Automatic Tissue Traction with Haptics-Enabled Forceps for Minimally Invasive Surgery

A common limitation of autonomous tissue manipulation in robotic minimally invasive surgery (MIS) is the absence of force sensing and control at the tool level. Recently, our team has developed haptics-enabled forceps that can simultaneously measure the grasping and pulling forces during tissue manipulation. Based on this design, here we further present a method to automate tissue traction with controlled grasping and pulling forces. Specifically, the grasping stage relies on a controlled grasping force, while the pulling stage is under the guidance of a controlled pulling force. Notably, during the pulling process, the simultaneous control of both grasping and pulling forces is also enabled for more precise tissue traction, achieved through force decoupling. The force controller is built upon a static model of tissue manipulation, considering the interaction between the haptics-enabled forceps and soft tissue. The efficacy of this force control approach is validated through a series of experiments comparing targeted, estimated, and actual reference forces. To verify the feasibility of the proposed method in surgical applications, various tissue resections are conducted on ex vivo tissues employing a dual-arm robotic setup. Finally, we discuss the benefits of multi-force control in tissue traction, evidenced through comparative analyses of various ex vivo tissue resections. The results affirm the feasibility of implementing automatic tissue traction using micro-sized forceps with multi-force control, suggesting its potential to promote autonomous MIS. A video demonstrating the experiments can be found at https://youtu.be/8fe8o8IFrjE.