enters into the body including all required sensors and or actuators should be keep in less than 10mm [1]. It is difficult to realize the requirements. Moreover, some of researcher located the sensors outside of the patient to measure the interaction force, which may pick up unwanted abdominal wall friction and the stiffness of trocar site in that causing the distortion of force measurement. Therefore, it is one of challenges to measure interaction force in slave system, which is not the scope of this paper. The estimated interaction force instead of the measured force was used in this paper to simplify analysis. Viewed from master system, it will deteriorate operating performance because of lacking of haptic perception. Therefore, haptic interface design with a characteristic of providing haptic perception to surgeon is another challenge.

In this paper, one of challenges in teleoperation scenario to improve surgery performance was addressed by introducing haptic interface design. In Section II, theory analysis of teleoperated robot assisted surgery is presented, including human operator-centered teleoperation, 2-Channel architecture of information exchange, stability and transparency as well as psychophysics based safety operation consciousness. In section III, human operator-centered haptic interface was designed and fabricated through exploiting MR fluids. Haptic interface mechanical model and control scheme of transparency and safety operation consciousness are presented in Section IV. Performance evaluation of the designed haptic interface was conducted in Section V. Finally, conclusions and discussion are presented in Section VI.

II. TELEOPERATED ROBOT ASSISTED SURGERY THEORY

ANALYSIS

Catheter interventional surgery is a minimally invasive surgical procedure which demands high accuracy of insertion velocity control and force control. As far as high accuracy as concerned, robotic system with autonomous control algorithms have been exploited as the main tool to achieve high accuracy and reliability [15]. It is not desirable, however, to introduce autonomous robotic control, for the safety and acceptance consideration by the surgical community and the patients. Thus, it is acceptable to introduce semi-autonomous control idea with haptic perception technologies enabling surgical practice with a kind directly control the motion of the remote slave manipulator sensation. In essence, it is still a human operator-centered medical operation technology to ensure the safety surgery not only viewed from traditional surgical but also the modern teleoperated robotic assisted surgery.

A. Human Operator-Centered Teleoperated Surgery

A human operator-centered haptic assisted teleoperated robot assisted surgery system is shown in Fig.1. In haptic based telesurgery, the surgeon determines the motion of a remote slave manipulator by moving a master robot (haptic interface) while sense the forces reflected from the remote and recreated by the haptic interface in the local site. Currently, Surgeons overwhelmingly rely on vision as their dominant source of feedback during surgery. However, time delay caused by vision image transmitted from the remote site is unavoidable [16] (time delay in the communication channel has not been considered in proposed system). Force-reflecting system provides a kind of kinesthetic supplement for currently vision based teleoperated medical application, which has advantages to avoid waiting due to time delay caused by image feedback as well as confusing by the blurred image.

Teleoperated robot assisted surgery system as shown in Fig.1 (a) consist of human operator, haptic interface, local controller, transmission channel, remote controller, slave manipulator, environment. xh is the position of the human operator, Fhaptic is the kinesthetic force recreated by the

haptic interface, which can be felt by the human operator. xs is the position of the slave manipulator, and fe is the interaction force between the end-effector of the slave manipulator and the tissue. System structure can be simplified as shown in Fig.1 (b). Fp(s)e

−t1 is the position information transmitted

function from the master system to the slave system, and FF(s)e

−t2 is the interaction force information was fed back from the slave site. t1 and t2 are the forward channel time delay and backward channel time delay respectively. From the simplified case of teleoperated robot assisted system, we know that human operator is always in control in teleoperated robot assisted system. Therefore, it is a human operator-centered teleoperation system, especially medical application.

B. 2-Channel Architecture of Information Exchange

In telesurgery system, the 2-channel architecture allows transmission position signal to the remote slave manipulator and reflecting force information signal to the haptic interface [2]. The primary control method is either position-position control (P-P) or position-force control (P-F). In the case of



position-position control architecture, it is suitable for rigid tool interaction because there are no force sensors measurements. The controller tires to minimize the position difference between the haptic interface and the end-effector of slave manipulator. The reflecting force to the surgeon through the haptic interface is proportional to the difference. Therefore, position-position control has a good position tracking and a poor performance of force tracking. However, this control idea is not suitable for teleoperated catheter MIS. Because the catheter and catheter tip has a big flexibility characteristics. In another case of position-force control architecture, a force sensor is attached on the end-effector of remote slave manipulator to measure the interaction force between the end-effector and the tissue while the remote slave manipulator tracks the position of the human operator command. Thus, the position-force control achieves good position tracking between the haptic interface and the slave manipulator while keeps perfect force reflecting performance.

(a) General case

(b) Simplified case

Fig.1. Teleoperated robot assisted surgery system [16] (a) general case, (b) simplified case.

C. Stability and Transparency

The basic goal of a haptic system is to achieve transparency while keeping the system stable [17] [18].Stability and transparency of a haptic system has close relationship to each other. Representing the effective

relationship between force and velocity with voltage and current, a 2-channel architecture of a teleoperation system can be represented as 2-port network model [19]( shown in Fig.2). Where the components of teleoperated robotic system are represented by two ports, the human operator and the patient environment expressed by a single port respectively is distributed at both ends.

Fig.2. 2-port model [19]

Relations among these components can be expressed by a hybrid matrix [19], the hybrid matrix is defined in:

[𝐹ℎ𝑎𝑝𝑡𝑖𝑐

−𝑣𝑠] = 𝐻 [

𝑥ℎ

𝑓𝑒] = [

ℎ11 ℎ12

ℎ21 ℎ22] [

𝑥ℎ

𝑓𝑒] (1)

where 𝑓ℎ𝑎𝑝𝑡𝑖𝑐 , denote the felt force by the human operator,

which is displayed by the haptic interface, and 𝑣ℎ is the velocity output of the human-haptic interface. And 𝑓𝑒 is the interaction force between end-effector of robotic slave manipulator and environment, 𝑣𝑠 is velocity of the slave manipulator. 𝐻 is Hybrid matrix defined, which can be interprete as:

𝐻(𝑠) = [ℎ11(𝑠) ℎ12(𝑠)

ℎ21(𝑠) ℎ22(𝑠)] = [

𝑍𝑖𝑛 𝐹𝑜𝑟𝑐𝑒 𝑠𝑐𝑎𝑙𝑖𝑛𝑔

𝑉𝑒𝑙𝑜𝑐𝑖𝑡𝑦 𝑠𝑐𝑎𝑙𝑖𝑛𝑔 𝑍𝑜𝑢𝑡−1 ] (2)

in which 𝑍𝑖𝑛 and 𝑍𝑜𝑢𝑡 are the input and the output impedances,respectively. The hybrid parameters, ℎ12(𝑠) and ℎ21(𝑠) are functions of the master and slave dynamics and the control parameters. 𝐻(𝑠) represents kinesthetic relationship between the human operator and the environment while build a relationship between force and velocity. In ideal codition, it is clear that the Hybrid matrix 𝐻 representing the ideal teleopeator is

ℎ𝑖𝑑𝑒𝑎𝑙 = [0 1−1 0

] (3)

The target of this paper is improve the transparency and providing safety operating consciousness of system while keep the stability.The transparency condition was defined as follows [20]:

𝑍𝑡 = 𝑍𝑒 (4)

In which, 𝑍𝑡 denotes the transmitted impedance perceived by the operator and 𝑍𝑒 is the environment impedance. The



transmitted impedance can be expressed in terms of hybrid matrix:

𝑍𝑡 = ℎ11 −ℎ12ℎ21𝑍𝑒

1+ℎ22𝑍𝑒 (5)

Equation (4) can be proved by substituting (3) into (5). In order to acquire the high transparency, the force scaling should keep ℎ12(𝑠) = 1 . The surgeon can get ‘immerse’ operation, i.e. good ‘telepresence’. The velocity of the remote slave manipulator follows the velocity of the surgeon. In case of collision, safety operating consciousness will be established to ensure surgery safety. Safety operating consciousness is defined as a kind of collision cues perceived by the surgeon easily during catheter surgery practice.

D. Collision Discrimination and Kinesthetic Sensation

Collision discrimination is depended on the perception of physical stimuli. Human-centered surgery in either traditional or telesurgery is the process of human decision making according to the perception of hand sensory system and visual cues.

Table I Sensory Resolution and Weber Fractions for a Range of Haptic Stimuli [21]

Therefore, in order to ensure surgery safety in telesurgery, it is significant important to provide enough perception to the surgeon. In this paper, a new method is proposed to provide a cue to the surgeon with collision discrimination during catheter insertion process. The method is detailed in scaling up the feedback force 𝑘𝑓 times. The magnitude of 𝑘𝑓 is

determined by the perception discrimination of a kinesthetic stimulus (∅) .i.e. the magnitude of the force sensation is different with the case of without collision. According to the psychophysics knowledge, there are two notions must be clear: absolute threshold (AL for Absolute Limen) and difference threshold (DL for Difference Limen). Absolute threshold is defined as the smallest amount of stimulus energy necessary to produce a stimuli sensation, which is dependent on the resolution of the sensory system (see Table I).

The difference threshold is defined as the smallest amount of stimulus change required to produce a just noticeable difference (JND) in sensation in a discrimination task [2] [21]. The linear relationship between DL and the stimulus intensity is known as German physiologist E.H. Weber. In Weber’s law [22], it is defined in

𝑐 =∆∅

∅0=

𝐷𝐿

∅0 (6)

where ∅0 is the initial intensity of the stimulus, ∆∅ is the smallest discriminable intensity of stimulus change, and the constant 𝑐 is called the Weber Fraction. However, it is well known that this relationship is not true for every circumstance. The relation between ∅0 and ∆∅ will be changed in very high and very low intensity stimuli. One way to compensate for the constant 𝑐 is expressed as [23]:

𝑐 =∆∅

∅0+𝛼 (7)

It can not be avoided division by zero, when the measuring stimulus intensity ∅0 near to zero. In telesurgery, in free mode, feedback force near to zero.

E. Safety Operation Consciousness

Based on above theoretical analysis, a haptic based teleoperated medical system should not only keep the stability of the system and provide a kind of transparency but also safety operation consciousness sensation during the surgery practice based on the kinesthetic discrimination. In this paper, a kind of estimated interaction force during the catheter surgery process was viewed as force measurement in the slave site.

The feedback force signal was divided into two kinds of stimuli, which is expressed as the follow Equations:

𝐹ℎ𝑎𝑝𝑡𝑖𝑐 = {𝑘𝑓𝐹𝑓𝑒𝑒𝑑𝑏𝑎𝑐𝑘 (𝐹𝑓𝑒𝑒𝑑𝑏𝑎𝑐𝑘 ≥ 𝐹𝑡ℎ,𝑣)

𝑘𝑓𝑠𝑐𝑎𝑙𝑒𝐹𝑓𝑒𝑒𝑑𝑏𝑎𝑐𝑘 (𝐹𝑓𝑒𝑒𝑑𝑏𝑎𝑐𝑘 < 𝐹𝑡ℎ,𝑣) (8)

where, 𝐹ℎ𝑎𝑝𝑡𝑖𝑐 is the haptic perception (kinesthetic

sensation), 𝐹𝑓𝑒𝑒𝑑𝑏𝑎𝑐𝑘 is the interaction force measured or

estimated in the remote site, 𝑘𝑓 is safety consciousness

operation scale factor, 𝑘𝑓𝑠𝑐𝑎𝑙𝑒 is a scale factor and 𝐹𝑡ℎ,𝑣 is the

safety threshold value, which can be used to detected the collision between the catheter tip and the blood vessel. When the feedback force exceeds the safety threshold value, it provides a collision alarm to the surgeon. Surgeon will retreat or rotate the catheter to change the direction of catheter tip during surgical practice. In this case, the feedback force was scaled up 𝑘𝑓 times to establish the safety operating

consciousness. In another case, transparency control idea will be used.

III. HUMAN OPERATOR–CENTERED HAPTIC INTERFACE

During the medical used haptic interface design process, two facets should be considered. One is the safety operation for the operator and another is haptic sensation provided by the haptic interface.

A. Human Operator-centered Haptic Interface Design Analysis as well as Safety Consideration

In Teleoperation scenario, many methods have been used to provide haptic sensation artificially, which consists of tactile sensation such as vibrio-tactile devices [15] and kinesthetic sensation, for example: force-reflecting system. A usually pursued target in telesurgery is ‘telepresence’. In [24], telepresence is defined as ‘the ideal of sensing sufficient information about the tele-operator and task environment, and communicating this to the human operator in a sufficiently



natural way, that the operators feel physically present at the remote site.’ According to the catheter insertion experience and operation habitation of surgeon, force-reflecting system is more suitable to provide kinesthetic perception to surgeon. The most basic rules of force-reflecting interface must rely on the perceptual process to produce realistic kinesthetic sensation in accordance with the catheter interventional process. Therefore, the critical point of force-reflecting system design is actuator choose and design.

The choice of the actuator experienced from generally active actuator (DC motor) to semi-active (DC motor and brake integrated device), until passivity actuator (smart material based actuator: ER fluids or MR fluids). DC motor is the most choice because its torque is directly proportional to current. Electrical motors usually used to drive a linkage mechanism or a stylus to provide haptic sensation to the user. It is difficult to obtain stable haptic performance because of uncertain dissipation, such as backlash, dry friction, limit cycles and torque amplification/transmission. Therefore, this kind of actuator is not suitable for catheter haptic interface requirements because it’s active characteristic which provides unsafety to the operator due to control failure and the difficulty of stiffness adjustment as well as mechanical complication. MR fluids based semi-active haptic interface has good controllability and adjustability of stiffness due to characteristics of reversibly changes in several milliseconds and viscosity proportional to an external magnetic field application. The most important issue is that MR fluids produce a passive force. Furthermore, MR fluids have a low power requirement, it is a safety actuator for the human hand directly operation. Generally condition, MR fluids power supply is about 2-50 watts [25]. The needed voltage is 2 - 2.5V, and current is 1-2A. In [26], the maximum power consumption of the designed MR fluid actuated medical simulator is 30 watt. Compared with another smart materials electrorheological fluids (ER fluids), which needs the actuated voltage about 2-5kV, it is a kind of low voltage actuated smart material. In addition, the fluid itself does not pose any risk in case of leakage [27]. Therefore, it is alternative choice as an actuator for haptic interface design.

Some design rules should be considered for haptic interface design in the context of telesurgery and virtual reality medical training system. Firstly, the basic requirement of haptic interface includes [28]: 1) Free space must feel free, 2) Solid virtual objects must feel stiff, 3) Virtual or actual constraints must not be easily saturated. Secondly, consideration from ergonomics and habit of operation, it is good choice to design a grounded haptic interface with operating real catheter not instead by a stick/rod or stylus. If the haptic device attached on the user’s hand, although it can give the operator more freedom of the movement, he must carry the weight of the device and feel tired in a long time surgery. Therefore, a desk-grounded haptic passivity catheter interface is good for catheter operation in a natural way the same as the traditional surgery. Furthermore, the actuator choice must have every low friction when they are in the off-state, and the high enough force in the on-state to make the dynamic range of haptic interface is large.

B. MR Fluids and Literatures of MR Fluids Based Haptic Interface

MR fluids, a kind of smart material, are non-homogenous suspension of micro-sized ferromagnetic particles in a carried fluid, which undergo in rheological behavior change when an external magnetic field is applied (see Fig.3). This mutual interaction among the magnetizable of particles from into columns (chains) aligned to the direction of the applied external magnetic field that [29] [30].

Fig.3. Chain structures of magnetorheological particles: (a) magnetorheological fluids in ‘off state,’ (b, c) magnetorheological fluid in ‘‘on state’’ and the magnitude of magnetic field (b) is smaller than (c). [30].

The degree of the resistive depended on yield stress in MR fluids has a relationship with the strength of the magnetic field. In the absence of magnetic field, the MR fluids exhibit as Newtonian fluids, whose viscosity changes proportionally to the shear rate.

MR Fluids based haptic interface have been extensively studied in engineering application in recently. Some recently developed haptic interface or rehabilitation device based on MR fluids in medical application and healthcare can be found. The Haptic Black Box I and II (HBBI and HBB II) based on a freehand concept has been developed [31] [32], in which the surgeon can put their hands within a box and freely interact with the suitably controlled magnetorheological fluids (MRFs) to acquire tactile sensation. An encountered-type of haptic interface through using MR fluid has been designed and evaluation [26] for surgical simulation. A kind of variable impedance knee mechanism (VIKM) by controlling a linear MR fluid damper with a four-bar linkage transmission to provide controllable resistance to knee motion has been developed by [33]. A haptic glove with MR brakes for virtual reality has been designed by [34]. Ahmadkhanlou, F. et al. [35] developed two degree of freedom MR Fluid based haptic system for tele robotic surgery.

Based on the magnetorheological fluid characteristics and catheter surgery application, a passivity haptic catheter interface actuated by the MR fluid (MRF-122EG, a product of the Lord. Corp., USA.) is fabricated to provide haptic perception (kinesthetic sensation). The main characteristics of MR fluid (MRF-122EG) are, viscosity: 0.42 ± 0.0020 (Pa.s,400𝐶), density: 2.28-2.48 (𝑔/𝑐𝑚3), solids content by



weight: 72%, and maximum magnetic permeability saturation: 200-250(kA/m).

C. Design Details

In the context of teleoperated robotic assisted minimally invasive surgery, the slave manipulator motion repeats the motion of the master system and feedback the measured force to the master site. Therefore, the haptic master should have two kinds of capability. One is measure the motion of the operator (read part is called here) and another is displaying the force measured in the slave site (write part or haptic display device is called here).

(a) Working principles of catheter motion measurement

(b) The fabricated motion measurement device.

Fig.4. Read part: (a) working principles of catheter motion measurement, (b) fabricated motion measurement device.

1) Read part: The read part is used to measure the surgeon’s hand motion and the measured information is used to control the remote slave manipulator (shown in Fig.4). The developed read part has some characteristics such as contactless measure, which not introduce the friction force and system complicates compared with encoder based

measurement system. Therefore, this kind of contactless measurement will benefit to the haptic (kinesthetic) sensation displaying.

2) Write part (haptic display): The write part is used to provide the kinesthetic perception, according to the fed back information from the remote site. The designed whole haptic catheter interface is shown in Fig.5.

Although the haptic sensation can be recreated by the measured force come from remote slave feedback, this only is a feeling. Viewed as catheter haptic sensation evaluation, it is necessary to measure the recreating kinesthetic. A force measurement system was designed, here called ‘calibration subsystem’. The detail was shown in [30].

Fig.5.The fabricated catheter haptic interface

IV. MECHANICAL MODEL OF HAPTIC INTERFACE AND

CONTROL SCHEME

In order to provide an kind of actual sensation just like directly operation catheter surgery nearby the patient when the operator operate the designed haptic interface, it is necessary to understand the haptic (kinesthetic) generation and control process. Firstly, mechanical model was established, and then the dynamic range of the haptic interface, transparency and safety operation consciousness control schemed was presented based on the theoretical analysis in Section II (part E).

A. Mechanical Model of Haptic Interface

In MR fluids application, the output of torque or force is determined by the two main factors, which are electromagnetic field and physical characteristic of MR fluid based mechanical structure. Cross-section of the MR Fluid based actuator is shown in Fig.6. MR fluid is full of the gap between the catheter and the MR fluid container.

Bingham visco-plastic model is often used to represent the shear stress of the MR fluids as a function of the applied field and shear rate. According to the Bingham model, the shear stress can be expressed as [30]:

𝜏 = 𝜏𝑦(𝐵) + 𝜂�̇� (9)

�̇� =𝑑�⃑�

𝑑𝑡 (10)



where, 𝜏 is the shear stress, 𝜏𝑦 is the dynamic yield stress,

dependent yield stress, B is the magnitude of magnetic field intensity, 𝜂 is Newtonian viscosity, which is defined as the slope of the measured shear stress versus the shear strain rate, and �̇� is the velocity gradient in the direction of the magnetic field.

Fig.6. Cross-section of the MR fluid based actuator

The surgeon will felt the resistance force when insertion or extraction the catheter in the MR fluid, and rotation it with the felling of torque sensation shown in Fig.7.

Torque model: the velocity gradient in the field, called ‘shear rate’:

�̇� =𝜔𝑟

ℎ (11)

ℎ = (∅𝐷𝑐 − ∅𝑑𝑐)/2 (12)

where, 𝜔 is the angular velocity between the catheter and the container (container is fixed, therefore, the angular velocity is the velocity of catheter rotation), 𝑟 is the radial distance from the radius of the catheter rotation axis, ℎ is the thickness of the MR fluid filled in the gap between the catheter and the container, and 𝑑𝑐 is the diameter of the catheter.

Submit Equation (11) into (9),

𝜏 = 𝜏𝑦(𝐵) + 𝜂𝜔𝑟

ℎ (13)

Furthermore,

𝑑𝑇 = 𝑟𝜏𝑑𝐴 (14)

where, 𝐴 is the area of active MR fluid enclosed the surface of the catheter in the MR fluid container, and 𝑑𝑇 is the torque of the catheter differential elements..

Therefore, we can obtain the torque Equation (MRFs in ‘on state’):

𝑇𝑂𝑁,𝑚𝑎𝑥 = 𝜋Ø𝑑𝑐(𝜏𝑦(𝐵)ℎ3 + 𝜂𝜔𝑙𝑟ℎ2) (15)

MRFs in ‘off state’:

𝑇𝑂𝐹𝐹 = 𝜋∅𝑑𝑐𝜂𝜔𝑙ℎ2 (16)

Here, ignore the system structure friction, 𝑙 is the length of the catheter goes through the MR fluid.

Force model:

Actuators based on MR fluid operate in three working modes depending on the type of deformation employed: shear mode, flow mode, and squeeze mode. In the case of the shear mode, the MR fluid is located between surfaces moving in relation to each other with the magnetic field perpendicularly to the direction of the motion of these shear surfaces. In this paper, the catheter was inserted through MR fluids, which worked in shear mode (Bi-surface shear mode), shown in Fig.7. The resistance force can be felt by the surgeon can be decomposed into a controllable force due to controllable yield stress and uncontrollable force. The uncontrollable force consists of a viscous force and a system structure friction force. The system structure friction force is caused by the dynamic seal of MR fluids. The detail of dynamic seal is shown in published paper [30]. Dimension parameters of MR fluid container and catheter:

Length, 𝐿 = 180𝑚𝑚 , diameter,∅𝐷𝐶 = 10𝑚𝑚, Catheter: 5Fr,∅𝑑𝑐 = 1.65𝑚𝑚 , which goes through the center of the container.

The controllable force can be calculated as:

𝐹𝜏 = 𝜋𝐿𝜏𝑦(𝐵)(∅𝐷𝐶

2−∅𝑑𝑐2)

2ℎ𝑠𝑔𝑛(𝑣) (17)

Therefore, the resistance force model should be (MRFs in ‘on state’):

𝐹𝑂𝑁 = 𝐹𝜏 + 𝐹𝑓 (18)

Where, 𝐹𝑂𝑁 is the resistance force felt by the surgeon when he/she operate the catheter in a velocity 𝑣 and 𝐹𝑓 is the

system structure friction force.

Viscosity drag force can be expressed as: when is in ‘off state’

𝐹𝑑 = 2𝜋 ∫ �̇�𝑟𝑑𝑟∅𝐷𝐶

2∅𝑑𝑐2

(19)

Therefore, the resistance force model should be (MRFs in ‘off state’):

𝐹𝑂𝐹𝐹 = 𝐹𝑑 + 𝐹𝑓 (20)

Fig.7. Working models of MRF actuator. (Bi-surface shear mode)



B. Dynamic Range

In haptic interface design (‘haptic display’) an important measure of performance is the dynamic range of achievable impedance-called ‘Z-width’ [36]. Here, MR based haptic interface dynamic range with respect to its input current as:

In case of the torque dynamic range:

𝑍𝑤𝑖𝑑𝑡ℎ𝑇 = 𝑇𝐷𝑅 =

𝑇𝑇𝑂𝑁,𝑚𝑎𝑥

𝑇𝑂𝐹𝐹 (21)

In case of the force dynamic range:

𝑍𝑤𝑖𝑑𝑡ℎ𝐹 = 𝐹𝐷𝑅 =

𝐹𝑂𝑁,𝑚𝑎𝑥

𝐹𝑂𝐹𝐹 (22)

where 𝐹𝑂𝑁,𝑚𝑎𝑥 is dependent on 𝜏𝑦,𝑚𝑎𝑥 , which is the

maximum attainable shear stress with the MR fluid for a given maximum input current and configuration of actuators. The maximum current is limits by the saturation of the magnetic field intensity, MR fluids chain structure saturation, and the highest temperature of the coil covering layer tolerable.

C. Control Scheme of Haptic Interface

In this paper, catheter interventional surgery has two situations: in case of catheter smooth insertion without collision happened between catheter tip and blood vessel wall, the good transparency will be obtained to make a ‘telepresence’ during telesurgery; in another case, the catheter tip has a collision with blood vessel wall, the safety consciousness (alarm) sensation would be provided to the surgeon, the surgeon will rotate the catheter to change the direction of the catheter tip to smooth insertion without penetrating the blood vessel wall. The whole control idea is shown in Fig.8. After obtaining the desired force generation signal (DFG), trigger process (TP) is used to set safety operation threshold value and do control classification, it can be divided into two types of signal, one is safety consciousness signal (SCS) and another is transparency signal (TS). These two kinds of signals will be changed into the designed catheter haptic interface input signal and generated safety operation sensation and transparency operation sensation. Any sensors attached on the catheter will make the operation neither comfortably nor obscuring haptic sensation even making a wrong decision and causing medical accident. Therefore, the whole control scheme is open loop control. The relationship between force/ torque and the current input is very important in the control scheme. In order to get the precise relationship between force and input current, parameters adjustment and identification was obtained by the close loop control (see Fig.5.and Fig.9).

V. PERFORMANCE EVALUATION OF DESIGNED HAPTIC

INTERFACE

In this section, three experiments have been done to evaluate the performance of the designed catheter haptic interface. Experiment I is used to verify that surgeon’s physiology tremor can be reduced by operating the developed catheter haptic interface. Experiment II and III are used to verify the effectiveness of the proposed control scheme.

Experimental I: Physiology Hand Tremor Reduction Performance Evaluation

1) Experimental Method:

The target of experiment is to verify the designed catheter haptic interface can reduce physiology hand tremor. The surgeon’s motion was measured by the motion measurement device (‘read part’), which is shown in Fig.4 (b). Another motion measurement experiment has conducted on the catheter haptic interface, which is shown in Fig. 5. Here, it needs to note that catheter haptic interface consists of ‘read part’ and ‘display part’. The displacement of catheter insertion is 20 mm. Insertion motion and extract motion have been measured by the ‘read part’. In catheter insertion through catheter haptic interface experiment, MR fluid is ‘on state’.

Fig.8 Block diagram of control scheme of the haptic sensation. 𝐹𝑓𝑑 : feedback force in the slave site, here desired

force is viewed as feedback force.

Fig.9. Online adjustment control block diagram (to find the precise relationship)

Fig.10. Motion measurement experiments (in two cases)



2) Experimental Result:

Experimental result was shown in Fig.10. The red curve shows the measured results by the motion measurement device (only ‘read part’) and the black curve shows measured results based on catheter haptic interface. As the Fig.10 shows, the tremor existed when operate catheter goes through ‘read part’. When the catheter goes through the designed catheter haptic interface, the physiology hand tremor was reduced. The measured error Equation is follows:

𝑀𝑒𝑟𝑟𝑜𝑟(%) =|𝑡ℎ𝑒𝑜𝑟𝑒𝑡𝑖𝑐𝑎𝑙 𝑣𝑎𝑙𝑢𝑒−𝑚𝑒𝑎𝑠𝑢𝑟𝑒𝑑 𝑣𝑎𝑙𝑢𝑒|

𝑡ℎ𝑒𝑜𝑟𝑒𝑡𝑖𝑐𝑎𝑙 𝑣𝑎𝑙𝑢𝑒 (23)

The insertion velocity measured error is 1.25% and the extraction measured error is 0.75%, (theoretical value of catheter insertion and extraction is 10mm/s, the insertion measured velocity 9.875mm/s, extraction measured velocity is 9.925mm/s).

3) Discussion:

In teleoperated robot assisted surgery, the surgeon’s motion is measured in the master site and transmitted to the slave site to control the slave robotic manipulator. Physiology tremor of the surgeon is bad for robot-assisted the surgery, Ghorbanian, A. et al [37] proposed novel control architecture and Riviere, C. N. et al. [38] presents adaptive control algorithm to cancel the physiology tremor. Based on the experiments results, the designed catheter haptic interface is not only measure the surgeon’s hand motion but also can reduce the physiology tremor. Therefore, MR fluid can be used to reduce physiology tremor in medical haptic interface structure design.

Experimental II: Transparency Evaluation

Transparency is significant important in haptic interface performance evaluation. The whole evaluation system is shown in Fig.11. The detail of experiment setup is shown in published paper [30].


Based on the above theory analysis and the proposed control algorithm, it needs to determine the safety operation threshold value. The interaction force between the catheter tip and the blood vessel wall is instead by the simulated force, which is not affect performance evaluation of the designed catheter haptic interface. The simulated force (blue curve) is shown in Fig.12. According to the experience surgeon practice, the force of catheter minimally invasive surgery is kind of non-continuous force. The force increased immediately when catheter tip contacts with blood vessel wall, and decreased at once when catheter slips smoothly in the blood vessel wall. However, it will increase with the length of catheter insertion into the blood vessel. The peaks of the wave in the simulated force indicate that possible collision events happened. It needs to point out that it is impossible without contact and collision between catheter tip and blood vessel during catheter operation practice. Therefore, only when the force exceeds safety threshold value, it can be viewed as ‘real’ collision. Meanwhile, it needs to provide ‘alarm’ to the surgeon to ensure safety operation. However, the critical force, which is used to detect the collision situation, is only

sensed by the experienced surgeon who has been trained for a long time. Zakaria, N. et al. [39] points out that the contact force of the catheter and blood vessel is more than 0.12 [N], the blood vessel wall will be penetrated. Therefore, in the case of catheter operation practice, safety operation threshold value Equation is governed as follows:

𝐹𝑡ℎ,𝑣 = 0.12 + 𝑓𝑥 (24)

where, the ‘0.12’ [N] is the value of ‘alarm’ force, the fx is the total force during the catheter insertion including viscous drag force and contact friction force between the catheter surface and blood as well as friction force between the catheter and the catheter sheath. It notes that 𝑓𝑥 and 𝐹𝑡ℎ,𝑣 are variables, which

are depended on the blood vessel characteristics.

In other cases of surgery practice such as needle insertion or palpation, the safety operation threshold values (‘alarm force’) will be changed with the different characteristics of tissue.

In this paper, when the simulated force is less than 0.12 [N], it can be viewed as without collision. In this case, it needs to provide a kind of high fidelity force sensation to the surgeon i.e. transparency.


The result of transparency control is shown in Fig.12. The blue line is the simulated and the green line is the force generated by controlling of the viscosity of the MR fluids. The red line described the error of the simulated force and the generated haptic force.

3) Discussion:

According to the theory analysis in Section II (part C and E), the force scale factor of transparency control in teleoperation scenario is 1, i.e. 𝐾𝑓𝑠𝑐𝑎𝑙𝑒 = 1. The maximum

difference between the simulated force and the generated haptic force is 7mN.According to Table I, the force resolution is 19mN (human’s finger detection resolution, i.e. just notice difference (JND)). Because the error is blow the JND, the surgeon can not be affected by the error. Therefore, it can be viewed as good transparency acquired.

However, slight delay existed between the simulated force and the haptic force will deteriorate the performance of transparency. Slight delay is caused by the characteristics of hysteresis of electromagnetic field, which is an important component of catheter haptic interface. In order to reduce the hysteresis effect, Yadmellat, P. and Kermani, M. [40] proposed an adaptive hysteresis compensation to improve the performance for the MR fluid actuated robot. In further research, hysteresis compensation control method should be introduced in the control scheme to improve the performance of the designed catheter haptic interface.

Safety operation issue is determined whether the surgeon can detect the collision correctly. This has relation with human haptics, which includes issues such as haptic cognition [41] (how haptics supports thought and action), psychophysics, perception and neurological processes through haptic operations as well as perception based action. Kinesthetic sensations come from the mechanoreceptor bedded in the finger is afferent to the central nervous system (CNS) and



action is based on the perception of this kind of kinesthetic. Nisky, I. et al. [42] proposed perceptual transparency concept, which quantifies human perception of the remote environment. Therefore, safety issue is determined by the perceptual transparency. The time delay will affect the perceptual transparency. A prerequisite of safety operation is perfect perceptual transparency. Therefore, to ensure safety, it needs to reduce the delay below to the response time of action based perceptual transparency.

Fig.11. Experiment setup of catheter haptic interface

Fig.12. Haptic sensation (transparency control scheme)

Here, the slight delay has no effect of the safety issues, because the surgeon’s action is based on the kinesthetic sensation and visual sensation (visual feedback) in real teleoperated catheter operation. However, in order to improve performance, we should reduce the error between the simulated force and the generated haptic force. In addition, adaptive compensation method should be introduced into the control scheme to enhance the performance.

Experimental III: Safety operation consciousness recreation


A Safety operation consciousness stimulus is obtained by amplifying the collision force, when detected the collision between the catheter tip and the blood vessel wall. The parameter of amplifying 𝑘𝑓 is determined by the different

limen (DL). In Weber’s law [22], according to Equation (6), a new calibration method can be obtained:

∆∅ = 𝐷𝐿 = 𝑐 ∙ ∅0 = 𝑐 ∙ 𝐹𝑡ℎ,𝑣 (25)

𝑘𝑓 ≥𝐹𝑡ℎ,𝑣+𝑐∙𝐹𝑡ℎ,𝑣

𝐹𝑡ℎ,𝑣= 1 + 𝑐 (26)

where, ∅0 is the initial intensity of the stimulus, which is the collision detection value, also called ‘safety threshold value’. The simulated force is shown in Fig.13. Here, for example, assumption of the total force is 0.28N (except the force of catheter tip collision with the blood vessel wall), i.e. 𝑓𝑥 =0.28𝑁. When the simulated force exceeds 0.40N according to the Equation (23), collision happened. The surgeon will adjust the operation skill, such as rotation the catheter or retreat the catheter to advance again with the direction change of catheter tip to avoid the penetration of the blood vessel wall and cause medical accident. In usually visual image based teleoperation scenario, the collision message will be found by the surgeon though watch the monitor. The safety operating consciousness i.e. ‘alarm’ can be felt by the operator through the generated kinesthetic sensation. From Fig.14, three times of catheter collision with the blood vessel wall happened; the surgeon will felt three times of collision based kinesthetic sensation by adopted safety operation consciousness control scheme.

According to the control idea proposed in Section II (part E), when the collision is detected, the simulated force will be amplified to realize safety operation consciousness sensation. The simulated force was changed into the current to control the MR fluids to generate the needed kinesthetic sensation. This change process is just like transparency control scheme described in the Experiments II.


The result was shown in Fig.14. The surgeon will change the catheter operation skill (slow down insertion speed or rotate the catheter to change the direction of catheter tip) to ensure surgery safety based on the kinesthetic perception provided by the haptic catheter interface.

3) Discussion:

In telesurgery scenario, stability is also needed consideration, Hannaford.et al. [43] introduced a man machine perception threshold as:

𝑇𝑚𝑚 =(𝐹𝑚𝑖𝑛+𝐹𝑡ℎ)

ℎ12 (27)

Here, 𝐹𝑚𝑖𝑛 is the friction force level, 𝐹𝑡ℎ is a human operator perceptual threshold, and ℎ12 is a force feedback scale factor descripted in Section II (part C). They pointed out that the force-feedback scale factor can be reduced to make operation stable. However, ‘‘the cost of stability obtained in this manner was not only reduction of the kinesthetic feedback of force information, but also, effective magnification of the man-machine ‘perception threshold’. Therefore, the parameter 𝑘𝑓 is impacted by the system stability. Here, three different

values of 𝑘𝑓 parameters have been designed based on

Equation (25)-(27), 𝑘𝑓1 = 1.39, 𝑘𝑓2 = 1.32, and 𝑘𝑓3 = 1.28

. These scaling up parameter were used to provide different kinesthetic sensation to the surgeon to avoid misoperation caused medical accidents.



Fig.13. Simulated force according to theory hypothesis

Fig.14. Haptic sensation (safety operating consciousness control scheme)

VI. Conclusions

In this paper, a catheter haptic interface for teleoperated

robot assisted minimally invasive surgery has been presented.

MR fluids with promising characteristics are well-suited for

design of semi-active actuation systems which is operate by

human directly. The designed catheter haptic interface exhibit

several characteristics that are sought after for

human-friendly interface, such as: low output inertia, superior

performance and haptic width, as well as high precision in the

control of output of force and torque.

In the context of telesurgery scenario, one of the

challenges is addressed by introducing the human-centered

haptic interface design concept through exploiting MR fluids.

The performances of the designed haptic interface were

evaluated, the operator can obtain haptic sensation through

operating the interface just like he/she practices surgery near

by the patient. In addition, a novel safety operating

consciousness control scheme was firstly presented, which

can provide a kind of kinesthetic alarm to the surgeon to

remind the surgeon. Therefore, the designed catheter haptic

interface can be used as a master console in the context of

telesurgery.

It is noted that the designed catheter haptic interface can

generated force sensation and torque sensation respectively.

The torque sensation will be evaluated in future. And

integrating vascular physical model [44] based virtual reality

technology into the haptic technology will be a promising

research direction in catheter minimally invasive surgery.

ACKNOWLEDGEMENT

This research was supported partly by National High

Tech. Research and Development Program of China

(No.2015AA043202) and the Kagawa University

Characteristic Prior Research Fund 2015.

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AUTHORS’ BIOGRAPHY

Xuanchun Yin is currently working toward

the Ph.D. degree in Intelligent Mechanical

Systems Engineering at Kagawa University,

Japan. He received the B.S. degree in

Changchun University of Science and

Technology, China, in 2005 and the M.S.

degree in South China Agriculture University,

China, in 2012, both in Mechanical

Engineering. For four years, he worked in

Toyota Auto Body, Co., Ltd, Japan, and then worked in Henan

Polytechnic Institute, China. His research interests include

minimally invasive surgery, micro robotic catheter operation

system; smart material (MR Fluids) based actuators, haptics and

medical robot.

Shuxiang Guo (SM’03) received the Ph.D.

degree in mechanoinformatics and systems

from Nagoya University, Nagoya, Japan, in

1995.

He had been a Full Professor at the

Department of Intelligent Mechanical System

Engineering, Kagawa University,Takamatsu,

Japan, since 2005. He is also the Chair

Professor in Key Laboratory of Convergence

Medical Engineering System and Healthcare Technology, Ministry

of Industry and Information Technology, Beijing Institute of

Technology, China. He has published about 470 refereed journal and

conference papers. His current research interests include biomimetic

underwater robots and medical robot systems for minimal invasive

surgery, micro catheter system, micropump, and smart material

(SMA, IPMC) based on actuators.

Dr. Guo is Editor in chief for International Journal of

Mechatronics and Automation.

Nan Xiao(S’2008-M’2012) received his B.Sc.

degree from Harbin Engineering University,

Heilongjiang, Harbin, China, in 2004, and his

M.Sc. degree from Harbin Engineering

University, Heilongjiang, Harbin, China, in

2007. He received his Ph.D. in Kagawa

University, Japan, in 2011.

He is currently an Associate Professor of

Beijing Institute of Technology and Key

Laboratory of Convergence Medical Engineering System and

Healthcare Technology, the Ministry of Industry and Information

Technology, China. He researches interests on medical robotics and

micro-operating systems for biomedical applications and robotic

catheter system.

Takashi Tamiya received the Ph.D. degree

from Okayama University Medical School,

Japan, in 1990.

He had fellowships in Massachusetts General

Hospital, Harvard Medical School in the USA

from 1993 to 1994.

He is currently a Full Professor and chairman

of the Department of Neurological Surgery,

Faculty of Medicine, at Kagawa University,

Japan. He has published over 400 refereed journal and conference

papers. His current research interests include the surgical techniques

of neurosurgical operations and intravascular surgery system.

Hideyuki Hirata received the B.S. and M.S.

degrees in mechanical engineering from

Yokohama National University, Japan, in 1981

and in 1983, respectively, and the Ph.D. degree

from Tokyo Institute of Technology, Japan, in

1992.

He is currently a Professor at the


Engineering, Kagawa University, Takamatsu,

Japan. He has published about 32 refereed

journal and conference papers. His current research interests include

material strength, material design and microdevices based on

computer simulation technology.

Hidenori Ishihara received the B.S., M.S. and

Ph.D. degrees in electrical machinery from

Nagoya University, Nagoya, Japan, in 1991,

in 1993 and in 1995, respectively.

He is currently an Associate Professor at the


Engineering, Kagawa University, Takamatsu,

Japan. He has published about 81refereed

journal and conference papers. His current

research interests include intellectualization and functionalization of

robotics.

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