Haptics in Medical Simulation

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1 Haptics in Medical Simulation Allison M. Okamura Associate Professor Department of Mechanical Engineering Design and Biomechanics Groups Stanford University Collaborative Haptics and Robotics in Medicine (CHARM) Lab

2 Haptics Tissue modeling for haptic simulation Augmented reality Current Projects

3 Haptics Tissue modeling for haptic simulation Augmented reality Current Projects

4 hearing sight which sense is most valuable to you? smell taste touch which would you relinquish last?

5 what would life be like without touch? Ian Waterman

6 why do we have brains? Daniel Wolpert

7 centralized broad passive cognitive sight touch distributed narrow active physical

8 hap tic ('hap-tik) adj. Of or relating to the sense of touch. [Greek haptikos, from haptesthai, to grasp, touch. (1890)] Cutaneous Temperature Texture Slip Vibration Force Johansson and Westling Kinesthesia Location/configuration Motion Force Compliance The haptic senses work together with the motor control system to: - Coordinate movement - Enable perception

9 haptics making inroads Entertainment Education Nintendo Stanford/JHU Immersion Human-Computer Interfaces BMW Samsung Boeing

10 Haptics Tissue modeling for haptic simulation Augmented reality Current Projects

11 Haptics for medical simulation Main Challenge: Users should be allowed to interact with the simulator in any manner, and the simulator should respond appropriately. (Unanswered) Question: How realistic does the simulation need to be to have a significant impact? This talk addresses the mechanical and haptic interaction components medical simulation.

12 is the simulator is any good? Face validity: does the system present an environment resembling that which is encountered during a medical procedure? Content validity: is a skill measured by the system measured the specific skill desired, and not a different one? Construct validity: can the system capture the differences between experts and novices? Concurrent validity: to what extent does testing performance with the simulator yield the same results as other measures? Predictive validity: does performance/training with the simulator transfer to improvements in clinical practice?

13 Reality-Based Modeling UBC videos courtesy Simon DiMaio

14 Cutting with Scissors Blank Skin Force Liver Tendon Scissor angle

15 Needle Insertion Force Velocity Time

16 Needle Insertion

17 Simulation Needle Insertion Accuracy

18 Good models also lead to new technology: Needle Steering Alterovitz, et al. Webster, Reed, et al.

19 Haptics Tissue modeling for haptic simulation Augmented reality Current Projects

20 Open Surgery Surgeon Image source: Patient

21 Minimally Invasive Surgery Surgeon Instrument/Camera Image source: Patient

22 Teleoperated Robot-Assisted Minimally Invasive Surgery Surgeon Master Console Information-Enhanced RMIS (with Haptics) Patient-Side Robot Instrument/Camera 2008 Intuitive Surgical, Inc. Patient

23 da Vinci Surgical System (Intuitive Surgical) patient-side robot surgeon s console

24 Experimental Platform research version of the da Vinci surgical system

25 Force feedback: haptics and graphics

26 Effects of force feedback 1. Haptic + Graphical 2. Haptic Only 3. Graphical Only 4. No Force Feedback Error (deg) error (deg) haptic feedback reduces error feedback

27 Differentiating material properties

28 Lump detection task fiducial markers fiducial markers porcine kidney fiducial markers fiducial markers porcine kidney fiducial markers fiducial markers artificial lumps fiducial markers fiducial markers Camera image X-ray image

29 Lump detection Results

30 What about manipulation? no overlay dot overlay Graphical force feedback results in lower peak forces, lower variability of forces, and fewer broken sutures for novice robot-assisted surgeons In collaboration with D. D. Yuh of JHMI Cardiac Surgery

31 Haptics Tissue modeling for haptic simulation Augmented reality Current Projects

32 In medical simulation today, haptic feedback is typically restricted to that provided by artificial materials (e.g., mannequins) or Laerdal s SimMan resolved forces (e.g., force feedback haptic interfaces in virtual reality simulators) Simon DiMaio, UBC

33 Kinetic System for Medical Simulation (KineSys MedSim) In collaboration with T. Judkins (IAI), J. E. Colgate (Tangible Haptics), D. Gaba (Stanford)

34 Kinesthetic haptic display Images courtesy T. Judkins (IAI)

35 Electrostatic tactile display Disney Research Tangible Haptics

36 Haptic Jamming: A Deformable Geometry, Variable Stiffness Tactile Display using Pneumatics and Particle Jamming Simultaneously controllable surface geometry and mechanical properties Uses pneumatics and particle jamming : a cell made from a flexible membrane filled with granular material solidifies when air is vacuumed out Jim Gwilliam and Andrew Stanley

37 Haptic Jamming Display

38 No Inflation Max Inflation 1.0" Cell 2.0" Cell 1.5" Cell 3.0" Cell Forcedeflection curves after vacuuming the cells Force (N) Vacuumed After Inflation Inflated, not Vacuumed Force deflection curves before vacuuming the cells Deflection (mm) Deflection (mm)

39 Haptics Tissue modeling for haptic simulation Augmented reality Current projects

40 JHU APL

41 Acknowledgments Collaborators Amy Bastian (KKI/JHU Neurosci.) Michael Choti (JHU Surgery) Noah Cowan (JHU Mech. Eng.) David Gaba (Stanford Medicine) Ken Goldberg (UCB IEOR) Gregory Hager (JHU Comp. Sci.) Steven Hsiao (JHU Neuroscience) Michael Hsieh (Stanford Urology) Peter Kazanzides (JHU Comp. Sci.) KT Ramesh (JHU Mech Eng.) Danny Song (JHU Radiology) Russell Taylor (JHU Comp. Sci.) Louis Whitcomb (JHU Mech. Eng.) David Yuh (JHU Surgery) Intuitive Surgical, Inc. Support National Science Foundation National Institutes of Health (NIBIB, NCI, NINDS) Whitaker Foundation JHU Brain Science Institute DARPA Past PhD/Postdoc Lab Members Jake Abbott (Univ. Utah) Nasir Bhanpuri* (USC) Steven Charles*+ (BYU) Jessica Crouch+ (Old Dominion Univ.) David Grow (New Mexico Tech.) Paul Griffiths+ (Intuitive Surgical) Netta Gurari (IIT) Katherine Kuchenbecker+ (UPenn) Mohsen Mahvash+ (Boston Univ.) Panadda Marayong (Cal St Long Beach) Steven Marra+ (JHU) Sarthak Misra (U. Twente) Kyle Reed*+ (USF) Lawton Verner (Intuitive Surgical) Robert Webster* (Vanderbilt Univ.) Tomonori Yamamoto (EndoMaster) *co-advised, +postdoc And many talented undergraduate researchers! Current Lab Members Troy Adebar (Stanford) Amy Blank* (JHU) Nick Colonnese (Stanford) Tricia Gibo* (JHU) Jim Gwilliam* (JHU) Ann Majewicz (Stanford) Kirk Nichols (Stanford) Ilana Nisky+ (Stanford) Zhan Fan Quek (Stanford) Michele Rotella (Stanford) Sam Schorr (Stanford) Andrew Stanley (Stanford) Tom Wedlick (JHU)

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