Haptic Feedback and Force-Based Teleoperation in Surgical Robotics

This article presents an overview of the current state of research and application of haptic (primarily kinesthetic) feedback and force-based teleoperation in the context of surgical robotics. Telerobotic surgery provides an approach for transferring the sensorimotor skills of a surgeon through a robotic platform to perform surgical intervention inside a patient's body. Integration of advanced sensing and haptic technologies in telerobotic surgery can help to enhance the sensory awareness and motor accuracy of the surgeon, thereby leading to improved surgical procedures and outcomes for patients. The primary mode of sensory feedback has been through 3-D visual observation using stereo endoscopes. However, until recently, the sense of touch, i.e., haptics, has been missing in the commercial telesurgery robots approved for use in the operating room despite over two decades of research and development in the field of haptics for teleoperated systems ("telehaptics"). Research has shown that high-fidelity force feedback can enhance the performance of telesurgery and potential outcomes by enabling the surgeon to have a more natural feel of interaction between surgical tools and tissue as normally experienced during open surgery. Interaction forces, such as those generated during palpation of tissue, insertion of a needle, unintentional (and potentially unsafe) exertion of force by a tool, suture breakage, needle slippage, or tool interaction, are replaced by indirect (virtual) sensations, termed visual haptics, which provides an alternative to sensory compensation. Although there is a significant amount of literature supporting this benefit, there are still several important technical challenges in introducing haptics in telesurgery, including instrumentation, fidelity (transparency), stability, and modalities for force reflection, e.g., direct or indirect. This article examines these challenges and discusses recent work on haptics-based teleoperated surgical robotic systems.