Velocity Optimization via Thermal Imaging Enhances Autonomous Tumor Resection

Autonomous soft-tissue cancer surgery has been limited to interventions on organ surfaces, because current systems cannot perceive and adapt to anatomy once it deforms or is cut. We introduce the first vision-guided autonomous system capable of performing complete tumor resections for partial nephrectomy. Our system integrates conditional occupancy networks, trained entirely in a physics-based simulation, that infer full 3-D anatomy (tumor, margin tissue, and kidney) from single-view partial point clouds. These occupancy networks maintain intraoperative tracking even as tissue is cut and deformed, enabling adaptive planning and execution. The surgical platform combines a depth camera for capturing surface point clouds, dual robotic arms for electrosurgical cutting and vacuum-based tissue manipulation, and an autonomous control strategy for tumor resection. In patient-derived hydrogel phantoms under an open partial nephrectomy setting, the robot performed eight consecutive autonomous tumor resections comprising 77 electrosurgical cuts, with all cuts achieving negative surgical margins and 1.61 $\pm$ 0.48 mm mean absolute margin error. This work demonstrates, for the first time, a foundation for supervised autonomous closed-loop, imaging-driven, margin-negative tumor removal in phantoms.

Background and Objective: Image-guided surgical navigation has been actively studied because of its advantage of identifying subsurface targets and critical structures, whereas it requires incision trajectories to update the preoperative three-dimensional model dynamically during the surgery. The novelty of this study is the thermal feature distinguishment of whether the electric tools contacting the tissue by Convolutional Neural Network (CNN), and the extraction of the knife contacting frames, to form incision trajectories which can meet with the requirement during the surgery. Methods: This study firstly verified that CNN can classify the thermal images of electric knife and ultrasonic cutter operations separately, and can raise the accuracy of the incision trajectories derived from the connection of the thermal intensity centroid of the frames predicted by CNN as contacting. Results: Our results obtained by employing the electric knife not only reveal a remarkably high accuracy 97.2 % in CNNs identification, but also can achieve an error reduction as high as more than 2.5 times of the incision trajectory prediction as compared to those proceeded in the conventional method. Besides electric knife, the results obtained by employing another electric tool, ultrasonic cutter, reveal a high accuracy up to 93.7 %. Conclusion: In this study, we ensured the possibility of CNN in distinguishing electric tools contacting with the tissue, and confirmed that the proposed method has not only overcome the problem of missing trajectories which usually occurs in the convolutional long-short term memory method but also achieved a remarkable improvement of the accuracy with less limitation.

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.