Design and Evaluation of a Novel Haptic Interface for Endoscopic Simulation

Inspection of the colon with an endoscope for early signs of cancer (colonoscopy) has become an extremely widespread procedure, since early treatment radically improves the outlook of patients. The procedure requires a close coordination between the sense of touch and vision to navigate the endoscope along the colon. This raises the need to develop efficient training methods for physicians. Training simulators based on virtual reality, where realistic graphics are combined with a mechatronic system providing haptic feedback, are alternative to traditional training methods. To provide physicians with realistic haptic sensations of an endoscopic procedure, we have designed a haptic interface, instrumented a clinical endoscope and combined them with a simulation software for colonoscopy. In this contribution, we present the mechatronic components of the simulator. The haptic interface is able to generate high forces using the combination of electrical motors and brakes in a compact design. Experiments were performed to determine the characteristics of the device. A model-based control has been implemented and the results show that the control successfully compensates for the device nonlinearities, such as friction. The proposed haptic interface, together with the virtual reality, form a highly realistic training simulator for endoscopic surgeons, applicable not only to colonoscopy, but also to similar interventions.

Haptic interface design and control with application to surgery simulation

Ulrich Spälter

This thesis proposes a framework for haptic devices interacting with virtual environments. As application of the theoretical results a haptic device for the surgical training of hysteroscopy, a gynecologic intervention, is presented. Surgery simulators, which can be described as 'flight simulators for surgeons', comprise a virtual reality for modeling and visualization of organs, and the haptic device: While the surgeon interactively follows the scene on the computer screen, he perceives the contact forces at the tool handle of the surgical instrument. The haptic device tracks the position of the surgery tool and transforms the virtual contact forces to real forces, which can be actually felt by the surgeon. This thesis treats haptic devices with application to surgery simulators for minimally-invasive surgery. Haptic interfaces are complex mechatronic systems and show inherent trade-offs between haptic realism and system stability. Human factors play an important role, as the human operator can both stabilize or destabilize the system. The haptic perception, which can vary between individuals, as a criterion for haptic rendering quality is still not formalized. The optimization of haptic interfaces, within focus of research since 15 years ago, has remained a complex task. However, with look at the emerging applications for haptics, it has become an even more important topic. For this reason it is necessary to integrate mechanical design, control design, mechatronic elements and human factors in a unifying approach. This thesis highlights the principal trade-offs of haptic interfaces and works out design guidelines for new developments and quantitative information on where and how to optimize haptic systems. As application example a haptic interface for the simulation of hysteroscopy, a gynecologic intervention on the female uterus, has been realized as prototype. The device takes the characteristics of hysteroscopy into account and introduces features like insertion and complete removal of the surgery tool from the haptic interface. A design methodology is proposed, which combines aspects of theoretical kinematics based on Lie-Groups with integrated product development – a systematic approach for engineering tasks. The result, a novel kinematic design, has been realized as haptic interface prototype. The well-known affine parameterization for all stabilizing controllers is shown to be a well-suited tool for haptic control synthesis. It provides insights into the control trade-offs and allows to integrate human factors at controller design stage. The resulting controller, demonstrated by experimental results, can reduce parasitic effects (friction, device dynamics) close to and below the human perception threshhold, thus making the device transparent within the specified bandwidth and suitable for real-time implementation. For numerical controller representation the δ-operator is discussed. It unifies continuous and discrete time domain and has beneficial numerical properties. As there is still no standardized procedure for technical performance evaluation of haptic interfaces methods proposed in literature are summarized. In the near future a large market for haptic technology can be expected with applications from surgery-assist devices and drive-by-wire interfaces in automobiles to entertainment, which highlights the relevance of the treated topic.

EPFL2006

Experimental Evaluation of a Haptic Interface for Endoscopic Simulation

Hannes Bleuler, Lionel Flaction, Evren Samur

The main goal of virtual reality based surgery simulators with haptic feedback is to provide an alternative to traditional training methods on animals, cadavers or real patients. Haptic feedback is a key feature for every surgery simulator for the training of hand-eye coordination. To address the need for higher fidelity and complexity in an endoscopic simulator, we have designed a new haptic interface, instrumented a clinical endoscope and integrated it with a software simulation for colonoscopy. The proposed haptic interface provides high translational force and rotational torque with combined electrical motors and passive brakes. This paper presents the evaluation of the haptic interface. Experimental analyzes are performed for characterization and performance evaluation. A model-based feed-forward control is implemented and the results show that the control successfully compensates for the device dynamics and nonlinearities such as Coulomb and viscous friction.

2011

Haptic instrumentation for an interventional radiology simulator

Dejan Ilic

Low trauma, reduced costs and fast recovery are only a few factors why minimally invasive surgery (MIS) is taking over classical surgical methods. Interventional Radiology (IR) is a minimally invasive procedure where thin tubular instruments are steered through the patient's vascular system under X-ray imaging. In order to perform these procedures, a radiologist has to be trained to master hand-eye coordination, instrument manipulation and procedure protocols. The importance of training IR procedures rises with the increasing variety and sophistication of the procedures performed using this approach. Apart from the traditional "see one, do one, teach one" model, radiologists have only had few mock devices with limitations in practical use. Training on animals is an alternative, but its use is hindered by high costs and ethical issues. The existing simulation systems all have major drawbacks: the requirement to use modified instruments, high inertia of the haptic feedback that creates a noticeably degraded dynamic behavior, or excessive friction that is not properly compensated. In this thesis we propose a quality training environment dedicated to IR. The system is composed of a virtual reality (VR) simulation of the patients anatomy linked to a robotic interface providing haptic force feedback. This thesis focuses on the requirements, design and prototyping of a specific haptic interface for the manipulation of catheters and guide wires. Translational tracking and force feedback on the catheter are provided by two cylinders forming a friction drive arrangement. The complete friction drive can be set in rotation with an additional motor providing torque feedback. A force and a torque sensor are integrated in the cylinders for direct measurement on the catheter enabling disturbance cancellation with a closed-loop force control strategy. One of the specific requirements during a simulated intervention is to measure the position of the tip of a guide wire inside a catheter. This is a so called "tube in tube" problem. The guide wire is detected at the entrance of the simulator and then grasped by a micro-gripper. Forces and movements of the guidewire moving inside the catheter are then transmitted through a gripper and along a rod to an external unit. This thesis also reports a study of several micro-gripper designs developed and tested on a haptic force feedback interface developed at the LSRO-EPFL. A virtual reality environment has been developed to provide real-time visualisation and force feedback. Several different software routines are integrated in the system. During an IR procedure the tip of an employed instrument interacts with a wall of blood vessels and a repulsive force is transmitted to the user. Force feedback helps radiologist to orient and navigate the inserted instrument in the vessel. This thesis presents a novel method for measurement of internal constraints during an IR procedure. The measurements help to determine the maximum interaction forces between the catheter and the wall of the blood vessel and to observe the shape of dynamic interaction during manipulation. In order to recreate a realistic simulation environment it is necessary to derive the elastic properties and behavior of arteries when contact with an instrument occurs. A novel method for measurement of mechanical properties of blood vessels is proposed in this work. Information derived with this method is also very useful to determine coherent boundary conditions for hemodynamic simulations. Measurements of the modulus of elasticity of an artery are carried out by measuring the deformations due to the inflation of an angioplasty balloon catheter used for IR procedures. A test bench, consisting of an angioplasty balloon, a PVA model and an actuator used to inflate the balloon, is developed for realization of experiments. The pressure-volume curve during the inflation of the balloon is observed. The Young's modulus is derived with an analytical model of the measurement system. The results are then analyzed and compared to existing data from literature.