A Digital Twin for Telesurgery under Intermittent Communication

Telesurgery is an effective way to deliver service from expert surgeons to areas without immediate access to specialized resources. However, many of these areas, such as rural districts or battlefields, might be subject to different problems in communication, especially latency and intermittent periods of communication outage. This challenge motivates the use of a digital twin for the surgical system, where a simulation would mirror the robot hardware and surgical environment in the real world. The surgeon would then be able to interact with the digital twin during communication outage, followed by a recovery strategy on the real robot upon reestablishing communication. This paper builds the digital twin for the da Vinci surgical robot, with a buffering and replay strategy that reduces the mean task completion time by 23% when compared to the baseline, for a peg transfer task subject to intermittent communication outage.

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

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.

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.

An Effectiveness Study Across Baseline and Neural Network-based Force Estimation Methods on the da Vinci Research Kit Si System

In this study, we further investigate the robustness and generalization ability of an neural network (NN) based force estimation method, using the da Vinci Research Kit Si (dVRK-Si). To evaluate our method's performance, we compare the force estimation accuracy with several baseline methods. We conduct comparative studies between the dVRK classic and dVRK-Si systems to benchmark the effectiveness of these approaches. We conclude that the NN-based method provides comparable force estimation accuracy across the two systems, as the average root mean square error (RMSE) over the average range of force ratio is approximately 3.07% for the dVRK classic, and 5.27% for the dVRK-Si. On the dVRK-Si, the force estimation RMSEs for all the baseline methods are 2 to 4 times larger than the NN-based method in all directions. One possible reason is, we made assumptions in the baseline methods that static forces remain the same or dynamics is time-invariant. These assumptions may hold for the dVRK Classic, as it has pre-loaded weight and maintains horizontal self balance. Since the dVRK-Si configuration does not have this property, assumptions do not hold anymore, therefore the NN-based method significantly outperforms.

Real-time Surgical Instrument Segmentation in Video Using Point Tracking and Segment Anything

The Segment Anything Model (SAM) is a powerful vision foundation model that is revolutionizing the traditional paradigm of segmentation. Despite this, a reliance on prompting each frame and large computational cost limit its usage in robotically assisted surgery. Applications, such as augmented reality guidance, require little user intervention along with efficient inference to be usable clinically. In this study, we address these limitations by adopting lightweight SAM variants to meet the speed requirement and employing fine-tuning techniques to enhance their generalization in surgical scenes. Recent advancements in Tracking Any Point (TAP) have shown promising results in both accuracy and efficiency, particularly when points are occluded or leave the field of view. Inspired by this progress, we present a novel framework that combines an online point tracker with a lightweight SAM model that is fine-tuned for surgical instrument segmentation. Sparse points within the region of interest are tracked and used to prompt SAM throughout the video sequence, providing temporal consistency. The quantitative results surpass the state-of-the-art semi-supervised video object segmentation method on the EndoVis 2015 dataset, with an over 25 FPS inference speed running on a single GeForce RTX 4060 GPU.

Suturing Tasks Automation Based on Skills Learned From Demonstrations: A Simulation Study

In this work, we develop an open-source surgical simulation environment that includes a realistic model obtained by MRI-scanning a physical phantom, for the purpose of training and evaluating a Learning from Demonstration (LfD) algorithm for autonomous suturing. The LfD algorithm utilizes Dynamic Movement Primitives (DMP) and Locally Weighted Regression (LWR), but focuses on the needle trajectory, rather than the instruments, to obtain better generality with respect to needle grasps. We conduct a user study to collect multiple suturing demonstrations and perform a comprehensive analysis of the ability of the LfD algorithm to generalize from a demonstration at one location in one phantom to different locations in the same phantom and to a different phantom. Our results indicate good generalization, on the order of 91.5%, when learning from more experienced subjects, indicating the need to integrate skill assessment in the future.

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.

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.