Early Failure Detection in Autonomous Surgical Soft-Tissue Manipulation via Uncertainty Quantification

Autonomous surgical robots are a promising solution to the increasing demand for surgery amid a shortage of surgeons. Recent work has proposed learning-based approaches for the autonomous manipulation of soft tissue. However, due to variability in tissue geometries and stiffnesses, these methods do not always perform optimally, especially in out-of-distribution settings. We propose, develop, and test the first application of uncertainty quantification to learned surgical soft-tissue manipulation policies as an early identification system for task failures. We analyze two different methods of uncertainty quantification, deep ensembles and Monte Carlo dropout, and find that deep ensembles provide a stronger signal of future task success or failure. We validate our approach using the physical daVinci Research Kit (dVRK) surgical robot to perform physical soft-tissue manipulation. We show that we are able to successfully detect task failure and request human intervention when necessary while still enabling autonomous manipulation when possible. Our learned tissue manipulation policy with uncertainty-based early failure detection achieves a zero-shot sim2real performance improvement of 47.5% over the prior state of the art in learned soft-tissue manipulation. We also show that our method generalizes well to new types of tissue as well as to a bimanual soft tissue manipulation task.

Leveraging Fixed-Parameter Tractability for Robot Inspection Planning

Autonomous robotic inspection, where a robot moves through its environment and inspects points of interest, has applications in industrial settings, structural health monitoring, and medicine. Planning the paths for a robot to safely and efficiently perform such an inspection is an extremely difficult algorithmic challenge. In this work we consider an abstraction of the inspection planning problem which we term Graph Inspection. We give two exact algorithms for this problem, using dynamic programming and integer linear programming. We analyze the performance of these methods, and present multiple approaches to achieve scalability. We demonstrate significant improvement both in path weight and inspection coverage over a state-of-the-art approach on two robotics tasks in simulation, a bridge inspection task by a UAV and a surgical inspection task using a medical robot.

Reward Learning from Suboptimal Demonstrations with Applications in Surgical Electrocautery

Automating robotic surgery via learning from demonstration (LfD) techniques is extremely challenging. This is because surgical tasks often involve sequential decision-making processes with complex interactions of physical objects and have low tolerance for mistakes. Prior works assume that all demonstrations are fully observable and optimal, which might not be practical in the real world. This paper introduces a sample-efficient method that learns a robust reward function from a limited amount of ranked suboptimal demonstrations consisting of partial-view point cloud observations. The method then learns a policy by optimizing the learned reward function using reinforcement learning (RL). We show that using a learned reward function to obtain a policy is more robust than pure imitation learning. We apply our approach on a physical surgical electrocautery task and demonstrate that our method can perform well even when the provided demonstrations are suboptimal and the observations are high-dimensional point clouds.

Modeling Kinematic Uncertainty of Tendon-Driven Continuum Robots via Mixture Density Networks

Tendon-driven continuum robot kinematic models are frequently computationally expensive, inaccurate due to unmodeled effects, or both. In particular, unmodeled effects produce uncertainties that arise during the robot's operation that lead to variability in the resulting geometry. We propose a novel solution to these issues through the development of a Gaussian mixture kinematic model. We train a mixture density network to output a Gaussian mixture model representation of the robot geometry given the current tendon displacements. This model computes a probability distribution that is more representative of the true distribution of geometries at a given configuration than a model that outputs a single geometry, while also reducing the computation time. We demonstrate one use of this model through a trajectory optimization method that explicitly reasons about the workspace uncertainty to minimize the probability of collision.

Accounting for Hysteresis in the Forward Kinematics of Nonlinearly-Routed Tendon-Driven Continuum Robots via a Learned Deep Decoder Network

Tendon-driven continuum robots have been gaining popularity in medical applications due to their ability to curve around complex anatomical structures, potentially reducing the invasiveness of surgery. However, accurate modeling is required to plan and control the movements of these flexible robots. Physics-based models have limitations due to unmodeled effects, leading to mismatches between model prediction and actual robot shape. Recently proposed learning-based methods have been shown to overcome some of these limitations but do not account for hysteresis, a significant source of error for these robots. To overcome these challenges, we propose a novel deep decoder neural network that predicts the complete shape of tendon-driven robots using point clouds as the shape representation, conditioned on prior configurations to account for hysteresis. We evaluate our method on a physical tendon-driven robot and show that our network model accurately predicts the robot's shape, significantly outperforming a state-of-the-art physics-based model and a learning-based model that does not account for hysteresis.

General-purpose foundation models for increased autonomy in robot-assisted surgery

The dominant paradigm for end-to-end robot learning focuses on optimizing task-specific objectives that solve a single robotic problem such as picking up an object or reaching a target position. However, recent work on high-capacity models in robotics has shown promise toward being trained on large collections of diverse and task-agnostic datasets of video demonstrations. These models have shown impressive levels of generalization to unseen circumstances, especially as the amount of data and the model complexity scale. Surgical robot systems that learn from data have struggled to advance as quickly as other fields of robot learning for a few reasons: (1) there is a lack of existing large-scale open-source data to train models, (2) it is challenging to model the soft-body deformations that these robots work with during surgery because simulation cannot match the physical and visual complexity of biological tissue, and (3) surgical robots risk harming patients when tested in clinical trials and require more extensive safety measures. This perspective article aims to provide a path toward increasing robot autonomy in robot-assisted surgery through the development of a multi-modal, multi-task, vision-language-action model for surgical robots. Ultimately, we argue that surgical robots are uniquely positioned to benefit from general-purpose models and provide three guiding actions toward increased autonomy in robot-assisted surgery.

DefGoalNet: Contextual Goal Learning from Demonstrations For Deformable Object Manipulation

Shape servoing, a robotic task dedicated to controlling objects to desired goal shapes, is a promising approach to deformable object manipulation. An issue arises, however, with the reliance on the specification of a goal shape. This goal has been obtained either by a laborious domain knowledge engineering process or by manually manipulating the object into the desired shape and capturing the goal shape at that specific moment, both of which are impractical in various robotic applications. In this paper, we solve this problem by developing a novel neural network DefGoalNet, which learns deformable object goal shapes directly from a small number of human demonstrations. We demonstrate our method's effectiveness on various robotic tasks, both in simulation and on a physical robot. Notably, in the surgical retraction task, even when trained with as few as 10 demonstrations, our method achieves a median success percentage of nearly 90%. These results mark a substantial advancement in enabling shape servoing methods to bring deformable object manipulation closer to practical, real-world applications.

Efficient and Accurate Mapping of Subsurface Anatomy via Online Trajectory Optimization for Robot Assisted Surgery

Robotic surgical subtask automation has the potential to reduce the per-patient workload of human surgeons. There are a variety of surgical subtasks that require geometric information of subsurface anatomy, such as the location of tumors, which necessitates accurate and efficient surgical sensing. In this work, we propose an automated sensing method that maps 3D subsurface anatomy to provide such geometric knowledge. We model the anatomy via a Bayesian Hilbert map-based probabilistic 3D occupancy map. Using the 3D occupancy map, we plan sensing paths on the surface of the anatomy via a graph search algorithm, $A^*$ search, with a cost function that enables the trajectories generated to balance between exploration of unsensed regions and refining the existing probabilistic understanding. We demonstrate the performance of our proposed method by comparing it against 3 different methods in several anatomical environments including a real-life CT scan dataset. The experimental results show that our method efficiently detects relevant subsurface anatomy with shorter trajectories than the comparison methods, and the resulting occupancy map achieves high accuracy.

DeformerNet: Learning Bimanual Manipulation of 3D Deformable Objects

Applications in fields ranging from home care to warehouse fulfillment to surgical assistance require robots to reliably manipulate the shape of 3D deformable objects. Analytic models of elastic, 3D deformable objects require numerous parameters to describe the potentially infinite degrees of freedom present in determining the object's shape. Previous attempts at performing 3D shape control rely on hand-crafted features to represent the object shape and require training of object-specific control models. We overcome these issues through the use of our novel DeformerNet neural network architecture, which operates on a partial-view point cloud of the manipulated object and a point cloud of the goal shape to learn a low-dimensional representation of the object shape. This shape embedding enables the robot to learn a visual servo controller that computes the desired robot end-effector action to iteratively deform the object toward the target shape. We demonstrate both in simulation and on a physical robot that DeformerNet reliably generalizes to object shapes and material stiffness not seen during training. Crucially, using DeformerNet, the robot successfully accomplishes three surgical sub-tasks: retraction (moving tissue aside to access a site underneath it), tissue wrapping (a sub-task in procedures like aortic stent placements), and connecting two tubular pieces of tissue (a sub-task in anastomosis).

Toward a Millimeter-Scale Tendon-Driven Continuum Wrist with Integrated Gripper for Microsurgical Applications

Microsurgery is a particularly impactful yet challenging form of surgery. Robot assisted microsurgery has the potential to improve surgical dexterity and enable precise operation on such small scales in ways not previously possible. Intraocular microsurgery is a particularly challenging domain in part due to the lack of dexterity that is achievable with rigid instruments inserted through the eye. In this work, we present a new design for a millimeter-scale, dexterous wrist intended for microsurgery applications. The wrist is created via a state-of-the-art two-photon-polymerization (2PP) microfabrication technique, enabling the wrist to be constructed of flexible material with complex internal geometries and critical features at the micron-scale. The wrist features a square cross section with side length of 1.25 mm and total length of 3.75 mm. The wrist has three tendons routed down its length which, when actuated by small-scale linear actuators, enable bending in any plane. We present an integrated gripper actuated by a fourth tendon routed down the center of the robot. We evaluate the wrist and gripper by characterizing its bend-angle. We achieve more than 90 degrees bending in both axes. We demonstrate out of plane bending as well as the robot's ability to grip while actuated. Our integrated gripper/tendon-driven continuum robot design and meso-scale assembly techniques have the potential to enable small-scale wrists with more dexterity than has been previously demonstrated. Such a wrist could improve surgeon capabilities during teleoperation with the potential to improve patient outcomes in a variety of surgical applications, including intraocular surgery.