Lack of haptic feedback in teleoperated robot-assisted surgery (RAS) is known to be detrimental in many surgical tasks. While performing a class of force sensitive tasks, surgeons commonly use both hands. Oftentimes, one hand is used to exert tension/compression forces, and the other to hold the suture knot or tissue. A novel control framework to accomplish haptic force feedback for two-handed tasks in teleoperated RAS is presented in this paper. The force applied on the surgical environment by the action hand is not transferred back to the same hand, but rather to the other hand. In two-handed tasks that involve an action and a reaction force, this provides an intuitive way of feeling the action. Because the loop in not closed from the slave back to the master of the same hand, it does not have a destabilizing effect. The technique can be easily implemented using a variable-structure controller that combines two PD controllers and a switch. It has been evaluated with an experimental setup consisting of four haptic devices with promising results.

In this study we evaluated a new method for registering three-dimensional ultrasound (3DUS) data to external coordinate systems. First, 3DUS was registered to the stereo endoscope of a da Vinci Surgical System by placing a registration tool against an air-tissue boundary so that the 3DUS could image ultrasound fiducials while the stereo endoscope could image camera markers on the same tool. The common points were used to solve the registration between the 3DUS and camera coordinate systems. The target registration error (TRE) when imaging through a PVC tissue phantom ranged from 3.85 1.76 mm to 1.82 1.03 mm using one to four registration tool positions. TRE when imaging through an ex-vivo liver tissue sample ranged from 2.36 1.01 mm to 1.51 0.70 mm using one to four registration tool positions. Second, using a similar method, 3DUS was registered to the kinematic coordinate system of a da Vinci Surgical System by using the da Vinci surgical manipulators to identify common points on an air-tissue boundary. TRE when imaging through a PVC tissue phantom was 0.95 0.38 mm. This registration method is simpler and potentially more accurate than methods using commercial motion tracking systems. This method may be useful in the future in augmented reality systems for laparoscopic and robotic-assisted surgery.

Vision-based tracking of tissue is a key component to enable augmented reality during a surgical operation. Conven- tional tracking techniques in computer vision rely on identifying strong edge features or distinctive textures in a well-lit environ- ment; however endoscopic tissue images do not have strong edge features, are poorly lit and exhibit a high degree of specular reflection. Therefore, prior work in achieving densely populated 3D features for describing tissue surface profiles require complex image processing techniques and have been limited in providing stable, long-term tracking or real-time processing. In this paper, we present an integrated framework for ac- curately tracking tissue in surgical stereo-cameras at real-time speeds. We use a combination of the STAR feature detector and Binary Robust Independent Elementary Features to acquire salient features that can be persistently tracked at high frame rates. The features are then used to acquire a densely-populated map of the deformations of tissue surface in 3D. We evaluate the method against popular feature algorithms in in-vivo animal study video sequences, and we also apply the proposed method to human partial nephrectomy video sequences. We extend the salient feature framework to support region tracking in order to maintain the spatial correspondence of a tracked region of tissue or a medical image registration to the surrounding tissue. In-vitro tissue studies show registration accuracies of 1.3-3.3 mm using a rigid-body transformation method.