This article presents an overview of the current state of research and application of haptic (primarily kinesthetic) feedback and force-based teleoperation in the context of surgical robotics. Telerobotic surgery provides an approach for transferring the sensorimotor skills of a surgeon through a robotic platform to perform surgical intervention inside a patient’s body. Integration of advanced sensing and haptic technologies in telerobotic surgery can help to enhance the sensory awareness and motor accuracy of the surgeon, thereby leading to improved surgical procedures and outcomes for patients. The primary mode of sensory feedback has been through 3-D visual observation using stereo endoscopes. However, until recently, the sense of touch, i.e., haptics, has been missing in the commercial telesurgery robots approved for use in the operating room despite over two decades of research and development in the field of haptics for teleoperated systems (“telehaptics”). Research has shown that high-fidelity force feedback can enhance the performance of telesurgery and potential outcomes by enabling the surgeon to have a more natural feel of interaction between surgical tools and tissue as normally experienced during open surgery. Interaction forces, such as those generated during palpation of tissue, insertion of a needle, unintentional (and potentially unsafe) exertion of force by a tool, suture breakage, needle slippage, or tool interaction, are replaced by indirect (virtual) sensations, termed visual haptics, which provides an alternative to sensory compensation. Although there is a significant amount of literature supporting this benefit, there are still several important technical challenges in introducing haptics in telesurgery, including instrumentation, fidelity (transparency), stability, and modalities for force reflection, e.g., direct or indirect. This article examines these challenges and discusses recent work on haptics-based teleoperated surgical robotic systems.

中文翻译：

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手术机器人中的触觉反馈和基于力的远程操作


本文概述了手术机器人背景下触觉（主要是动觉）反馈和基于力的远程操作的研究和应用的现状。远程机器人手术提供了一种通过机器人平台转移外科医生的感觉运动技能以在患者体内进行手术干预的方法。在远程机器人手术中集成先进的传感和触觉技术有助于提高外科医生的感觉意识和运动准确性，从而改善患者的手术过程和结果。感觉反馈的主要模式是通过使用立体内窥镜进行 3D 视觉观察。然而，直到最近，尽管远程操作系统触觉领域（“远程触觉”）已经进行了二十多年的研究和开发，但批准在手术室使用的商业远程手术机器人中一直缺少触觉（即触觉）。 。研究表明，高保真力反馈可以增强远程手术的性能和潜在的结果，使外科医生能够像开放手术期间通常经历的那样，在手术工具和组织之间有更自然的相互作用感觉。相互作用力，例如在触诊组织、插入针、工具无意（且可能不安全）用力、缝线断裂、针滑移或工具相互作用过程中产生的相互作用力，被间接（虚拟）感觉所取代，称为视觉触觉，提供了感觉补偿的替代方案。 尽管有大量文献支持这一益处，但在远程手术中引入触觉仍然存在几个重要的技术挑战，包括仪器、保真度（透明度）、稳定性和力反射模式（例如直接或间接）。本文探讨了这些挑战，并讨论了基于触觉的遥控手术机器人系统的最新工作。