Micro camera augmented endoscopic instruments: Towards superhuman performance in remote surgical cutting

This paper introduces a new method for remote surgical cutting by providing haptic guidance along a trajectory that is measured in-situ through a miniature, tool-tip mounted endoscopic camera. By directly augmenting the instrument with a camera, instead of relying on an additional conventional endoscope, the approach becomes independent from inherent calibration uncertainties of the telemanipulation system, other than the micro camera itself, and from registration of pre- and intra-operative surgical data. We calculate a smooth cut path with corresponding scalpel orientation to guide the user towards the optimal trajectory. Experiments are conducted with passive and active haptic virtual fixtures. During active fixturing the optimal forward velocity is calculated to follow the path. The results indicate an improvement in terms of position accuracy, blade orientation, and forward velocity.