Abstract:

Endovascular surgery requires careful maneuvering of highly flexible tools using limited hand movements under conditions of poor and non intuitive visual feedback. While robotic systems provide potential means of improving the surgical condition and outcome of these procedures, there is no formal research to determine the issues behind design and construction of such systems. Additionally, there is no comprehensive study to identify, quantify or categorize the motor skills needed for endovascular procedures. This dissertation work addresses these two key problems and also evaluates the effect of haptic interfaces and robotic surgery on the surgeon's motor skills. A comprehensive study of endovascular surgeon's motor skills was carried out to model their hand movements during surgery. This provided previously unavailable quantitative insights into fine motor skills required to perform complicated surgical procedures. A new system for endovascular teleoperative access (SETA) was constructed. SETA allowed teleoperative control of interventional tools, equivalent to that of manual interventions. SETA also featured force monitoring for patient safety and force feedback to assist surgeons performing the procedure. Finally, SETA was evaluated by a cohort of surgical experts who provided feedback about teleoperative surgery, and issues, and the importance they attached to haptic feedback device for performing the procedure. This research has opened a new avenue in automation of endovascular surgery, providing firm preliminary results. This could now serve as the foundation for developing autonomous interventional system.