Towards a Modern and Lightweight Rendering Engine for Dynamic Robotic Simulations

Interactive dynamic simulators are an accelerator for developing novel robotic control algorithms and complex systems involving humans and robots. In user training and synthetic data generation applications, a high-fidelity visualization of the simulation is essential. Visual fidelity is dependent on the quality of the computer graphics algorithms used to render the simulated scene. Furthermore, the rendering algorithms must be implemented on the graphics processing unit (GPU) to achieve real-time performance, requiring the use of a graphics application programming interface (API). This paper presents a performance-focused and lightweight rendering engine supporting the Vulkan graphics API. The engine is designed to modernize the legacy rendering pipeline of Asynchronous Multi-Body Framework (AMBF), a dynamic simulation framework used extensively for interactive robotics simulation development. This new rendering engine implements graphical features such as physically based rendering (PBR), anti-aliasing, and ray-traced shadows, significantly improving the image quality of AMBF. Computational experiments show that the engine can render a simulated scene with over seven million triangles while maintaining GPU computation times within two milliseconds.

SurgicAI: A Fine-grained Platform for Data Collection and Benchmarking in Surgical Policy Learning

Despite advancements in robotic-assisted surgery, automating complex tasks like suturing remain challenging due to the need for adaptability and precision. Learning-based approaches, particularly reinforcement learning (RL) and imitation learning (IL), require realistic simulation environments for efficient data collection. However, current platforms often include only relatively simple, non-dexterous manipulations and lack the flexibility required for effective learning and generalization. We introduce SurgicAI, a novel platform for development and benchmarking addressing these challenges by providing the flexibility to accommodate both modular subtasks and more importantly task decomposition in RL-based surgical robotics. Compatible with the da Vinci Surgical System, SurgicAI offers a standardized pipeline for collecting and utilizing expert demonstrations. It supports deployment of multiple RL and IL approaches, and the training of both singular and compositional subtasks in suturing scenarios, featuring high dexterity and modularization. Meanwhile, SurgicAI sets clear metrics and benchmarks for the assessment of learned policies. We implemented and evaluated multiple RL and IL algorithms on SurgicAI. Our detailed benchmark analysis underscores SurgicAI's potential to advance policy learning in surgical robotics. Details: \url{https://github.com/surgical-robotics-ai/SurgicAI

Realistic Data Generation for 6D Pose Estimation of Surgical Instruments

Automation in surgical robotics has the potential to improve patient safety and surgical efficiency, but it is difficult to achieve due to the need for robust perception algorithms. In particular, 6D pose estimation of surgical instruments is critical to enable the automatic execution of surgical maneuvers based on visual feedback. In recent years, supervised deep learning algorithms have shown increasingly better performance at 6D pose estimation tasks; yet, their success depends on the availability of large amounts of annotated data. In household and industrial settings, synthetic data, generated with 3D computer graphics software, has been shown as an alternative to minimize annotation costs of 6D pose datasets. However, this strategy does not translate well to surgical domains as commercial graphics software have limited tools to generate images depicting realistic instrument-tissue interactions. To address these limitations, we propose an improved simulation environment for surgical robotics that enables the automatic generation of large and diverse datasets for 6D pose estimation of surgical instruments. Among the improvements, we developed an automated data generation pipeline and an improved surgical scene. To show the applicability of our system, we generated a dataset of 7.5k images with pose annotations of a surgical needle that was used to evaluate a state-of-the-art pose estimation network. The trained model obtained a mean translational error of 2.59mm on a challenging dataset that presented varying levels of occlusion. These results highlight our pipeline's success in training and evaluating novel vision algorithms for surgical robotics applications.

Improving the realism of robotic surgery simulation through injection of learning-based estimated errors

The development of algorithms for automation of subtasks during robotic surgery can be accelerated by the availability of realistic simulation environments. In this work, we focus on one aspect of the realism of a surgical simulator, which is the positional accuracy of the robot. In current simulators, robots have perfect or near-perfect accuracy, which is not representative of their physical counterparts. We therefore propose a pair of neural networks, trained by data collected from a physical robot, to estimate both the controller error and the kinematic and non-kinematic error. These error estimates are then injected within the simulator to produce a simulated robot that has the characteristic performance of the physical robot. In this scenario, we believe it is sufficient for the estimated error used in the simulation to have a statistically similar distribution to the actual error of the physical robot. This is less stringent, and therefore more tenable, than the requirement for error compensation of a physical robot, where the estimated error should equal the actual error. Our results demonstrate that error injection reduces the mean position and orientation differences between the simulated and physical robots from 5.0 mm / 3.6 deg to 1.3 mm / 1.7 deg, respectively, which represents reductions by factors of 3.8 and 2.1.

Integrating 3D Slicer with a Dynamic Simulator for Situational Aware Robotic Interventions

Image-guided robotic interventions represent a transformative frontier in surgery, blending advanced imaging and robotics for improved precision and outcomes. This paper addresses the critical need for integrating open-source platforms to enhance situational awareness in image-guided robotic research. We present an open-source toolset that seamlessly combines a physics-based constraint formulation framework, AMBF, with a state-of-the-art imaging platform application, 3D Slicer. Our toolset facilitates the creation of highly customizable interactive digital twins, that incorporates processing and visualization of medical imaging, robot kinematics, and scene dynamics for real-time robot control. Through a feasibility study, we showcase real-time synchronization of a physical robotic interventional environment in both 3D Slicer and AMBF, highlighting low-latency updates and improved visualization.

Haptic-Assisted Collaborative Robot Framework for Improved Situational Awareness in Skull Base Surgery

Skull base surgery is a demanding field in which surgeons operate in and around the skull while avoiding critical anatomical structures including nerves and vasculature. While image-guided surgical navigation is the prevailing standard, limitation still exists requiring personalized planning and recognizing the irreplaceable role of a skilled surgeon. This paper presents a collaboratively controlled robotic system tailored for assisted drilling in skull base surgery. Our central hypothesis posits that this collaborative system, enriched with haptic assistive modes to enforce virtual fixtures, holds the potential to significantly enhance surgical safety, streamline efficiency, and alleviate the physical demands on the surgeon. The paper describes the intricate system development work required to enable these virtual fixtures through haptic assistive modes. To validate our system's performance and effectiveness, we conducted initial feasibility experiments involving a medical student and two experienced surgeons. The experiment focused on drilling around critical structures following cortical mastoidectomy, utilizing dental stone phantom and cadaveric models. Our experimental results demonstrate that our proposed haptic feedback mechanism enhances the safety of drilling around critical structures compared to systems lacking haptic assistance. With the aid of our system, surgeons were able to safely skeletonize the critical structures without breaching any critical structure even under obstructed view of the surgical site.

A Data-Driven Model with Hysteresis Compensation for I2RIS Robot

Retinal microsurgery is a high-precision surgery performed on an exceedingly delicate tissue. It now requires extensively trained and highly skilled surgeons. Given the restricted range of instrument motion in the confined intraocular space, and also potentially restricting instrument contact with the sclera, snake-like robots may prove to be a promising technology to provide surgeons with greater flexibility, dexterity, space access, and positioning accuracy during retinal procedures requiring high precision and advantageous tooltip approach angles, such as retinal vein cannulation and epiretinal membrane peeling. Kinematics modeling of these robots is an essential step toward accurate position control, however, as opposed to conventional manipulators, modeling of these robots does not follow a straightforward method due to their complex mechanical structure and actuation mechanisms. Especially, in wire-driven snake-like robots, the hysteresis problem due to the wire tension condition can have a significant impact on the positioning accuracy of these robots. In this paper, we proposed an experimental kinematics model with a hysteresis compensation algorithm using the probabilistic Gaussian mixture models (GMM) Gaussian mixture regression (GMR) approach. Experimental results on the two-degree-of-freedom (DOF) integrated robotic intraocular snake (I2RIS) show that the proposed model provides 0.4 deg accuracy, which is an overall 60% and 70% of improvement for yaw and pitch degrees of freedom, respectively, compared to a previous model of this robot.

Improving Surgical Situational Awareness with Signed Distance Field: A Pilot Study in Virtual Reality

The introduction of image-guided surgical navigation (IGSN) has greatly benefited technically demanding surgical procedures by providing real-time support and guidance to the surgeon during surgery. To develop effective IGSN, a careful selection of the information provided to the surgeon is needed. However, identifying optimal feedback modalities is challenging due to the broad array of available options. To address this problem, we have developed an open-source library that facilitates the development of multimodal navigation systems in a wide range of surgical procedures relying on medical imaging data. To provide guidance, our system calculates the minimum distance between the surgical instrument and the anatomy and then presents this information to the user through different mechanisms. The real-time performance of our approach is achieved by calculating Signed Distance Fields at initialization from segmented anatomical volumes. Using this framework, we developed a multimodal surgical navigation system to help surgeons navigate anatomical variability in a skull-base surgery simulation environment. Three different feedback modalities were explored: visual, auditory, and haptic. To evaluate the proposed system, a pilot user study was conducted in which four clinicians performed mastoidectomy procedures with and without guidance. Each condition was assessed using objective performance and subjective workload metrics. This pilot user study showed improvements in procedural safety without additional time or workload. These results demonstrate our pipeline's successful use case in the context of mastoidectomy.

Fully Immersive Virtual Reality for Skull-base Surgery: Surgical Training and Beyond

Purpose: A fully immersive virtual reality system (FIVRS), where surgeons can practice procedures on virtual anatomies, is a scalable and cost-effective alternative to cadaveric training. The fully digitized virtual surgeries can also be used to assess the surgeon's skills automatically using metrics that are otherwise hard to collect in reality. Thus, we present FIVRS, a virtual reality (VR) system designed for skull-base surgery, which combines high-fidelity surgical simulation software with a real hardware setup. Methods: FIVRS integrates software and hardware features to allow surgeons to use normal clinical workflows for VR. FIVRS uses advanced rendering designs and drilling algorithms for realistic surgery. We also design a head-mounted display with ergonomics similar to that of surgical microscopes. A plethora of digitized data of VR surgery are recorded, including eye gaze, motion, force and video of the surgery for post-analysis. A user-friendly interface is also designed to ease the learning curve of using FIVRS. Results: We present results from a user study involving surgeons to showcase the efficacy FIVRS and its generated data. Conclusion: We present FIVRS, a fully immersive VR system for skull base surgery. FIVRS features a realistic software simulation coupled with modern hardware for improved realism. The system is completely open-source and provides feature-rich data in an industry-standard format.

Twin-S: A Digital Twin for Skull-base Surgery

Purpose: Digital twins are virtual interactive models of the real world, exhibiting identical behavior and properties. In surgical applications, computational analysis from digital twins can be used, for example, to enhance situational awareness. Methods: We present a digital twin framework for skull-base surgeries, named Twin-S, which can be integrated within various image-guided interventions seamlessly. Twin-S combines high-precision optical tracking and real-time simulation. We rely on rigorous calibration routines to ensure that the digital twin representation precisely mimics all real-world processes. Twin-S models and tracks the critical components of skull-base surgery, including the surgical tool, patient anatomy, and surgical camera. Significantly, Twin-S updates and reflects real-world drilling of the anatomical model in frame rate. Results: We extensively evaluate the accuracy of Twin-S, which achieves an average 1.39 mm error during the drilling process. We further illustrate how segmentation masks derived from the continuously updated digital twin can augment the surgical microscope view in a mixed reality setting, where bone requiring ablation is highlighted to provide surgeons additional situational awareness. Conclusion: We present Twin-S, a digital twin environment for skull-base surgery. Twin-S tracks and updates the virtual model in real-time given measurements from modern tracking technologies. Future research on complementing optical tracking with higher-precision vision-based approaches may further increase the accuracy of Twin-S.