In various surgical procedures, regions of interest (ROIs) such as organs or lesions are often occluded by overlying tissues, requiring surgeons to achieve adequate exposure for precise intervention. However, the irregular geometry, nonlinear biomechanical properties of overlying tissues, and limited intraoperative visibility of the ROI pose significant challenges to the autonomous execution of tissue retraction. To address this, we formulate a realistic model of the tissue retraction task and propose a learning-based adaptive control framework for achieving ROI exposure. The method optimizes control inputs online by monitoring changes in the visual boundary of the tissue, while leveraging a deep deformation estimation model trained on simulation data to identify the optimal grasping point and ensure the convergence and safety of the adaptive controller. Through simulations and real-world experiments on different deformable materials, it has been demonstrated that this framework exhibits zero-shot adaptation to similar tasks and can complete the autonomous retraction process, from initial grasp selection to full ROI exposure. Therefore, it has the potential to be applied in actual surgical assistance scenarios.
Surgical tissue retraction requires effective manipulation planning under partial and noisy perception. We study state estimation for deformable tissue retraction, where only sparse observations of the tissue surface are available at decision time. We propose a learned state estimator that reconstructs the full deformable mesh state from 40 noisy vertex observations. The estimator combines a multilayer perceptron with a low-dimensional PCA latent representation and is trained using geometry-aware regularization that encourages smooth and physically plausible deformations. We evaluate the approach in a 2D deformable sheet simulation using single-step and multi-step retraction planning. Results show that the learned estimator achieves 98.1% of oracle performance in multi-step retraction while supporting efficient inference. These results demonstrate that learned, geometry-regularized state estimation can support effective deformable manipulation under realistic perception constraints.
Autonomous robotic craniotomy requires continuous regulation of tool-tissue interactions to mitigate mechanical overload and thermal damage while maintaining surgical efficiency. However, this process is inherently partially observable due to unknown, time-varying tissue properties and the inability to directly measure cutting temperatures under physical occlusion. To address these challenges, we propose RL-MACRO, a cybernetic closed-loop intelligence framework that couples multimodal perception, adaptive decision-making, and robotic execution. This framework empowers the surgical robot to autonomously perceive inaccessible states from partial sensory feedback and dynamically optimize its behaviors under uncertain environment. A CNN-LSTM observer first fuses force and sound feedback to reconstruct the hidden temperature state (R^2=0.939, MAE = 1.717 deg C). This reconstructed temperature, alongside multi-sensor features, forms the belief state for an offline Implicit Q-Learning (IQL) policy. A novel dual-head Actor dynamically coordinates the feed rate, spindle speed, and cutting depth to optimize efficiency within strict safety bounds. These decisions are seamlessly translated into spatial motions via online trajectory re-planning and velocity servoing. Experiments on bovine ribs and six ex vivo goat skulls validate the system's robust perception, adaptive recovery from force/temperature excursions, and smooth execution on irregular surfaces, establishing a data-driven cybernetic paradigm for safe and efficient autonomous bone cutting.
In this paper, we address the development of an adaptive assistance system for robot-assisted laparoscopic surgery, specifically for delicate tasks such as Resection and Dissection. Even if Virtual Fixtures offer significant advantages for guiding a surgeon's movements, conventional Virtual Fixtures are often defined by fixed geometries, lacking the flexibility to adapt to the surgical workflow or the surgeon's immediate intent. To address these limitations, we propose a novel framework for an adaptive and anisotropic virtual fixture. In addition, we introduce an intuitive control interface that modulates the fixture's geometry in real-time based on the surgeon's intent, inferred from EMG signals. This approach allows the surgeon to dynamically expand or disengage the constraint by contracting their forearm muscles, enabling seamless transitions between precise guided motion and free repositioning of the tool. Experimental results from a pilot user study, based on a standardized surgical training task, demonstrate the effectiveness of the proposed method. The system showed significant improvements in task accuracy and movement consistency, alongside a reduction in perceived cognitive load, effort, and frustration.