MEDiC: Autonomous Surgical Robotic Assistance to Maximizing Exposure for Dissection and Cautery

Surgical automation has the capability to improve the consistency of patient outcomes and broaden access to advanced surgical care in underprivileged communities. Shared autonomy, where the robot automates routine subtasks while the surgeon retains partial teleoperative control, offers great potential to make an impact. In this paper we focus on one important skill within surgical shared autonomy: Automating robotic assistance to maximize visual exposure and apply tissue tension for dissection and cautery. Ensuring consistent exposure to visualize the surgical site is crucial for both efficiency and patient safety. However, achieving this is highly challenging due to the complexities of manipulating deformable volumetric tissues that are prevalent in surgery.To address these challenges we propose \methodname, a framework for autonomous surgical robotic assistance to \methodfullname. We integrate a differentiable physics model with perceptual feedback to achieve our two key objectives: 1) Maximizing tissue exposure and applying tension for a specified dissection site through visual-servoing conrol and 2) Selecting optimal control positions for a dissection target based on deformable Jacobian analysis. We quantitatively assess our method through repeated real robot experiments on a tissue phantom, and showcase its capabilities through dissection experiments using shared autonomy on real animal tissue.

JIGGLE: An Active Sensing Framework for Boundary Parameters Estimation in Deformable Surgical Environments

Surgical automation can improve the accessibility and consistency of life saving procedures. Most surgeries require separating layers of tissue to access the surgical site, and suturing to reattach incisions. These tasks involve deformable manipulation to safely identify and alter tissue attachment (boundary) topology. Due to poor visual acuity and frequent occlusions, surgeons tend to carefully manipulate the tissue in ways that enable inference of the tissue's attachment points without causing unsafe tearing. In a similar fashion, we propose JIGGLE, a framework for estimation and interactive sensing of unknown boundary parameters in deformable surgical environments. This framework has two key components: (1) a probabilistic estimation to identify the current attachment points, achieved by integrating a differentiable soft-body simulator with an extended Kalman filter (EKF), and (2) an optimization-based active control pipeline that generates actions to maximize information gain of the tissue attachments, while simultaneously minimizing safety costs. The robustness of our estimation approach is demonstrated through experiments with real animal tissue, where we infer sutured attachment points using stereo endoscope observations. We also demonstrate the capabilities of our method in handling complex topological changes such as cutting and suturing.