Steering of flexible needles combining kinesthetic and vibratory force feedback

Needle insertion in soft-tissue is a minimally invasive surgical procedure which demands high accuracy. In this respect, robotic systems with autonomous control algorithms have been exploited as the main tool to achieve high accuracy and reliability. However, for reasons of safety and acceptance by the surgical community, autonomous robotic control is not desirable. Thus, it is necessary to focus more on techniques enabling clinicians to directly control the motion of surgical tools. In this work we address that challenge and present a novel teleoperated robotic system able to steer flexible needles. The proposed system tracks the position of the needle using an ultrasound imaging system, and, from that, it computes needle's ideal position and orientation to reach a given target. The master haptic interface then provides mixed kinesthetic-vibratory navigation cues about this ideal position and orientation to the clinician as she steers the needle. Six subjects carried out an experiment of teleoperated needle insertion into a soft-tissue phantom. They showed a mean targeting error of 1.36 mm. An additional experiment of remote teleoperation has been carried out to highlight the passivity-based stability of the proposed system.