Retinal surgery is a bimanual operation in which surgeons operate with an instrument in their dominant hand (more capable hand) and simultaneously hold a light pipe (illuminating pipe) with their nondominant hand (less capable hand) to provide illumination inside the eye. Manually holding and adjusting the light pipe places an additional burden on the surgeon and increases the overall complexity of the procedure. To overcome these challenges, a robot-assisted automatic light pipe actuating system is proposed. A customized light pipe with force-sensing capability is mounted at the end effector of a follower robot and is actuated through a hybrid force–velocity controller to automatically illuminate the target area on the retinal surface by pivoting about the scleral port (incision on the sclera). Static following accuracy evaluation and dynamic light tracking experiments are carried out. The results show that the proposed system can successfully illuminate the desired area with negligible offset (the average offset is 2.45 mm with standard deviation of 1.33 mm). The average scleral forces are also below a specified threshold (50 mN). The proposed system not only can allow for increased focus on dominant hand instrument control, but also could be extended to three-arm procedures (two surgical instruments held by surgeon plus a robot-holding light pipe) in retinal surgery, potentially improving surgical efficiency and outcome.

中文翻译：

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用于双手机器人辅助视网膜手术的自动光管驱动系统


视网膜手术是一种双手手术，外科医生用惯用手（能力较强的手）操作器械，同时用非惯用手（能力较弱的手）握住光管（照明管），以在眼睛内部提供照明。手动固定和调整光管给外科医生带来了额外的负担，并增加了手术的整体复杂性。为了克服这些挑战，提出了一种机器人辅助的自动光管驱动系统。具有力感应功能的定制光管安装在跟随机器人的末端执行器上，并通过混合力-速度控制器驱动，通过围绕巩膜端口（巩膜上的切口）旋转，自动照亮视网膜表面的目标区域）。进行了静态跟随精度评估和动态光跟踪实验。结果表明，所提出的系统可以成功照亮所需区域，偏移量可忽略不计（平均偏移量为 2.45 毫米，标准偏差为 1.33 毫米）。平均巩膜力也低于指定阈值 (50 mN)。所提出的系统不仅可以增加对惯用手器械控制的关注，而且可以扩展到视网膜手术中的三臂手术（外科医生持有的两个手术器械加上机器人持有的光管），有可能提高手术效率和结果。