Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. Unfortunately, there are disadvantages due to the reduced dexterity, workspace, and sensory input to the surgeon which is only available through a single video image.

In this joint project between the Robotics and Intelligent Machines Laboratory of the University of California, Berkeley (UCB) and the Department of Surgery of the University of California San Francisco (UCSF), a robotic telesurgical workstation for laparoscopy is developed. Our Robotic Telesurgical Workstation for Laparoscopy is a bimanual system with two 6 DOF manipulators instrumented with grippers, controlled by a pair of 6 DOF master manipulators.

With the telesurgical workstation, the conventional surgical tools are replaced with robotic instruments which are under direct control of the surgeon through teleoperation. The goal is to restore the manipulation and sensation capabilities of the surgeon which were lost due to minimally invasive surgery. A 6 DOF slave manipulator, controlled through a spatially consistent and intuitive master, will restore the dexterity, the force feedback to the master will increase the fidelity of the manipulation, and the tactile feedback will restore the lost tactile sensation.

For more information please visit our Robotic Telesurgical Workstation for Laparoscopy page.

Our Second Generation Robotic Telesurgical System for Laparoscopy during tests in the Experimental Surgery Lab at UC San Francisco

Close-up View of the Laparoscopic Manipulators while Tying Knots in a Laparoscopic Training Box

Current needle holders, graspers, and other surgical tools for minimally invasive surgery transmit surgeon's hand motions by passive mechanics. As the instruments slide, twist, and pivot through the point at which they enter the body wall, they are four-degree-of-freedom manipulators. Consequently, the surgeon can reach points within a three-dimensional volume but cannot fully control orientation. For simple tasks this is not a major hindrance, but it makes complex skills such as suturing and knot tying extremely difficult. Also, the instrument handles are anchored with respect to the patient and it is difficult for the surgeon to align the video display to the camera and instrument axes, resulting in misleading perspective cues. To address these difficulties, we are designing multi-degree-of-freedom end effectors with an appropriate surgeon-machine interface to build laparoscopic manipulators that are more versatile and dextrous.

For more information please visit our Robotic Telesurgical Workstation for Laparoscopy page.

Laparoscopic Manipulator with a Roll-Pitch-Roll Wrist and a Gripper

Tendon Driven Multifingered Manipulator for Laparoscopy

The second application of this project is to develop a virtual reality simulator for minimally invasive surgery. Learning laparoscopic techniques is much more difficult for surgeons than learning open surgery procedures. Currently, surgeons are trained during actual operations or in the animal laboratory. Training in the operating room increases risk to the patient and slows the operation, resulting in greater cost. Animal training is expensive and cannot duplicate human anatomy. Computer-based training has many potential advantages. It is interactive, yet an instructor's presence is not necessary, so students may practice in their free moments. Any pathology or anatomical variation can be created. Simulated positions and forces can be recorded to compare with established performance metrics for assessment and credentialing. Students could also try different techniques and look at anatomy from perspectives that would be impossible during surgery.

In the context of this application, we are developing real-time finite element models for soft tissue behavior. We will incorporate these models in the VR simulations to generate a realistic environment for training. The visual and haptic displays developed in this project will be used as the human interface for high fidelity feedback.

You can refer to our Virtual Environments for Surgical Training and Augmentation (VESTA) page, the home page of the OPTICAL project, and the home pages of the virtual reality and computer animation classes taught at UC Berkeley, for related information.

Laparoscopic Interface

Laparoscopic Cholecystectomy Simulator

The objective of this effort is to study organ level modeling and simulation for surgical applications. The point to the proposed research is to explore the feasibility of developing open source, open architecture models of different levels of granularity and spatio-temporal scale for a project that has been labeled the Digital Human project. While the emphasis on this program will be on how the simulations that we develop will allow for the interconnections between individual organ simulations, and between different types of physical processes within a given organ, we will develop our tools on a specific test bed application: the construction of a heart model for simulation of heart surgery.

Please visit Berkeley Open Surgical Simulator Project page for more information.