Percutaneous nephrolithotomy is a procedure used to treat patients with large or irregularly shaped kidney stones. Surgical instruments are inserted through a small incision to access the kidney and remove the calculi. Surgeons who have less experience with the procedure manifest significantly higher rates of complications due to the procedure’s steep learning curve. This issue is further exacerbated by a lack of training opportunities in clinical settings. This paper introduces a teleoperative framework that can provide training to surgeons as well as assistance during procedures, based on two main components. Firstly, a type of constrained inverse kinematics that decouples the tooltip position from its orientation using a remote centre of motion, and incorporates the joint limits analytically. This reduces the workload of the procedure by having the surgeon control only the tooltip position rather than the position and the orientation while preventing the inverse kinematics from returning joint angles outside of the robot’s abilities. This kinematic framework also allows a three-degrees-of-freedom haptic device to control a six-degrees-of-freedom manipulator. Secondly, haptic feedback is provided to help guide and teach the surgeon during the procedure. Haptic feedback allows the surgeon to remain in full control during the procedure while still receiving haptic cues and assistance.

Experimental results indicate that the haptic cues improved user’s accuracy, and they had shorter and smoother paths. This leads to a shorter procedure time overall. The results also indicate that the haptic assistance helped teach users the ideal trajectory of the procedure and that users who were taught with haptic feedback performed better than those who never experienced any haptic feedback.

经皮肾镜取石术是一种用于治疗肾结石较大或形状不规则的患者的方法。手术器械通过一个小切口插入，以进入肾脏并清除结石。手术经验较少的外科医生由于其陡峭的学习曲线而显示出明显更高的并发症发生率。在临床环境中缺乏培训机会进一步加剧了这个问题。本文介绍了一个远程手术框架，该框架可以基于两个主要方面为外科医师提供培训以及在手术过程中提供帮助。首先，一种受约束的逆运动学，它使用远程运动中心将刀尖位置从其方向上解耦出来，并分析性地结合了关节极限。通过让外科医生仅控制工具提示位置而不控制位置和方向，从而减少了手术的工作量，同时防止反向运动学使关节角度返回机器人的能力范围之外。这种运动学框架还允许三自由度的触觉设备控制六自由度的操纵器。其次，在手术过程中提供触觉反馈以帮助指导和教导外科医生。触觉反馈使外科医生可以在手术过程中保持完全控制，同时仍能获得触觉提示和帮助。这种运动学框架还允许三自由度的触觉设备控制六自由度的操纵器。其次，在手术过程中提供触觉反馈以帮助指导和教导外科医生。触觉反馈使外科医生可以在手术过程中保持完全控制，同时仍能获得触觉提示和帮助。这种运动学框架还允许三自由度的触觉设备控制六自由度的操纵器。其次，在手术过程中提供触觉反馈以帮助指导和教导外科医生。触觉反馈使外科医生可以在手术过程中保持完全控制，同时仍能获得触觉提示和帮助。

实验结果表明，触觉提示提高了用户的准确性，并且触觉提示的路径更短且更平滑。这总体上缩短了手术时间。结果还表明，触觉辅助功能可以帮助用户教会程序的理想轨迹，并且受过触觉反馈教育的用户的表现要好于从未经历过任何触觉反馈的用户。