The Endo[PA]R system for minimally invasive robotic surgery

Minimally invasive robotic surgery systems has entered daily practice in dedicated clinical centers. Especially heart surgery profits from this new technique, due to a higher accuracy compared to conventional endoscopic interventions. Nevertheless some drawbacks have restricted a broader acceptance of these devices. The most urgent issues are lack of haptic feedback and prolonged operation time. Our research project tackles both topics, on the one hand by adding high fidelity force-feedback, on the other hand by automating recurrent manipulation tasks. These features have been integrated into the Endo[PA]R (endoscopic partially-autonomous robot) system, an open evaluation platform for robotic surgery. The setup comprises two low-payload robots equipped with sensorized surgical instruments and a third robot carrying a stereo camera system. Trocar kinematics, enabling surgical manipulation through small incisions, has been implemented for all robotic arms. In order to ensure operation close to reality, a thorax and heart phantom for surgical training was used in the experiments. Stereo vision is provided via a head-mounted display and force-reflective input devices are employed for user interaction. The system was evaluated by surgeons and it was capable of performing autonomous knot-tying.