Surgical Master Console Using General-Purpose Robot Arms and a Separable Articulated Distal Interface: Porcine In-Vivo Evaluation
Authors: Minsung Kim, Seonho Shim, Dongho Yee, Younghoon Noh, Juahn Oh, Yechan Seo, Jinseok Lee, Jiyul Lee, +4 more
Organizations: Department of Transdisciplinary Medicine, Seoul National University Hospital, Seoul, Republic of Korea. · Rosota Inc., Seoul, Republic of Korea. · Department of Mechanical Engineering, Seoul National University, Seoul, Republic of Korea. · Department of Mechanical Engineering, Chungang University, Seoul, Republic of Korea. · Department of Computer Science and Engineering, Seoul National University, Seoul, Republic of Korea. · Eulji University College of Medicine, Daejeon, Republic of Korea. · Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. · Interdisciplinary Program in Medical Informatics, Seoul National University College of Medicine. · Institute of Convergence Medicine with Innovative Technology, Seoul National University Hospital, Seoul, Republic of Korea.
High-performance surgical master consoles offer intuitive articulated manipulation but are expensive and difficult to reproduce, while accessible commercial haptic devices lack built-in interfaces for surgical wrist articulation and continuous grasp. We present a laparoscopic master in which general-purpose robot manipulators provide the programmable base and surgical-specific interaction is concentrated in a separable distal adapter. Each 6-DoF arm carries a custom 2-DoF direct-drive wrist, continuous grasp sensing, and clutch-based workspace management; the complete bimanual hardware costs approximately US$5,500, below common bimanual commercial haptic references. To support sustained hand-guided use, we characterize current scaling, gravity, and break-away friction and use them for posture-dependent gravity compensation and motion-gated assistance, reducing continuous actuation and thermal loading. A common master state drives either Isaac Sim or an RCM-constrained dual-FR3 platform. Master-state publication to FR3 target update adds at most 8 ms, and tip tracking shows 0.31-0.66 mm mean delay-aligned residuals. In a porcine cholecystectomy experiment, five common operator-side metrics and hand/tip-speed distributions were compared descriptively with human in-vivo telemetry from 120 clinical Versius recordings of 99 cholecystectomy procedures; no interruption originated from the master console, and no abnormal clinical signs were recorded during the 7-day postoperative observation period. These results demonstrate a surgical master built from general-purpose robot arms with surgical-specific interaction concentrated in a separable distal interface.
Figures & tables
TABLE I: Positioning relative to representative teleoperation approaches.
Fig. 2: System architecture and common endpoint-independent master state. The master console combines a general-purpose 6-DoF robotic leader arm, the custom 2-DoF direct-drive wrist, continuous grasp sensing, and clutch input. These measurements are normalized into a common master state M(t)={Ttool,qwrist,g,c} . The same state drives either (top) the Isaac Sim branch with FEM soft-tissue organs for cholecystectomy-oriented teleoperation practice or (bottom) the physical branch, where ROS 2/DDS and an endpoint-specific adapter map the operator command to the Franka Research 3 (FR3) laparoscopic platform. Endpoint-specific mapping, safety checks, and the pre-existing 1-kHz RCM controller remain on the patient side.
Fig. 3: Mechanical design and implementation of the custom distal module. (a) Overall flange-mounted module with palm rest and 2-DoF articulated wrist. (b) Passive thumb/index levers, external gear pair, geared-shaft magnet, and sensor board. (c) Section view of the sensor–magnet arrangement; grasp is sampled at 167 Hz. (d) Implemented electronics and operator hand interface.
Fig. 4: Break-away characterization and sustained holding behavior of the direct-drive wrist. (a) Friction and gravity currents separated by bidirectional break-away measurements over 13 roll/yaw wrist postures; friction exceeds gravity throughout the tested workspace. (b) Current-flow duty and estimated copper loss for the earlier current-on implementation and the final motion-gated holding test. (c) Motor-case temperature observations: the earlier current-on baseline rose from 37 ∘ C to 52 ∘ C within 2 min, whereas the final holding test remained near 36 ∘ C over 8 min. The 48 ∘ C dashed line denotes the wrist thermal-protection threshold used to prevent overheating, not an external contact-temperature standard.
Fig. 5: Isaac Sim environment and operator familiarization on the same console. (a) The simulated dual-FR3 laparoscopic setup operating through fixed trocar ports in a phantom containing a simulated gallbladder model, with the endoscopic view at lower right. (b) The veterinarian practicing in the simulator through the same physical master console later used in the porcine experiment; no operator-side hardware or mapping was changed between the two settings.
Fig. 6: Bench evaluation of the physical teleoperation path and master-to-target integration timing. (a) Raw and delay-aligned Cartesian error between the commanded tool-tip target and the measured tip position (FR3 base frame; samples with commanded tip speed >2 mm/s) for line, circular, and free 3-D trajectories. (b) Delay-aligned residual statistics. (c) Clutch re-anchoring across four bench trials. (d) Measured timing from master-state publication to FR3 target-command update; the proposed path is ≤8 ms and excludes patient-side RCM-controller and actuator response.
Fig. 7: Porcine in-vivo re-anchoring and clinical reference comparison. (a) Instrument drift while the hand is re-centered during 46 valid releases. (b) Target-command discontinuity at re-engagement, in micrometres. (c) Representative release showing centimeter-scale hand motion while the instrument tip remains nearly stationary. (d) Five operator-side metrics—clutch releases per minute, hand re-centring per release, share of console time spent manipulating, grip movements per engaged minute, and handle angular speed—normalized by the median and IQR of 120 human in-vivo Versius recordings (99 cholecystectomy procedures); the blue diamond denotes the proposed console and the light-blue interval its IQR over 2-min windows. (e,f) Cumulative distributions of hand speed and commanded instrument-tip speed; thin gray curves show individual Versius recordings, the dark-gray curve pooled clinical data, and blue the proposed console. The Versius data provide descriptive clinical context rather than a matched benchmark.
Robotic minimally invasive surgery offers well-documented clinical benefits, but the cost and infrastructure requirements of purpose-built platforms limit access in rural and lower-resourced facilities. Recent work has teleoperated general-purpose robots for laparoscopic tasks and in vivo procedures, but relied on handheld instruments coupled through passive linkages rather than native robotic actuation. Instead, we adapt da Vinci Classic and Xi instruments onto general-purpose robots that can integrate in clinical workflows. We present DASH, a da Vinci Adapter for Serial-link and Humanoid platforms, consisting of two types of adapters that require no modification to the instruments themselves. Each adapter is compatible with many robotic platform load capacities, engages the instrument's native latch, and wirelessly identifies inserted tools to load instrument-specific kinematics and coupling matrices. Teleoperated experiments demonstrate the efficacy of DASH and its benefits for enabling research access to surgical robotic platforms.
Sara Wickenhiser, Junrong Zhou, Zekai Liang +2
Mechanical and Aerospace Engineering Department, University of California San Diego, La Jolla, CA 92093 USA · Electrical and Computer Engineering Department, University of California, San Diego, La Jolla, CA 92093 USA.
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.
Korab Hoxha, Mirza Imamovic, Angelo Henriques +1
Department of Ophthalmology, School of Medicine and Health, TUM University Hospital, Munich, Germany · Chair of Ergonomics, Munich Institute of Robotics and Machine Intelligence, Technical University of Munich, Munich, Germany · Department of Biomedical Engineering, University of Alberta, Canada
Recent advances in actuation, control and learning have rapidly pushed humanoid robots from a distant vision towards near-term real-world deployment. Healthcare is a particularly pressing domain, in which staffing shortages and increasing care demand are widening the gap between clinical workload and available skilled labour. Although current automation has largely focused on digital and logistical tasks, much hospital work remains embodied, requiring mobility, manipulation and safe interaction in human-designed environments. Humanoid form factors offer unique potential, particularly for assisting with surgical tasks. Traditionally, robotic systems for surgery are purpose-built platforms such as Intuitive Surgical's da Vinci Surgical System, and it remains unclear how close current humanoid systems are to meeting the precision, control and safety requirements of minimally invasive surgery. Here we present a systematic evaluation of contemporary humanoid technology for laparoscopic surgical tasks. We develop a humanoid-based laparoscopic teleoperation framework using general-purpose instruments and assess its abilities through benchtop characterization, dry-laboratory user studies spanning diverse surgical experience levels and in vivo porcine studies. Across these evaluations, we quantify technical feasibility, task performance and clinical readiness relative to established surgical platforms. Together, our study provides an evidence-based assessment of current humanoid abilities and limitations for surgical applications, highlighting both their promise and key technical challenges that must be addressed before clinical deployment.
Zekai Liang, Nikita Thareja, Peihan Zhang +7
Jacobs School of Engineering, UC San Diego, 9500 Gilman Drive, La Jolla, 92093, CA, USA. · Department of Surgery, UC San Diego, 9300 Campus Point Drive, La Jolla, 92037, CA, USA.