Surgical Cockpit 

Human-machine interfaces for laparoscopic surgery

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

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

Other CAMI Partners:  Icube, LIRMM

Started: July 1st 2017


Motivations and objectives:

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.

fig1
More and more technical devices into the OR

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

HM

  • 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.


 

Main Publications
  • Vitrani, MA (2018). A Surgical Cockpit to ease laparoscopic surgery. Medical Robotics days. Brussels, Belgium. Communication invitée.
  • Ferrier-Barbut, E. (2018). Quels changements dans l’apprentissage en chirurgie par cœlioscopie avec l’arrivée des assistances robotisées ?.
    Workshop Le robot chirurgical : Quelles approches interprofessionnelles techniques et non techniques? https://wrobot-cerefige.event.univ-lorraine.fr/
  • Avellino, I. (2018). Événements Indésirables de la Chirurgie Robot-Assisté. Workshop: Le robot chirurgical : Quelles approches interprofessionnelles techniques et non techniques? https://wrobot-cerefige.event.univ-lorraine.fr/
Chalard, R. and Reversat,D. and Morel,G. and Mozer, P. and Vitrani, M.-A. (2018). Precisely positioning the tip of an instrument inserted through an orifice with a free wrist robot. Application to prostate biopsies.
IJCARS. Vol 13 Pages 1-8. Best paper award – runner-up.
  • Vitrani, M.-A. and Poquet Torterotot, C. and Morel, G. (2017). Applying virtual fixtures to the distal end of a minimally invasive surgery instrument.
    IEEE Transactions on Robotics. Vol 33 No 1 Pages 114-123.
  • Candalh-Touta, N. and Szewczyk, J. (2017). How can we improve the Training of Laparoscopic Surgery thanks to the Knowledge in Robotics?.
    15th International Conference on Education and Information Systems, Technologies and Applications. Pages pp.137.
  • Candalh-Touta, N. and Szewczyk, J. (2017). Is proprioception a key sensory modality to be successful in laparoscopy training?.
    Computer Assisted Radiology and Surgery (CARS). Pages pp.S132.

Surgical Cockpit team:

Catherine Achard (MCF)
• Mario Aricò (PhD student)
• Ignacio Avellino (Post-Doctorant)
• Ninon Candalh-touta (PhD student)
• Jimmy Da Silva (IE))
• Guillaume Morel (PR)
• Jérôme Szecwzyk (PR)
• Marie-Aude Vitrani (MCF)

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