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\n\n \n \n \n \n \n Sclera Force Control in Robot-assisted Eye Surgery: Adaptive Force Control vs. Auditory Feedback.\n \n \n \n\n\n \n Ebrahimi, A.; He, C.; Patel, N.; Kobilarov, M.; Gehlbach, P.; and Iordachita, I.\n\n\n \n\n\n\n In
2019 International Symposium on Medical Robotics, ISMR 2019, pages 1–7, 2019. IEEE\n
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@inproceedings{ebrahimi2019sclera,\nabstract = {Surgeon hand tremor limits human capability during microsurgical procedures such as those that treat the eye. In contrast, elimination of hand tremor through the introduction of microsurgical robots diminishes the surgeons tactile perception of useful and familiar tool-to-sclera forces. While the large mass and inertia of eye surgical robot prevents surgeon microtremor, loss of perception of small scleral forces may put the sclera at risk of injury. In this paper, we have applied and compared two different methods to assure the safety of sclera tissue during robot-assisted eye surgery. In the active control method, an adaptive force control strategy is implemented on the Steady-Hand Eye Robot in order to control the magnitude of scleral forces when they exceed safe boundaries. This autonomous force compensation is then compared to a passive force control method in which the surgeon performs manual adjustments in response to the provided audio feedback proportional to the magnitude of sclera force. A pilot study with three users indicate that the active control method is potentially more efficient.},\narchivePrefix = {arXiv},\narxivId = {1901.03307},\nauthor = {Ebrahimi, Ali and He, Changyan and Patel, Niravkumar and Kobilarov, Marin and Gehlbach, Peter and Iordachita, Iulian},\nbooktitle = {2019 International Symposium on Medical Robotics, ISMR 2019},\ndoi = {10.1109/ISMR.2019.8710205},\neprint = {1901.03307},\nisbn = {9781538678251},\norganization = {IEEE},\npages = {1--7},\ntitle = {{Sclera Force Control in Robot-assisted Eye Surgery: Adaptive Force Control vs. Auditory Feedback}},\nyear = {2019}\n}\n\n
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\n Surgeon hand tremor limits human capability during microsurgical procedures such as those that treat the eye. In contrast, elimination of hand tremor through the introduction of microsurgical robots diminishes the surgeons tactile perception of useful and familiar tool-to-sclera forces. While the large mass and inertia of eye surgical robot prevents surgeon microtremor, loss of perception of small scleral forces may put the sclera at risk of injury. In this paper, we have applied and compared two different methods to assure the safety of sclera tissue during robot-assisted eye surgery. In the active control method, an adaptive force control strategy is implemented on the Steady-Hand Eye Robot in order to control the magnitude of scleral forces when they exceed safe boundaries. This autonomous force compensation is then compared to a passive force control method in which the surgeon performs manual adjustments in response to the provided audio feedback proportional to the magnitude of sclera force. A pilot study with three users indicate that the active control method is potentially more efficient.\n
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\n\n \n \n \n \n \n Adaptive control of sclera force and insertion depth for safe robot-assisted retinal surgery.\n \n \n \n\n\n \n Ebrahimi, A.; Patel, N.; He, C.; Gehlbach, P.; Kobilarov, M.; and Iordachita, I.\n\n\n \n\n\n\n In
Proceedings - IEEE International Conference on Robotics and Automation, volume 2019-May, pages 9073–9079, 2019. IEEE\n
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@inproceedings{ebrahimi2019adaptive,\nabstract = {One of the significant challenges of moving from manual to robot-assisted retinal surgery is the loss of perception of forces applied to the sclera (sclera forces) by the surgical tools. This damping of force feedback is primarily due to the stiffness and inertia of the robot. The diminished perception of tool-to-eye interactions might put the eye tissue at high risk of injury due to excessive sclera forces or extreme insertion of the tool into the eye. In the present study therefore a 1-dimensional adaptive control method is customized for 3-dimensional control of sclera force components and tool insertion depth and then implemented on the velocity-controlled Johns Hopkins Steady-Hand Eye Robot. The control method enables the robot to perform autonomous motions to make the sclera force and/or insertion depth of the tool tip to follow pre-defined desired and safe trajectories when they exceed safe bounds. A robotic light pipe holding application in retinal surgery is also investigated using the adaptive control method. The implementation results indicate that the adaptive control is able to achieve the imposed safety margins and prevent sclera forces and insertion depth from exceeding safe boundaries.},\nauthor = {Ebrahimi, Ali and Patel, Niravkumar and He, Changyan and Gehlbach, Peter and Kobilarov, Marin and Iordachita, Iulian},\nbooktitle = {Proceedings - IEEE International Conference on Robotics and Automation},\ndoi = {10.1109/ICRA.2019.8793658},\nisbn = {9781538660263},\nissn = {10504729},\norganization = {IEEE},\npages = {9073--9079},\ntitle = {{Adaptive control of sclera force and insertion depth for safe robot-assisted retinal surgery}},\nvolume = {2019-May},\nyear = {2019}\n}\n\n
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\n One of the significant challenges of moving from manual to robot-assisted retinal surgery is the loss of perception of forces applied to the sclera (sclera forces) by the surgical tools. This damping of force feedback is primarily due to the stiffness and inertia of the robot. The diminished perception of tool-to-eye interactions might put the eye tissue at high risk of injury due to excessive sclera forces or extreme insertion of the tool into the eye. In the present study therefore a 1-dimensional adaptive control method is customized for 3-dimensional control of sclera force components and tool insertion depth and then implemented on the velocity-controlled Johns Hopkins Steady-Hand Eye Robot. The control method enables the robot to perform autonomous motions to make the sclera force and/or insertion depth of the tool tip to follow pre-defined desired and safe trajectories when they exceed safe bounds. A robotic light pipe holding application in retinal surgery is also investigated using the adaptive control method. The implementation results indicate that the adaptive control is able to achieve the imposed safety margins and prevent sclera forces and insertion depth from exceeding safe boundaries.\n
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\n\n \n \n \n \n \n Towards securing the sclera against patient involuntary head movement in robotic retinal surgery.\n \n \n \n\n\n \n Ebrahimi, A.; Urias, M.; Patel, N.; He, C.; Taylor, R. H.; Gehlbach, P.; and Iordachita, I.\n\n\n \n\n\n\n In
2019 28th IEEE International Conference on Robot and Human Interactive Communication, RO-MAN 2019, 2019. IEEE\n
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\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n
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@inproceedings{ebrahimi2019romanem,\nabstract = {Retinal surgery involves manipulating very delicate tissues within the confined area of eyeball. In such demanding practices, patient involuntary head movement might abruptly raise tool-to-eyeball interaction forces which would be detrimental to eye. This study is aimed at implementing different force control strategies and evaluating how they contribute to attaining sclera force safety while patient head drift is present. To simulate patient head movement, a piezoelectric-actuated linear stage is used to produce random motions in a single direction in random time intervals. Having an eye phantom attached to the linear stage then an experienced eye surgeon is asked to manipulate the eye and repeat a mock surgical task both with and without the assist of the Steady-Hand Eye Robot. For the freehand case, warning sounds were provided to the surgeon as auditory feedback to alert him about excessive slclra forces. For the robot-assisted experiments two variants of an adaptive sclera force control and a virtual fixture method were deployed to see how they can maintain eye safety under head drift circumstances. The results indicate that the developed robot control strategies are able to compensate for head drift and keep the sclera forces under safe levels as well as the free hand operation.},\nauthor = {Ebrahimi, Ali and Urias, Muller and Patel, Niravkumar and He, Changyan and Taylor, Russell H. and Gehlbach, Peter and Iordachita, Iulian},\nbooktitle = {2019 28th IEEE International Conference on Robot and Human Interactive Communication, RO-MAN 2019},\ndoi = {10.1109/RO-MAN46459.2019.8956341},\nisbn = {9781728126227},\npublisher = {IEEE},\ntitle = {{Towards securing the sclera against patient involuntary head movement in robotic retinal surgery}},\nyear = {2019}\n}\n\n
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\n Retinal surgery involves manipulating very delicate tissues within the confined area of eyeball. In such demanding practices, patient involuntary head movement might abruptly raise tool-to-eyeball interaction forces which would be detrimental to eye. This study is aimed at implementing different force control strategies and evaluating how they contribute to attaining sclera force safety while patient head drift is present. To simulate patient head movement, a piezoelectric-actuated linear stage is used to produce random motions in a single direction in random time intervals. Having an eye phantom attached to the linear stage then an experienced eye surgeon is asked to manipulate the eye and repeat a mock surgical task both with and without the assist of the Steady-Hand Eye Robot. For the freehand case, warning sounds were provided to the surgeon as auditory feedback to alert him about excessive slclra forces. For the robot-assisted experiments two variants of an adaptive sclera force control and a virtual fixture method were deployed to see how they can maintain eye safety under head drift circumstances. The results indicate that the developed robot control strategies are able to compensate for head drift and keep the sclera forces under safe levels as well as the free hand operation.\n
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\n\n \n \n \n \n \n Sclera Force Evaluation during Vitreoretinal Surgeries in Ex Vivo Porcine Eye Model.\n \n \n \n\n\n \n Patel, N.; Urias, M.; Ebrahimi, A.; He, C.; Gehlbach, P.; and Iordachita, I.\n\n\n \n\n\n\n In
Proceedings of IEEE Sensors, volume 2019-Octob, 2019. IEEE\n
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\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n
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@inproceedings{patel2019sensorexvivo,\nabstract = {Vitreoretinal surgery is among the most challenging microsurgical procedures as it requires precise tool manipulation in a constrained environment, while the tool-tissue interaction forces are at the human perception limits. While tool tip forces are certainly important, the scleral forces at the tool insertion ports are also important. Clinicians often rely on these forces to manipulate the eyeball position during surgery. Measuring sclera forces could enable valuable sensory input to avoid tissue damage, especially for a cooperatively controlled robotic assistant that otherwise removes the sensation of these familiar intraoperative forces. Previously, our group has measured sclera forces in phantom experiments. However, to the best of our knowledge, there are no published data measuring scleral forces in biological (ex-vivo/in-vivo) eye models. In this paper, we measured sclera forces in ex-vivo porcine eye model. A Fiber Bragg Grating (FBG) based force sensing instrument with a diameter of $\\sim$900 $\\mu$m and a resolution of $\\sim$1 mN was used to measure the forces while the clinician-subject followed retinal vessels in manual and robot-assisted modes. Analysis of measured forces show that the average sclera force in manual mode was 133.74 mN while in robot-assisted mode was 146.03 mN.},\nauthor = {Patel, Niravkumar and Urias, Muller and Ebrahimi, Ali and He, Changyan and Gehlbach, Peter and Iordachita, Iulian},\nbooktitle = {Proceedings of IEEE Sensors},\ndoi = {10.1109/SENSORS43011.2019.8956820},\nisbn = {9781728116341},\nissn = {21689229},\npublisher = {IEEE},\ntitle = {{Sclera Force Evaluation during Vitreoretinal Surgeries in Ex Vivo Porcine Eye Model}},\nvolume = {2019-Octob},\nyear = {2019}\n}\n\n
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\n Vitreoretinal surgery is among the most challenging microsurgical procedures as it requires precise tool manipulation in a constrained environment, while the tool-tissue interaction forces are at the human perception limits. While tool tip forces are certainly important, the scleral forces at the tool insertion ports are also important. Clinicians often rely on these forces to manipulate the eyeball position during surgery. Measuring sclera forces could enable valuable sensory input to avoid tissue damage, especially for a cooperatively controlled robotic assistant that otherwise removes the sensation of these familiar intraoperative forces. Previously, our group has measured sclera forces in phantom experiments. However, to the best of our knowledge, there are no published data measuring scleral forces in biological (ex-vivo/in-vivo) eye models. In this paper, we measured sclera forces in ex-vivo porcine eye model. A Fiber Bragg Grating (FBG) based force sensing instrument with a diameter of $∼$900 $μ$m and a resolution of $∼$1 mN was used to measure the forces while the clinician-subject followed retinal vessels in manual and robot-assisted modes. Analysis of measured forces show that the average sclera force in manual mode was 133.74 mN while in robot-assisted mode was 146.03 mN.\n
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\n\n \n \n \n \n \n A Novel Semi-Autonomous Control Framework for Retina Confocal Endomicroscopy Scanning.\n \n \n \n\n\n \n Li, Z.; Yang, G. Z.; Taylor, R. H.; Shahbazi, M.; Patel, N.; Sullivan, E. O.; Zhang, H.; Vyas, K.; Chalasani, P.; Gehlbach, P. L.; and Iordachita, I.\n\n\n \n\n\n\n In
IEEE International Conference on Intelligent Robots and Systems, pages 7083–7090, 2019. IEEE\n
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\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n
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@inproceedings{li2019confocaleyerobot,\nabstract = {In this paper, a novel semi-autonomous control framework is presented for enabling probe-based confocal laser endomicroscopy (pCLE) scan of the retinal tissue. With pCLE, retinal layers such as nerve fiber layer (NFL) and retinal ganglion cell (RGC) can be scanned and characterized in real-time for an improved diagnosis and surgical outcome prediction. However, the limited field of view of the pCLE system and the micron-scale optimal focus distance of the probe, which are in the order of physiological hand tremor, act as barriers to successful manual scan of retinal tissue.Therefore, a novel sensorless framework is proposed for real-time semi-autonomous endomicroscopy scanning during retinal surgery. The framework consists of the Steady-Hand Eye Robot (SHER) integrated with a pCLE system, where the motion of the probe is controlled semi-autonomously. Through a hybrid motion control strategy, the system autonomously controls the confocal probe to optimize the sharpness and quality of the pCLE images, while providing the surgeon with the ability to scan the tissue in a tremor-free manner. Effectiveness of the proposed architecture is validated through experimental evaluations as well as a user study involving 9 participants. It is shown through statistical analyses that the proposed framework can reduce the work load experienced by the users in a statistically-significant manner, while also enhancing their performance in retaining pCLE images with optimized quality.},\nauthor = {Li, Zhaoshuo and Yang, Guang Zhong and Taylor, Russell H. and Shahbazi, Mahya and Patel, Niravkumar and Sullivan, Eimear O. and Zhang, Haojie and Vyas, Khushi and Chalasani, Preetham and Gehlbach, Peter L. and Iordachita, Iulian},\nbooktitle = {IEEE International Conference on Intelligent Robots and Systems},\ndoi = {10.1109/IROS40897.2019.8967751},\nisbn = {9781728140049},\nissn = {21530866},\norganization = {IEEE},\npages = {7083--7090},\ntitle = {{A Novel Semi-Autonomous Control Framework for Retina Confocal Endomicroscopy Scanning}},\nyear = {2019}\n}\n\n
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\n In this paper, a novel semi-autonomous control framework is presented for enabling probe-based confocal laser endomicroscopy (pCLE) scan of the retinal tissue. With pCLE, retinal layers such as nerve fiber layer (NFL) and retinal ganglion cell (RGC) can be scanned and characterized in real-time for an improved diagnosis and surgical outcome prediction. However, the limited field of view of the pCLE system and the micron-scale optimal focus distance of the probe, which are in the order of physiological hand tremor, act as barriers to successful manual scan of retinal tissue.Therefore, a novel sensorless framework is proposed for real-time semi-autonomous endomicroscopy scanning during retinal surgery. The framework consists of the Steady-Hand Eye Robot (SHER) integrated with a pCLE system, where the motion of the probe is controlled semi-autonomously. Through a hybrid motion control strategy, the system autonomously controls the confocal probe to optimize the sharpness and quality of the pCLE images, while providing the surgeon with the ability to scan the tissue in a tremor-free manner. Effectiveness of the proposed architecture is validated through experimental evaluations as well as a user study involving 9 participants. It is shown through statistical analyses that the proposed framework can reduce the work load experienced by the users in a statistically-significant manner, while also enhancing their performance in retaining pCLE images with optimized quality.\n
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\n\n \n \n \n \n \n \n Real-Time Sclera Force Feedback for Enabling Safe Robot-Assisted Vitreoretinal Surgery.\n \n \n \n \n\n\n \n Ebrahimi, A.; He, C.; Roizenblatt, M.; Patel, N.; Sefati, S.; Gehlbach, P.; and Iordachita, I.\n\n\n \n\n\n\n In
Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS, volume 2018-July, pages 3650–3655, 2018. IEEE\n
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Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n
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@inproceedings{ebrahimi2018real,\nabstract = {One of the major yet little recognized challenges in robotic vitreoretinal surgery is the matter of tool forces applied to the sclera. Tissue safety, coordinated tool use and interactions between tool tip and shaft forces are little studied. The introduction of robotic assist has further diminished the surgeon's ability to perceive scleral forces. Microsurgical tools capable of measuring such small forces integrated with robotmanipulators may therefore improve functionality and safety by providing sclera force feedback to the surgeon. In this paper, using a force-sensing tool, we have conducted robotassisted eye manipulation experiments to evaluate the utility of providing scleral force feedback. The work assesses 1) passive audio feedback and 2) active haptic feedback and evaluates the impact of these feedbacks on scleral forces in excess of aboundary. The results show that in presence of passive or active feedback, the duration of experiment increases, while the duration for which scleral forces exceed a safe threshold decreases.},\nauthor = {Ebrahimi, Ali and He, Changyan and Roizenblatt, Marina and Patel, Niravkumar and Sefati, Shahriar and Gehlbach, Peter and Iordachita, Iulian},\nbooktitle = {Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS},\ndoi = {10.1109/EMBC.2018.8513255},\nisbn = {9781538636466},\nissn = {1557170X},\norganization = {IEEE},\npages = {3650--3655},\npmid = {30441165},\ntitle = {{Real-Time Sclera Force Feedback for Enabling Safe Robot-Assisted Vitreoretinal Surgery}},\nurl = {https://doi.org/10.1109/EMBC.2018.8513255},\nvolume = {2018-July},\nyear = {2018}\n}\n\n
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\n One of the major yet little recognized challenges in robotic vitreoretinal surgery is the matter of tool forces applied to the sclera. Tissue safety, coordinated tool use and interactions between tool tip and shaft forces are little studied. The introduction of robotic assist has further diminished the surgeon's ability to perceive scleral forces. Microsurgical tools capable of measuring such small forces integrated with robotmanipulators may therefore improve functionality and safety by providing sclera force feedback to the surgeon. In this paper, using a force-sensing tool, we have conducted robotassisted eye manipulation experiments to evaluate the utility of providing scleral force feedback. The work assesses 1) passive audio feedback and 2) active haptic feedback and evaluates the impact of these feedbacks on scleral forces in excess of aboundary. The results show that in presence of passive or active feedback, the duration of experiment increases, while the duration for which scleral forces exceed a safe threshold decreases.\n
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\n\n \n \n \n \n \n \n Evaluation of a Force-Sensing Handheld Robot for Assisted Retinal Vein Cannulation∗.\n \n \n \n \n\n\n \n Gonenc, B.; Patel, N.; and Iordachita, I.\n\n\n \n\n\n\n In
Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS, volume 2018-July, pages 1–5, 2018. IEEE\n
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\n\n \n \n Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n
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@inproceedings{gonenc2018evaluation,\nabstract = {Approximately 16.4 million people are affected by retinal vein occlusion (RVO) resulting from hypercoagulability, low blood flow or thrombosis in the central or the branched retinal veins. Most common current treatments for RVO aim to limit the damage. In recent years, an experimental procedure, retinal vein cannulation (RVC) has been studied in animal models as well as human eye models. RVC is a procedure for targeted delivery of a therapeutic agent into the occluded retinal vein for dissolving the thrombi. Although effective treatment has been demonstrated via RVC, performing this procedure manually still remains at the limits of human skills. RVC requires to precisely insert a thin cannula into a delicate thin retinal vein, and to maintain it inside the vein throughout the infusion. The needle-vein interaction forces are too small to sense even by an expert surgeon. In this work, we present an evaluation study of a handheld robotic assistant with a force-sensing microneedle for RVC. The system actively cancels hand tremor, detects venous puncture based on detected tool-tissue forces, and stabilizes the needle after venous puncture for reduced trauma and prolonged infusion. Experiments are performed cannulating the vasculature in fertilized chicken eggs. Results show 100% success in venous puncture detection and significantly reduced cannula position drift via the stabilization aid of the robotic system.},\nauthor = {Gonenc, Berk and Patel, Niravkumar and Iordachita, Iulian},\nbooktitle = {Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS},\ndoi = {10.1109/EMBC.2018.8513304},\nisbn = {9781538636466},\nissn = {1557170X},\norganization = {IEEE},\npages = {1--5},\npmid = {30440317},\ntitle = {{Evaluation of a Force-Sensing Handheld Robot for Assisted Retinal Vein Cannulation∗}},\nurl = {https://doi.org/10.1109/EMBC.2018.8513304},\nvolume = {2018-July},\nyear = {2018}\n}\n\n
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\n Approximately 16.4 million people are affected by retinal vein occlusion (RVO) resulting from hypercoagulability, low blood flow or thrombosis in the central or the branched retinal veins. Most common current treatments for RVO aim to limit the damage. In recent years, an experimental procedure, retinal vein cannulation (RVC) has been studied in animal models as well as human eye models. RVC is a procedure for targeted delivery of a therapeutic agent into the occluded retinal vein for dissolving the thrombi. Although effective treatment has been demonstrated via RVC, performing this procedure manually still remains at the limits of human skills. RVC requires to precisely insert a thin cannula into a delicate thin retinal vein, and to maintain it inside the vein throughout the infusion. The needle-vein interaction forces are too small to sense even by an expert surgeon. In this work, we present an evaluation study of a handheld robotic assistant with a force-sensing microneedle for RVC. The system actively cancels hand tremor, detects venous puncture based on detected tool-tissue forces, and stabilizes the needle after venous puncture for reduced trauma and prolonged infusion. Experiments are performed cannulating the vasculature in fertilized chicken eggs. Results show 100% success in venous puncture detection and significantly reduced cannula position drift via the stabilization aid of the robotic system.\n
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\n\n \n \n \n \n \n User Behavior Evaluation in Robot-Assisted Retinal Surgery.\n \n \n \n\n\n \n He, C.; Ebrahimi, A.; Roizenblatt, M.; Patel, N.; Yang, Y.; Gehlbach, P. L.; and Iordachita, I.\n\n\n \n\n\n\n In
RO-MAN 2018 - 27th IEEE International Symposium on Robot and Human Interactive Communication, pages 174–179, 2018. IEEE\n
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\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n
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@inproceedings{he2018user,\nabstract = {Retinal microsurgery is technically demanding and requires high surgical skill with very little room for manipulation error. The introduction of robotic assistance has the potential to enhance and expand a surgeon's manipulation capabilities during retinal surgery, i.e., improve precision, cancel physiological hand tremor, and provide sensing information. However, surgeon performance may also be negatively impacted by robotic assistance due to robot structural stiffness and nonintuitive controls. In complying with robotic constraints, the surgeon loses the dexterity of the human hand. In this paper, we present a preliminary experimental study to evaluate user behavior when affected by robotic assistance during mock retinal surgery. In these experiments user behavior is characterized by measuring the forces applied by the user to the sclera, the tool insertion/retraction speed, the tool insertion depth relative to the scleral entry point, and the duration of surgery. The users' behavior data is collected during three mock retinal surgery tasks with four users. Each task is conducted using both freehand and robot-assisted techniques. The univariate user behavior and the correlations of multiple parameters of user behavior are analyzed. The results show that robot assistance prolongs the duration of the surgery and increases the manipulation forces applied to sclera, but refines the insertion velocity and eliminates hand tremor.},\nauthor = {He, Changyan and Ebrahimi, Ali and Roizenblatt, Marina and Patel, Niravkumar and Yang, Yang and Gehlbach, Peter L. and Iordachita, Iulian},\nbooktitle = {RO-MAN 2018 - 27th IEEE International Symposium on Robot and Human Interactive Communication},\ndoi = {10.1109/ROMAN.2018.8525638},\nisbn = {9781538679807},\norganization = {IEEE},\npages = {174--179},\ntitle = {{User Behavior Evaluation in Robot-Assisted Retinal Surgery}},\nyear = {2018}\n}\n\n
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\n Retinal microsurgery is technically demanding and requires high surgical skill with very little room for manipulation error. The introduction of robotic assistance has the potential to enhance and expand a surgeon's manipulation capabilities during retinal surgery, i.e., improve precision, cancel physiological hand tremor, and provide sensing information. However, surgeon performance may also be negatively impacted by robotic assistance due to robot structural stiffness and nonintuitive controls. In complying with robotic constraints, the surgeon loses the dexterity of the human hand. In this paper, we present a preliminary experimental study to evaluate user behavior when affected by robotic assistance during mock retinal surgery. In these experiments user behavior is characterized by measuring the forces applied by the user to the sclera, the tool insertion/retraction speed, the tool insertion depth relative to the scleral entry point, and the duration of surgery. The users' behavior data is collected during three mock retinal surgery tasks with four users. Each task is conducted using both freehand and robot-assisted techniques. The univariate user behavior and the correlations of multiple parameters of user behavior are analyzed. The results show that robot assistance prolongs the duration of the surgery and increases the manipulation forces applied to sclera, but refines the insertion velocity and eliminates hand tremor.\n
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