A novel microwave tool for robotic liver resection in minimally invasive surgery.

INTRODUCTION: During the last two decades, many surgical procedures have evolved from open surgery to minimally invasive surgery (MIS). This limited invasiveness has motivated the development of robotic assistance platforms to obtain better surgical outcomes. Nowadays, the da Vinci robot is a commercial tele-robotic platform widely used for different surgical applications. MATERIAL AND METHODS: In this work, the da Vinci Research Kit (dVRK), namely the research version of the da Vinci, is used to manipulate a novel microwave device in a teleoperation scenario. The dVRK provides an open source platform, so that the novel microwave tool, dedicated to prevention bleeding during hepatic resection surgery, is mechanically integrated on the slave side, while the software interface is adapted in order to correctly control tool pose. Tool integration is validated through in-vitro and ex-vivo tests performed by expert surgeons, meanwhile the coagulative efficacy of the developed tool in a perfused liver model was proved in in-vivo tests. RESULTS AND CONCLUSIONS: An innovative microwave tool for liver robotic resection has been realized and integrated into a surgical robot. The tool can be easily operated through the dVRK without limiting the intuitive and friendly use, and thus easily reaching the hemostasis of vessels.

Haptic feedback in the da Vinci Research Kit (dVRK): A user study based on grasping, palpation, and incision tasks.

BACKGROUND: It was suggested that the lack of haptic feedback, formerly considered a limitation for the da Vinci robotic system, does not affect robotic surgeons because of training and compensation based on visual feedback. However, conclusive studies are still missing, and the interest in force reflection is rising again. METHODS: We integrated a seven-DoF master into the da Vinci Research Kit. We designed tissue grasping, palpation, and incision tasks with robotic surgeons, to be performed by three groups of users (expert surgeons, medical residents, and nonsurgeons, five users/group), either with or without haptic feedback. Task-specific quantitative metrics and a questionnaire were used for assessment. RESULTS: Force reflection made a statistically significant difference for both palpation (improved inclusion detection rate) and incision (decreased tissue damage). CONCLUSIONS: Haptic feedback can improve key surgical outcomes for tasks requiring a pronounced cognitive burden for the surgeon, to be possibly negotiated with longer completion times.