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CARS 2002 – H.U. Lemke, M.W. Vannier; K. Inamura, A.G. Farman, K. Doi & J.H.C. Reiber (Editors) Ó CARS/Springer. All rights reserved.

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Force feedback master arms, from telerobotics to robotics surgery training
J.P. Friconneau1, M. Karouia2, F. Gosselin1, Ph. Gravez1, N. Bonnet2, P. Leprince2 1 CEA-LIST, CEN/FAR BP6, F92265 Fontenay-aux-Roses, France 2 Cardiovascular Surgery Department, Pitié-Salpêtrière Hospital, 47-83, Bd de l'hôpital 75013 Paris, France

Abstract
Good performance of a force feedback input device is achieved when the surgeon would have the feeling in his hands of holding directly the surgical instruments interacting with the patient. This type of needs for high performance force feedback input device are similar to the requirement in telerobotics. In nuclear application, due to hazardous environment, remote operation are necessary. During maintenance phases, the operator should operate his set of tools remotely through a force feedback master/slave system. Advanced technics and technology have been developed sofar and many similarities could be pointed out with the surgical robotics applications. Therefore we aim benefits to apply this telerobotics background to develop surgical robotics systems. The development of a new input device calls first for a precise understanding of the application requirements. A complete bibliographic study as well as specific experiments were therefore undertaken to understand both the operators manipulative abilities (amplitude of movements, forces, bandwidth, …) and the requirements of the tasks to be done (workspace, environment’s behaviour, …). A new methodology was then developed to use these information to obtain precise design guidelines for the master arm. Keywords: telerobotics, surgery, haptic device.

1. Introduction
Since 10 years, endoscopic surgery has deeply changed surgical practice. Absence of direct viewing and direct access to the workspace associated with reduced dexterity and sensory feedback led surgeons to develop new skills, requiring long experimental trainings on animals and cadavers. Robotics assisted surgery recently introduced in surgical blocks constitutes a new revolution in surgical practice and will also need a new training phase. In fact, surgeons need to become familiar both with robotics systems and the surgical techniques before moving to clinical applications. Moreover, animal and cadaver experiments are more and more difficult because of high costs, regulations and risks of contamination (AIDS, Creutzfeld Jacob). Finally, surgery training requires changes. Today, mentors have direct access to the field of operation. Tomorrow, when considering endoscopic surgery, direct action to assist trainee surgeons becomes hazardous due to lack of space. Training methods must therefore be reconsidered. Virtual Reality Technology, featuring haptic feedback through proper input devices, offers a

CARS 2002 – H.U. Lemke, M.W. Vannier; K. Inamura, A.G. Farman, K. Doi & J.H.C. Reiber (Editors) Ó CARS/Springer. All rights reserved.

2 particularly attractive solution as it will allow to develop surgical simulators allowing surgeons to learn and train with enhanced technics.

2. Master arm design requirement
A large consensus exists on the characteristics a ‘good’ input device must exhibit [1] [2] [3]. Whether considering virtual reality, telesurgery or heavy arms teleoperation, all authors have the same conclusions. A ‘good’ master arm must be ‘transparent’. The operator must have the feeling that he performs the task directly in the remote environment. He must be free in unencumbered space (which requires a large and singularity free workspace, low inertia and low friction) and he must feel crisp contacts against the obstacles encountered by the slave arm (which requires a sufficient force feedback, a high bandwidth and a large stiffness). All existing input devices were designed using these qualitative criteria. They exhibit, however, very different performances [4] [5] and are therefore more or less adapted to different applications. It is however essential in the design phase of an input device to know if it will fit a particular task efficiently. Precise requirements must thus be associated with each criterion. In order to achieve this goal, we developed a method allowing the designer to specify the master arm and its control board (which drives data transmission between the operator and the slave arm, with or without advanced functions like amplifications, reductions or tremor cancellation) level of performance necessary to take advantage of the best operator’s and slave arm’s capacities within the limits of the desired tasks [6]. This method takes two types of limitations into account : · Intrinsic limitations due to the operator’s capacities : workspace, force range, position and force resolution are closely related with the operator. On one side, the ability of the master arm to generate movements or forces below the level of detection of an operator is useless but all significant information coming from the slave must be felt by the operator. On the other side, all the operator’s voluntary movement or force must be measured but the operator’s hand tremor computed on the slave side must be in accordance with the precision needed to perform all desired tasks with the slave arm. Limitations due to the master-slave system’s characteristics : in teleoperation, the master arm must be designed in accordance to the slave arm. Its position resolution must be high enough to restore to the operator slave arm behaviour. Moreover, low friction (required for force resolution), mass and inertia drives comfortable feeling in the master side and efficiency on the slave side. Conversely, master arm electric stiffness must be tuned in a way that the slave limits of stability are always reached before the master ones. Finally, Master direct force and position bandwidths must be high enough to follow the operator’s motor dynamics and to transmit all of his orders to the slave arm. Master inverse bandwidths must be higher than the sensitive bandwidth of the operator (considering the limitations introduced by the slave). This method requires a correct understanding of both the operator’s manipulative

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CARS 2002 – H.U. Lemke, M.W. Vannier; K. Inamura, A.G. Farman, K. Doi & J.H.C. Reiber (Editors) Ó CARS/Springer. All rights reserved.

3 abilities and tasks to perform. This is necessary to extract precise specifications for the master arm which direct influence the master slave system performances. Main Master arm parameters are the workspace, the position resolution, the maximum force capacity and force resolution, and finally the electric stiffness, apparent mass and bandwidth.

3. Master arm design drivers
Once specified, the new input device must be designed according to these specifications. The design and optimisation of a robot are however quite complex problems as results depend on the parameters taken into account. The first design driver taken into account is the workspace of the robot. It is defined as the set of configurations the robot can reach. To study this parameter, we scan the Cartesian space and check which positions the robot can effectively reach using its inverse geometric model q= g(X) . This model is used to tune the size of the robot until its workspace encompasses the specified workspace.

The second design driver to consider is the force capacity defined as the minimum amount of force applicable in any direction. To study this parameter, we use the notion of force ellipsoid defined as the operational forces produced by 1 N.m motor torques. Calling J mot and Gmot the direct and inverse Jacobian matrices from motor to operational space, T this ellipsoid can be defined by F T .(J mot.J mot ).F £1 . It allows to compute for each reachable configuration the minimum force the robot can apply in all directions. It is used to tune the reduction ratios until it is equal to the specified amount of force feedback.

The third design driver taken into account is the master arm’s electric stiffness. It is defined as the minimum static gain in any direction deduced in the operational space from the maximum stable static gain of the motor’s control loops. To study this parameter, we use the apparent stiffness ellipsoid defined as the operational forces produced by a normalised displacement (1m). Calling Kmot the motor static gain ( t mot = K mot.dqmot ), this ellipsoid can be defined by F T .(K.K T )-1.F £1 , with the apparent stiffness matrix T K =Gmot.K mot.Gmot . This ellipsoid allows to compute for each reachable configuration the minimum apparent stiffness in all directions. It is used to tune the reduction ratios until this stiffness is higher than specified.

Finally, the fourth design driver taken into account is the apparent mass of the robot. It is defined as the maximum mass experienced in all directions by the operator when moving the end tip of the robot in free space (the motor torques at zero). This parameter requires use of apparent mass ellipsoid defined as the operational forces produced by a normalised acceleration of 1 m/s2 . Calling Amot (q) the kinetic energy matrix of the robot, this ellipsoid can be defined by F T .(M.M T )-1.F £1 , with the apparent mass matrix T M =Gmot.Amot (q).Gmot computed under the following simplification assumptions : the centrifugal and Coriolis forces are neglected as the end tip of the robot manipulated by the operator experiences relatively small speeds and the gravity forces are neglected as the master arm will be statically balanced. This ellipsoid allows to compute for each reachable configuration the maximum apparent mass in all directions. It is used to optimise the size of the robot in order to minimise this maximum mass.

CARS 2002 – H.U. Lemke, M.W. Vannier; K. Inamura, A.G. Farman, K. Doi & J.H.C. Reiber (Editors) Ó CARS/Springer. All rights reserved.

4 By means of four criteria, this methodology is based on a designer controlled constrained optimisation scheme that aim to minimise the apparent mass and the compactness. Optimisation parameters are the geometry and size, as well as joints torques and stiffness. The constraints are a given workspace and a minimum amount of force feedback and electric stiffness in every direction along full workspace.

4. Application in telerobotics and virtual reality
This method was first applied to design new master arm for real and simulated nuclear remote handling application. Input data, essential for the design, such as operator’s manipulative abilities, were obtained from many data source such as medical science, ergonomics or robotics. Assuming remote handling application conditions, this drive the choice of the grasping interface of the master arm (Force grasping). As the master/slave system force reflective system is coupled, slave characteristics are essential for the master design. We took the assumption of the use of an electric robot such as a Staübli RX90 industrial robot. Using this information and considering a passive bilateral coupling scheme (both arms are reversible and torque controlled), we obtained the following design drivers [6].
Useful Workspace Total Workspace Position resolution Force capacity Force resolution Apparent mass Electric stiffness Mechanical stiffness Bandwidth Design Drivers 300x300x300mm 60mm >40N full range 0.4N <500g full range >5000N/m full range 16Hz Table 1 : Virtuose 3D Specifications Final Design Identified Performances 300x300x300 mm 420x490x920 mm 34 to 55 N 0.3 to 0.6 N 2350 to 6000 N/m 3650 to 7500 N/m

Several candidate structures were optimised to reach these specifications. The results obtained were used to design Virtuose 3D (cf. table 1). This master arm features a four bar mechanism serially connected to a rotational axis. This simple and efficient solution allows to obtain 3DOF with motors close to the base thus reducing inertia. Both arm and forearm are 350mm long as higher values increase cumbersomeness without significant mass decrease. It uses also capstan reducers. This technology allows to minimize clearance and friction. It limits however the reduction ratios that can be obtained in a small volume. As optimisation results exhibited such large reduction ratios, we choose to limit the force capacity in order to keep the device compact. Moreover, the structure is decoupled due to the use a centred wrist. This property allows ergonomic one hand operation as no cross-coupling between translations and rotations appears when moving the arm in free or encumbered space. As the first axis of the wrist is permanently maintained horizontal, this allows to reject singularity from the translational workspace. Finally, the arm and forearm are statically balanced using spiral springs. Virtuose 3D is

CARS 2002 – H.U. Lemke, M.W. Vannier; K. Inamura, A.G. Farman, K. Doi & J.H.C. Reiber (Editors) Ó CARS/Springer. All rights reserved.

5 thus less tiring and intrinsically safe. First tests shows high transparency compared to existing systems. Friction and inertia are small enough to feel unencumbered space as free. Stiffness and force capacity are high enough to feel crisp contacts with the environment. A 6 degrees of freedom upgrade of this arm is now available on the market (V6D RV, www.haption.com).

5. Design of a new input device for telesurgery
Robotic telesurgery systems are basically composed of three main subsystems : the master console, the slave robot holding the endoscope and the surgical instruments and the communication channel conveying positions and efforts bilaterally between master and slave arms, allowing the slave arms to mimick human gesture and instrument/tissues interaction to be sensed through force/displacement feedback. On the master side of the system, the surgeon is seated in front of a video monitor displaying images from the surgical site. He manipulates two master arms conveying his movements into orders for the slave robots, thus controlling the movements of surgical instruments as well as of the camera. In order to allow fine movements, a precision grasp is used (stylus grasp). Moreover, a support is provided to allow armrest manipulation. Design drivers associated with these constraints are summarized in table 2. They integrate and combine results obtained previously for telerobotics applications [6] and specific surgery constraints [7].
Translation Useful Workspace Force capacity Force resolution Electric stiffness 200x200x200mm 15N 0.15N 2500N/m Table 2 : Virtuose 6D Design Drivers Rotation 160x160x180° 1N.m Design

A new input device satisfying these requirements is actually under development. This master arm is based on a parallel structure (cf. table 2) that exhibits particularly good performances while being simple to implement [6].

4. Conclusion
Robotics employed in the industrial field since many years is beginning to be used in the medical field. Existing robotic systems requires however improvements to be adapted to mini-invasive surgical procedures in order to increase the patient benefits. This evolution towards MIS procedures calls for telesurgery systems whose performance depends on the quality of the input device allowing the surgeon to control the system.

CARS 2002 – H.U. Lemke, M.W. Vannier; K. Inamura, A.G. Farman, K. Doi & J.H.C. Reiber (Editors) Ó CARS/Springer. All rights reserved.

6 This evolution will also introduce a new and different way of surgery practice, which will probably require changes in methods of work and health organisations. In order to train and familiarize the medical staff (surgeons and operating room staff) to these new technologies, surgical simulators with realistic virtual models will be an efficient training tool. The advances in VR technologies (real time simulation, complex numeric models, haptic interfaces...) will contribute to develop more and more realistic surgical simulators and optimize the training costs. Surgical simulators have a double benefit. Firstly, it will permit to minimize animal and cadaver experiments, and to provide nearly realistic training environment (virtual human anatomy, 3D models, force feedback, life simulation…). Secondly, the simulators will allow to search and develop new surgical techniques via pre-operative preparation. It will also allow to update surgeon skills (training, valuation) via scenarios simulation of special cases and emergency situations in operating room environment (patient, medical staff, nurses, materials…). Performances of such simulators as well as performances of new telesurgery systems will however depend on input devices performances and adaptation to the tasks performed. We therefore developed new generic methodologies to design performant master arms. These tools were used to design a new input device for telerobotics and virtual reality (now available on the market). Based on the success of these methods, and due to the similarities between telerobotics and telesurgery requirements, we are now using these tools to design a new input device for telesurgery.

References
[1] T.H. Massie, J.K. Salisbury, ’The PHANToM haptic interface : a device for probing virtual objects’, Proceedings of the ASME Winter Annual Meeting, Symposium on Haptic Interfaces for Virtual Environment and Teleoperator Systems, Chicago, November 1994 [2] K. Young Woo, B.D. Jin, D.S. Kwon, ‘A 6-DOF force reflecting hand controller using the fivebar parallel mechanism’, Proceedings of the 1998 IEEE International Conference on Robotics and Automation, Louvain, Belgium, pp1597-1602, May 1998 R. Baumann, R. Clavel, ‘Haptic interface for virtual reality based minimally invasive surgery simulation’, Proceedings of the 1998 IEEE International Conference on Robotics and Automation, Louvain, Belgium, pp381-386, May 1998

[3]

[4] D.A. McAffee et P. Fiorini, ’Hand Controller Design Requirements and Performance Issues inTelerobotics’, ICAR 91, Robots in Unstructured Environments, Pisa, Italy, pp186-192 ,June 1991 [5] [6] [7] G. Burdea, P. Coiffet, ‘La réalité virtuelle’, Hermès Publishing, Paris, 1993 F. Gosselin, ‘Développement d’outils d’aide à la conception d’organes de commande pour la téléopération à retour d’effort’, Ph.D. diss. (in French), University of Poitiers, June 2000 L. Toledo, ‘Analyse des Actions Elémentaires en chirurgie Endoscopique: Applications au Développement d’un Instrument Basé sur le Concept du Poignet Articulé’, DEA diss. (in French), University Paris 5, 1995