EMG-Based Adaptation of Anisotropic Virtual Fixtures for Robot-Assisted Surgical Resection and Dissection
Authors: Dario Onfiani, Michael Dyck, Luigi Biagiotti, Julian Klodmann
Abstract
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.
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.
Computational attention models could help surgeons manage the visual demands of laparoscopy, but they require dense spatial labels that are difficult to obtain because surgical intent is highly specialized and tacit. Here, we introduce DiffeoAfford, an action-grounded tissue affordance framework that retrospectively derives visual attention supervision from completed surgical procedures. By combining diffeomorphism-constrained tissue tracking with instrument trajectory analysis, DiffeoAfford generates affordance hotspot labels without manual per-frame annotation. A real-time prediction model trained on these labels anticipates relevant surgical regions and enables AffordView, an assistive auto-framing system for laparoscopic visualization. The proposed framework aligns with expert annotations and intraoperative surgeon gaze, and reduces surgeon cognitive workload during real-world evaluations using subjective, physiological, and behavioral measures.
Robotic-assisted surgery offers significant clinical advantages but largely eliminates direct haptic feedback, increasing the risk of excessive tool-tissue interaction forces. Although recent commercial systems have begun to introduce force feedback, their high cost limits accessibility, particularly for surgical training. This paper presents a modular experimental robotic laparoscopic instrument integrated with a real-time haptic feedback framework. The proposed instrument employs a wrist-mounted force/torque (F/T) sensor to estimate tool-tissue interaction forces while avoiding the durability and integration challenges of tip-mounted sensors. A haptic feedback framework is developed to extract the external contact forces, render them to the haptic device, and generate stable and perceptually meaningful feedback. The instrument is integrated into the robotic surgery training system (RoboScope) and evaluated through a controlled user study involving a force regulation task. Experimental results demonstrate that haptic feedback significantly improves task success rate, force regulation accuracy, and task efficiency compared to visual-only feedback. The proposed instrument enables stable, high-fidelity haptic interaction, supporting effective robotic surgery training.