Surgical Cockpit : Man-machine interaction in CAMI

Coordinator: Marie-Aude VITRANI – ISIR Institut des Systèmes Intelligents et de Robotique

CAMI Partners:  Icube, LIRMM

Started: July 1st (Jimmy da Silva)

New Interfaces for minimally invasive surgery: allow each surgeon to operate through laparoscopy as easily as through laparotomy.

Motivations and objectives:

Context: Operating rooms integrate more and more technical devices: imaging, navigation, instruments (bipolar, monopolar, ultrasound, laser, etc.), robotics, etc.
During laparoscopic procedures, the installation of the various devices plus the constraints related to the uses of trocars have a considerable impact on the surgeon’s skills:

  • The posture of the surgeon is uncomfortable and leads to postural fatigue.
  • Visual space (screen) and manipulation space (instruments) are disjointed making hand-eye coordination difficult.
  • The insertion of instruments through trocars induces a well-known phenomenon of “fulcrum effect” in the transmission of movements. An equivalent phenomenon occurs for effort and becomes crucial for force feedback devices.
  • The perception of depth is degraded.

As a result, minimally invasive surgery is underused in clinical practice despite its undeniable medical benefits over open surgery. In this project, we propose to work to facilitate gestures in minimally invasive surgery by addressing more particularly the questions of interfaces and human-machine interactions.

Concept: sensorimotor facilitation: The concept of sensorimotor facilitator aims to facilitate laparoscopic surgery. We mean to increase the performance of the surgical gesture while reducing the cognitive and physical load.
The main idea is to optimize interactions between devices and practitioners. This involves designing and implementing new adaptive functions that integrate the visuo-motor coordination schemes and the surgeon’s learning patterns.

The project is divided into the following work packages:

  • Cobots to hold instruments and endoscope
  • Tangible interfaces and augmented reality
  • Time Shifting and Video On Demand
  • Human-Machine Interface for the Control of Multi-functions system
  • Learning analytics and evaluation protocols
  • Clinical validation (mainly digestive surgery and gynaecological surgery)

Main results and on-going work:

The level of development of the surgical cockpit devices varies greatly. Active instruments have already been transferred to an industrial partner (Endocontrol). The instrument holders have been tested by surgeons during preliminary animal trial, while aspects of visualization on interactive screens are only at the concept stage.

The objective of the project is that all the modules are validated on experimental laboratory benches (in vitro) by surgeons but also on anatomical subjects (in cadavero) or on animals (in vivo). For the most advanced devices, the objective is to conduct clinical validations on patients in order to be able to prepare the medical benefit analyzes.