Digital Theses Archive


Tesi etd-03172022-140455

Type of thesis
Training and usability of robot-assisted minimally invasive and non-invasive surgical platforms
Scientific disciplinary sector
Istituto di Biorobotica - BIOROBOTICS
relatore Prof.ssa MENCIASSI, ARIANNA
  • Augmentation
  • Autonomous camera motion
  • da Vinci surgery
  • dVRK
  • Feedback
  • Focused ultrasound
  • Motion compensation
  • Robot-assisted surgery
  • Simulation
  • Training
  • Usability
Exam session start date
The last few decades have witnessed an exponential growth in medical technologies, and one of the effects of this technological wave is the application of robotics to surgery. The introduction of robotics in a delicate field as surgery is a complex process, that involves a wide spectrum of issues. Probably due to the technology push, few of these issues have been late considered and addressed. Among these issues, the need for efficient training before using these novel platforms, as well as the optimization of their usability, have come to the forefront.<br><br>This thesis addresses the topics of training and usability in relation with two robot-assisted technologies. These two technologies differ in terms of technology readiness level, as well as in terms of invasiveness to the patient. On the one hand, the focus is first on da Vinci-like surgery (Intuitive Surgical Inc.) as a key actor in robot-assisted minimally invasive surgery. On the other hand, this thesis addresses focused ultrasound surgery as a new frontier in robot-assisted non-invasive surgery.<br><br>Robot-assisted minimally invasive surgery is now well established in clinical practice. However, the attention to the training and usability of platforms as the widespread da Vinci surgical system has arisen only in the recent years. This thesis reports a set of works that investigate the concept of augmentation applied both to simulation-based training, as well as to intra-operative usability and surgical workflow. All these works take advantage of the da Vinci Research Kit, an open research platform built upon the components of the first-generation da Vinci. Training augmentation is addressed by developing both virtual environments and physical simulators integrated with sensing technologies. Usability augmentation involves few research activities to mitigate changes in the surgical workflow introduced by robotics (namely, the camera control and the lack of haptic feedback).<br><br>Focused ultrasound is a non-invasive therapeutic technology that could potentially revolutionize the treatment paradigm of various medical conditions. However, the currently available platforms feature some limitations that still limit its application in surgery.<br>Robotics could represent the enabling technology for focused ultrasound, boosting its usability and accelerating its spread in the clinical scenario. Indeed, robotics can guarantee precision and automation in targeting different anatomical areas, thus speeding up the procedure and dealing with possible motions of the target.<br>In this thesis, a robot-assisted platform for focused ultrasound surgery is introduced. This thesis describes its development by taking into account strategies to simplify the therapy guidance and to ensure the patient&#39;s safety throughout the treatment. Its validation was carried out by moving from laboratory testing till in-vivo animal trials.