Automation of retinal surgery: A shared control robotic system for laser ablation

Abstract

Automation in medical robotics has been a subject of contention in recent years, with the medical industry wary of adopting fully autonomous surgical systems. Without a consensus on the appropriate amount of automation, the surgeon should decide how best to utilize the system. Hence, this paper reports the design and development of a robotic system, capable of varying levels of automation, from a fully autonomous plan execution to shared or manual control. In this work, we focus primarily on shared control to improve the efficiency and effectiveness of laser retinal surgery. By allocating most of the information processing to the robotic system, the surgeon collaborates closely with the robotic system during execution of the surgical plan, reducing the risk of damage to the fovea and ablation of healthy retinal tissue, and improving surgical outcome. In our solution, the joystick of the laser machine with which the clinician uses to align the laser to target a specific pathology is held onto by both the clinician as well as by the robot. The non-permanent robotic attachment tracks the operator's motion and provides haptic cues to guide the operator's positioning of the laser beam based on the input surgical plan. A prototype system with algorithms for haptic feedback is described and was implemented. Experiments were performed to determine the feasibility of this shared control robotic system for retinal surgery.