Manual, Joystick, or Haptic Control? An In Vitro Comparison of Navigation Strategies for Robotic Interventional Neuroradiology Procedures

Input devices for robotic microsurgery are frequently described as preserving the surgeon's trained technique, but the claim is rarely measured. We compared manual and teleoperated intraocular instrument motion with the trocar constraint, the instrument, the eye model and the tracking source common to both conditions, so that the control interface was the only factor varied. Prior comparisons cannot hold the instrument fixed, because a robotic instrument is not the tool used manually. Sixteen participants performed a navigation task on a commercial ophthalmic simulator by hand and through a three-degree-of-freedom input device commanding a five-joint robot. Task outcome was equal but at ceiling: every participant acquired all five targets under both interfaces with no retinal or lens injury. Execution differed on every measure. Teleoperated trials took three times as long at a quarter of the median speed, covered less than half the angular working range, and were broken into 3.5 times as many separate movements. Completion time and movement fragmentation improved substantially across four trials of practice and had not plateaued; the measures set by the configured rate ceiling and joint limit changed the least. Finger activity doubled and pinch variability tripled, so reducing instrument degrees of freedom redistributed manual effort rather than reducing it. The interface preserves the outcome and reshapes the execution.

Robot-assisted endovascular intervention can potentially reduce radiation exposure, improve surgeon ergonomics, enable telesurgery, support active assistance and autonomy, and enhance procedural precision. However, existing systems often suffer from limited procedural coverage because constrained patient-side setups, restricted flexibility, and complex instrument exchange hinder clinical workflow integration. This work presents a compact robotic system for endovascular interventions that enables continuous translational and rotational manipulation of standard endovascular instruments. The system consists of two alternating carts with pneumatically actuated membrane grippers integrated into rotating gripper gears. Its top-loading design allows rapid exchange of instruments such as guidewires and catheters without changing the robotic setup. A leader-follower control strategy enables continuous motion despite the finite stroke of each cart. The system was evaluated in motion-tracking experiments with guidewires and catheters and in an in vitro vascular phantom. The motion-tracking experiments showed generally smooth translational and rotational motion profiles. Across all tested guidewire and catheter experiments, the mean relative tracking errors were 3.6% for translational motion and 4.1% for rotational motion. In the vascular phantom, robot-assisted navigation reached the target in most trials, demonstrating the feasibility of the proposed manipulation concept under in vitro conditions. The presented robotic system demonstrates technical feasibility for continuous manipulation of standard endovascular instruments in bench-top and in vitro experiments. The compact top-loading design may ease instrument exchange and clinical workflow integration. Future work will focus on improving gripping performance, actuation speed, force feedback, and evaluation in more clinically realistic settings.

Intuitive teleoperation interfaces are crucial for the safe and effective operation of robotic manipulators in challenging environments. In the nuclear industry, surface contact tasks such as swab sampling require precise path and force tracking, obstacle avoidance, and sustained operator attention, which conventional joystick interfaces struggle to support effectively. This study designs and evaluates a novel touchscreen teleoperation interface that maps continuous finger movements directly to robotic manipulator motions, provides finer velocity control, and integrates control with visualization, enabling more natural, precise, and intuitive surface interaction than conventional controllers. A comparative user study with 20 participants evaluated task performance and workload using the proposed touchscreen, a conventional joystick, and a single-click autonomous mode. Tasks simulated realistic surface manipulation using a Franka Emika Panda arm, remotely controlled from another country. Kinematic, physiological, and behavioral data were recorded to comprehensively assess task performance, cognitive load, and operator trust across each control condition. Participants completed teleoperation tasks more efficiently and accurately with the touchscreen interface, achieving a 53.5% reduction in completion time (median: 2.50 vs. 5.38 min), higher in-area coverage on the sinusoidal path (90.7% vs. 84.1%), and lower overshoot on both path geometries compared with the joystick. Cognitive load, quantified via NASA-TLX (0-100), decreased from joystick to touchscreen (mean TLX 52 to 43; -9 points, -17.3%) and was lowest under the autonomous one-click mode (31; -21 points vs. joystick, -40.4%; -12 vs. touchscreen, -27.9%). This research presents an easy-to-implement touchscreen interface that improves performance in teleoperated surface tasks while reducing cognitive load.