Michael C. Yip

Autonomous robotic-assisted surgery (RAS) has emerged as a promising objective in biomedical technology, further enhanced by miniaturization toward microrobotic-assisted surgery (μ-RAS). This reduction in scale promises minimally invasive, partially or fully automated surgical procedures, with the potential to reduce patient recovery times, lower medical costs, and enable previously unavailable procedural options. This perspective highlights the specific advances in RAS that potentially map to the microscale (μ-RAS), organized across five surgical domains: endovascular, endoluminal, laparoscopic, ophthalmic, and orthopedic. We examine both clinical demands and technological advances in surgical robotics and identify the key innovations required for progress across these surgical fields. Our contribution is distinct in combining the perspectives of both surgical experts and bioengineering innovators, outlining a roadmap for the advancement and eventual integration of autonomous RAS and μ-RAS into mainstream surgical practice.

Screw-based propulsion systems offer promising capabilities for amphibious mobility, yet face significant challenges in optimizing locomotion across water, granular materials, and transitional environments. This study presents a systematic investigation into the locomotion performance of various screw configurations in media such as dry sand, wet sand, saturated sand, and water. Through a principles-first approach to analyze screw performance, it was found that certain parameters are dominant in their impact on performance. Depending on the media, derived parameters inspired from optimizing heat sink design help categorize performance within the dominant design parameters. Our results provide specific insights into screw shell design and adaptive locomotion strategies to enhance the performance of screw-based propulsion systems for versatile amphibious applications.

Surgical automation holds immense potential to improve the outcome and accessibility of surgery. Recent studies use reinforcement learning to automate various surgical tasks. However, these policies are developed independently, and their reusability is limited when applied to other scenarios, making it more time-consuming for robots to incrementally solve tasks. Inspired by how human surgeons build their expertise, we propose Surgical Incremental Reinforcement Learning (SurgIRL). SurgIRL aims to (1) acquire new skills by referring to external policies (knowledge) and (2) build an expandable knowledge base and reuse it to solve multiple unseen tasks incrementally (incremental learning). Our SurgIRL framework includes three major components. We first define an expandable knowledge set containing heterogeneous policies that can be helpful for surgical tasks. Then, we propose Knowledge Inclusive Attention Network with mAximum Coverage Exploration (KIAN-ACE), which enhances learning performance through extensive navigation of the knowledge base. Finally, we develop incremental learning pipelines to expand and reuse a knowledge base and solve multiple surgical tasks sequentially. Our simulation experiments show that SurgIRL efficiently learns to automate ten surgical tasks separately or incrementally. We also demonstrate successful sim-to-real transfers of SurgIRL's policies on the da Vinci Research Kit (dVRK). The results represent an initial step towards lifelong robot learning for surgical automation.

Robotic teleoperation over long communication distances poses challenges due to delays in commands and feedback from network latency. One simple yet effective strategy to reduce errors and increase performance under delay is to downscale the relative motion between the operating surgeon and the robot. The question remains as to what is the optimal scaling factor, and how this value changes depending on the level of latency as well as operator tendencies. We present user studies investigating the relationship between latency, scaling factor, and performance. The results of our studies demonstrate a statistically significant difference in performance between users and across scaling factors for certain levels of delay. These findings indicate that the optimal scaling factor for a given level of delay is specific to each user, motivating the need for personalized models for optimal performance. We present techniques to model the user-specific mapping of latency level to scaling factor for optimal performance, leading to an efficient and effective solution to optimizing performance of robotic teleoperation and specifically telesurgery under large communication delay.

Depth perception is essential for a robot’s spatial and geometric understanding of its environment, with many tasks traditionally relying on hardware-based depth sensors like RGB-D or stereo cameras. However, these sensors face practical limitations, including issues with transparent and reflective objects, high costs, calibration complexity, spatial and energy constraints, and increased failure rates in compound systems. While monocular depth estimation methods offer a cost-effective and simpler alternative, their adoption in robotics is limited due to their output of relative rather than metric depth, which is crucial for robotics applications. In this paper, we propose a method that utilizes a single calibrated camera, enabling the robot to act as a "measuring stick" to convert relative depth estimates into metric depth in real-time as tasks are performed. Our approach employs an LSTM-based metric depth regressor, trained online and refined through probabilistic filtering, to accurately restore the metric depth across the monocular depth map, particularly in areas proximal to the robot’s motion. Experiments with real robots demonstrate that our method significantly outperforms current state-of-the-art monocular metric depth estimation techniques, achieving a 22.1% reduction in depth error and a 52% increase in success rate for a downstream task.

Robot pose estimation is a challenging and crucial task for vision-based surgical robotic automation. Typical robotic calibration approaches, however, are not applicable to surgical robots, such as the da Vinci Research Kit (dVRK) [1], due to joint angle measurement errors from cable-drives and the partially visible kinematic chain. Hence, previous works in surgical robotic automation used tracking algorithms to estimate the pose of the surgical tool in real-time and compensate for the joint angle errors. However, a big limitation of these previous tracking works is the initialization step which relied on only keypoints and SolvePnP. In this work, we fully explore the potential of geometric primitives beyond just keypoints with differentiable rendering, cylinders, and construct a versatile pose matching pipeline in a novel pose hypothesis space. We demonstrate the state-of-the-art performance of our single-shot calibration method with both calibration consistency and real surgical tasks. As a result, this marker-less calibration approach proves to be a robust and generalizable initialization step for surgical tool tracking.

Accurate camera-to-robot calibration is essential for any vision-based robotic control system and especially critical in minimally invasive surgical robots, where instruments conduct precise micro-manipulations. However, MIS robots have long kinematic chains and partial visibility of their degrees of freedom in the camera, which introduces challenges for conventional camera-to-robot calibration methods that assume stiff robots with good visibility. Previous works have investigated both keypoint-based and rendering-based approaches to address this challenge in real-world conditions; however, they often struggle with consistent feature detection or have long inference times, neither of which are ideal for online robot control. In this work, we propose a novel framework that unifies the detection of geometric primitives (keypoints and shaft edges) through a shared encoding, enabling efficient pose estimation via projection geometry. This architecture detects both keypoints and edges in a single inference and is trained on large-scale synthetic data with projective labeling. This method is evaluated across both feature detection and pose estimation, with qualitative and quantitative results demonstrating fast performance and state-of-the-art accuracy in challenging surgical environments.

Reinforcement learning (RL) and sim-to-real transfer have advanced rigid-object manipulation. However, policies remain brittle for articulated mechanisms due to contact-rich dynamics that require both stable grasping and simultaneous free in-hand articulation. Furthermore, articulated objects and robot hands exhibit under-modeled joint phenomena such as friction, stiction, and backlash in real life that can increase the sim-to-real gap, and robot hands still fall short of idealized tactile sensing, both in terms of coverage, sensitivity, and specificity. In this paper, we present an original approach to learning dexterous in-hand manipulation of articulated tools that has reduced articulation and kinematic redundancy relative to the human hand. Our approach augments a simulation-trained base policy with a sensor-driven refinement learned from hardware demonstrations. This refinement conditions on proprioception and target articulation states while fusing whole-hand tactile and force-torque feedback with the policy's action intent through cross-attention. The resulting controller adapts online to instance-specific articulation properties, stabilizes contact interactions, and regulates internal forces under perturbations. We validate our method across diverse real-world tools, including scissors, pliers, minimally invasive surgical instruments, and staplers, demonstrating robust sim-to-real transfer, improved disturbance resilience, and generalization across structurally related articulated tools without precise physical modeling.

Recent developments in neural radiance field (NeRF) processing have leveraged the power of neural networks to quickly reconstruct 3D spaces from 2D images. Our objective was to utilize this technology to 3D render video recordings of diagnostic cystoscopies and test their fidelity. With institutional review board (IRB) approval, we recorded two diagnostic cystoscopies, one with an Ambu single-use flexible cystoscope and the other with a Richard Wolf digital cystoscope. We converted the videos to images and manually curated approximately 100 representative images, which minimized blur and spanned a large segment of the bladder. We then utilized the NVIDIA Instant Neural Graphics Primitives (iNGP), a NeRF algorithm that uses multiresolution hash encoding with a compact neural network for significantly faster convergence, to reconstruct the bladder and render novel, unseen views within seconds. We computed the structural similarity index (SSIM) and peak signal-to-noise ratio (PSNR) to assess the quality and fidelity of the 3D rendering. Both videos were able to be utilized for 3D rendering using iNGP. The rendering derived from the Richard Wolf cystoscopy had a PSNR = 29.8 (min = 27.2, max = 32.6) and SSIM = 0.89. Similarly, the rendering derived from the Ambu cystoscopy had a PSNR = 31.3 (min = 27.1, max = 35.1) and SSIM = 0.90. Independent of cystoscopy equipment, both 3D renderings achieved reasonable fidelity. Major limitations to widespread adoption of this technology include the need for a curator to select representative and high-quality images from the initial cystoscopy video recording and the relatively small segments of bladder successfully rendered. Nonetheless, we feel that with further refinement, this technology can be scaled to create 3D renderings of cystoscopies that will enable evaluation of both completeness and quality of the cystoscopy. Furthermore, this technology would be able to facilitate the comparison of cystoscopies performed in the same patient over time.

Foundation models in robotics are here to stay, but can surgical robotics keep up with their data-intense requirement?

Remote Center of Motion (RCM) robotic manipulators have revolutionized Minimally Invasive Surgery, enabling precise, dexterous surgical manipulation within the patient's body cavity without disturbing the insertion point on the patient. Accurate RCM tool control is vital for incorporating autonomous subtasks like suturing, blood suction, and tumor resection into robotic surgical procedures, reducing surgeon fatigue and improving patient outcomes. However, these cable-driven systems are subject to significant joint reading errors, corrupting the kinematics computation necessary to perform control. Although visual tracking with endoscopic cameras can correct errors on in-view joints, errors in the kinematic chain prior to the insertion point are irreparable because they remain out of view. No prior work has characterized the stability of control under these conditions. We fill this gap by designing a provably stable tracking-in-the-loop controller for the out-of-view portion of the RCM manipulator kinematic chain. We additionally incorporate this controller into a bilevel control scheme for the full kinematic chain. We rigorously benchmark our method in simulated and real world settings to verify our theoretical findings. Our work provides key insights into the next steps required for the transition from teleoperated to autonomous surgery.

Robotic teleoperation over long communication distances poses challenges due to delays in commands and feedback from network latency. One simple yet effective strategy to reduce errors and increase performance under delay is to downscale the relative motion between the operating surgeon and the robot. The question remains as to what is the optimal scaling factor, and how this value changes depending on the level of latency as well as operator tendencies. We present user studies investigating the relationship between latency, scaling factor, and performance. The results of our studies demonstrate a statistically significant difference in performance between users and across scaling factors for certain levels of delay. These findings indicate that the optimal scaling factor for a given level of delay is specific to each user, motivating the need for personalized models for optimal performance. We present techniques to model the user-specific mapping of latency level to scaling factor for optimal performance, leading to an efficient and effective solution to optimizing performance of robotic teleoperation and specifically telesurgery under large communication delay.

Human-robot physical interaction (pHRI) is a rapidly evolving research field with significant implications for physical therapy, search and rescue, and telemedicine. However, a major challenge lies in accurately understanding human constraints and safety in human-robot physical experiments without an IRB and physical human experiments. Concerns regarding human studies include safety concerns, repeatabil-ity, scalability of the number, and diversity of participants. This paper examines whether a physical approximation can serve as a stand-in for human subjects to enhance robot autonomy for physical assistance. This paper introduces the SHULDRD (Shoulder Haptic Universal Limb Dynamic Repositioning Device), an economical and anatomically similar device designed for real-time testing and deploying pHRI planning tasks on robots in the real world. SHULDRD replicates human shoulder motion, providing crucial force feedback and safety data. The device's open-source CAD and software facilitate easy construction and use, ensuring broad accessibility for researchers. By providing a flexible platform able to emulate infinite human subjects, ensure repeatable trials, and provide quantitative metrics to assess the effectiveness of the robotic intervention, SHULDRD aims to improve the safety and efficacy of human-robot physical interactions. Project URL: https://sites.google.com/view/haptic-shoulder/home

Camera-to-robot calibration is crucial for visionbased robot control and requires effort to make it accurate. Recent advancements in markerless pose estimation methods have eliminated the need for time-consuming physical setups for camera-to-robot calibration. While the existing markerless pose estimation methods have demonstrated impressive accuracy without the need for cumbersome setups, they rely on the assumption that all the robot joints are visible within the camera's field of view. However, in practice, robots usually move in and out of view, and some portion of the robot may stay out-of-frame during the whole manipulation task due to real-world constraints, leading to a lack of sufficient visual features and subsequent failure of these approaches. To address this challenge and enhance the applicability to visionbased robot control, we propose a novel framework capable of estimating the robot pose with partially visible robot manipulators. Our approach leverages the Vision-Language Models for fine-grained robot components detection, and integrates it into a keypoint-based pose estimation network, which enables more robust performance in varied operational conditions. The framework is evaluated on both public robot datasets and self-collected partial-view datasets to demonstrate our robustness and generalizability. As a result, this method is effective for robot pose estimation in a wider range of realworld manipulation scenarios.

Chronic wounds, including diabetic ulcers, pressure ulcers, and ulcers secondary to venous hypertension, affects more than 6.5 million patients and a yearly cost of more than $25 billion in the United States alone. Chronic wound treatment is currently a manual process, and we envision a future where robotics and automation will aid in this treatment to reduce cost and improve patient care. In this work, we present the development of the first robotic system for wound dressing removal which is reported to be the worst aspect of living with chronic wounds. Our method leverages differentiable physics-based simulation to perform gradient-based trajectory optimization for peeling trajectory planning. By integrating fracture mechanics of adhesion, we are able to model the peeling effect inherent to dressing adhesion. The system is further guided by carefully designed objective functions that promote both efficient and safe control, reducing the risk of tissue damage. We validated the efficacy of our approach through a series of experiments conducted on both synthetic skin phantoms and real human subjects. Our results demonstrate the system's ability to achieve precise and safe dressing removal trajectories, offering a promising solution for automating this essential healthcare procedure.

Artificial intelligence (AI) applications in medical robots are bringing a new era to medicine. Advanced medical robots can perform diagnostic and surgical procedures, aid rehabilitation, and provide symbiotic prosthetics to replace limbs. The technology used in these devices, including computer vision, medical image analysis, haptics, navigation, precise manipulation, and machine learning (ML) , could allow autonomous robots to carry out diagnostic imaging, remote surgery, surgical subtasks, or even entire surgical procedures. Moreover, AI in rehabilitation devices and advanced prosthetics can provide individualized support, as well as improved functionality and mobility (see the figure). The combination of extraordinary advances in robotics, medicine, materials science, and computing could bring safer, more efficient, and more widely available patient care in the future. <strong>-Gemma K. Alderton</strong>.

The increasing demand for healthcare workers, driven by aging populations and labor shortages, presents a significant challenge for hospitals. Humanoid robots have the potential to alleviate these pressures by leveraging their human-like dexterity and adaptability to assist in medical procedures. This work conducted an exploratory study on the feasibility of humanoid robots performing direct clinical tasks through teleoperation. A bimanual teleoperation system was developed for the Unitree G1 Humanoid Robot, integrating high-fidelity pose tracking, custom grasping configurations, and an impedance controller to safely and precisely manipulate medical tools. The system is evaluated in seven diverse medical procedures, including physical examinations, emergency interventions, and precision needle tasks. Our results demonstrate that humanoid robots can successfully replicate critical aspects of human medical assessments and interventions, with promising quantitative performance in ventilation and ultrasound-guided tasks. However, challenges remain, including limitations in force output for procedures requiring high strength and sensor sensitivity issues affecting clinical accuracy. This study highlights the potential and current limitations of humanoid robots in hospital settings and lays the groundwork for future research on robotic healthcare integration.

Reconstruction of deformable scenes from endoscopic videos is important for many applications such as intraop-erative navigation, surgical visual perception, and robotic surgery. It is a foundational requirement for realizing autonomous robotic interventions for minimally invasive surgery. However, previous approaches in this domain have been limited by their modular nature and are confined to specific camera and scene settings. Our work adopts the Neural Radiance Fields (NeRF) approach to learning 3D implicit representations of scenes that are both dynamic and deformable over time, and furthermore with unknown cam-era poses. This work removes the constraints of known cam-era poses and overcomes the drawbacks of the state-of-the-art unstructured dynamic scene reconstruction technique, which relies on the static part of the scene for accurate re-construction. Through several experimental datasets, we demonstrate the versatility of our proposed model to adapt to diverse camera and scene settings, and show its promise for both current and future robotic surgical systems.

Automating suturing during robotically-assisted surgery reduces the burden on the operating surgeon, enabling them to focus on making higher-level decisions rather than fatiguing themselves in the numerous intricacies of a surgical procedure. Accurate suture thread reconstruction and grasping are vital prerequisites for suturing, particularly for avoiding entanglement with surgical tools and performing complex thread manipulation. However, such methods must be robust to heavy perceptual degradation resulting from heavy noise and thread feature sparsity from endoscopic images. We develop a reconstruction algorithm that utilizes quadratic programming optimization to fit smooth splines to thread observations, satisfying reliability bounds estimated from measured observation noise. Additionally, we craft a grasping policy that generates gripper trajectories that maximize the probability of a successful grasp. Our full image-to-grasp pipeline is rigorously evaluated with over 400 grasping trials, exhibiting state-of-the-art accuracy. We show that this strategy can be applied to the various techniques in autonomous suture needle manipulation to achieve autonomous surgery in a generalizable way.

Abstract Background Herpes zoster infection is common in immunocompromised individuals. Recently, the Advisory Committee on Immunization Practices recommended immunizing with the recombinant zoster vaccine (RZV). Methods Objective: To evaluate the efficacy, immunogenicity and safety of RZV in immunocompromised individuals, such as transplant recipients, cancer patients undergoing chemotherapy, individuals with preexisting autoimmune diseases and HIV-infected patients. Data Sources and Study Selection: From January 1984 to October 2023, a systematic search of PubMed, MEDLINE, EMBASE, Scopus, Web of Science, CINAHL, and Cochrane CENTRAL was performed. Randomized clinical trials (RCT) evaluating RZV compared to placebo in immunocompromised adults were selected. Data Extraction and Synthesis: Study characteristics and estimates on the incidence of herpes zoster, humoral and cellular immune responses, and safety data were extracted from studies. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using subgroup meta-analysis and metaregression. Results Seven RCTs were included. Compared to placebo, RZV reduced the incidence of herpes zoster across all ages by 81% (RR: 0.19, 95%CI: 0.09, 0.44), with moderate heterogeneity across the studies (I2 = 60.49%; τ2 = 0.31; P=0.07). RZV significantly increased humoral and cellular immunity one month after the last dose. Transplant and past malignancy were associated with lower immunogenicity. RZV was more reactogenic with more local and systemic adverse events. There was no difference in serious adverse events or death between the vaccine and placebo arms. Conclusion This study suggests that RZV reduces the risk of herpes zoster infection in immunocompromised individuals. This vaccine should be routinely offered to immunocompromised individuals, preferably before chemotherapy or treatment. Disclosures All Authors: No reported disclosures

Designing controllers that accomplish tasks while guaranteeing safety constraints remains a significant challenge. We often want an agent to perform well in a nominal task, such as environment exploration, while ensuring it can avoid unsafe states and return to a desired target by a specific time. In particular we are motivated by the setting of safe, efficient, hands-off training for reinforcement learning in the real world. By enabling a robot to safely and autonomously reset to a desired region (e.g., charging stations) without human intervention, we can enhance efficiency and facilitate training. Safety filters, such as those based on control barrier functions, decouple safety from nominal control objectives and rigorously guarantee safety. Despite their success, constructing these functions for general nonlinear systems with control constraints and system uncertainties remains an open problem. This paper introduces a safety filter obtained from the value function associated with the reach-avoid problem. The proposed safety filter minimally modifies the nominal controller while avoiding unsafe regions and guiding the system back to the desired target set. By preserving policy performance while allowing safe resetting, we enable efficient hands-off reinforcement learning and advance the feasibility of safe training for real world robots. We demonstrate our approach using a modified version of soft actor-critic to safely train a swing-up task on a modified cartpole stabilization problem.

IMPORTANCE: Herpes zoster infection is common in immunocompromised individuals. Recently, the Advisory Committee on Immunization Practices recommended immunizing with the recombinant zoster vaccine (RZV). OBJECTIVE: To evaluate the efficacy, immunogenicity and safety of RZV in immunocompromised individuals, such as transplant recipients, cancer patients undergoing chemotherapy, individuals with preexisting autoimmune diseases and HIV-infected patients. DATA SOURCES AND SELECTION: From January 1984 to October 2023, a systematic search of PubMed, MEDLINE, EMBASE, Scopus, Web of Science, CINAHL, and Cochrane CENTRAL was performed. Randomized clinical trials (RCT) evaluating RZV compared to placebo in immunocompromised adults were selected. DATA EXTRACTION: Study characteristics and estimates on the incidence of herpes zoster, immune responses, and safety data were extracted from studies. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using subgroup meta-analysis and metaregression. RESULTS: Seven RCTs were included. Compared to placebo, RZV reduced the incidence of herpes zoster across all ages by 81% (RR: 0.19, 95%CI: 0.09, 0.44), with moderate heterogeneity across the studies (I2 = 60.49%; τ2 = 0.31; P = 0.07). RZV significantly increased humoral and cellular immunity one month after the last dose. Transplant and past malignancy were associated with lower immunogenicity. RZV was more reactogenic with more local and systemic adverse events. There was no difference in serious adverse events or death between the two arms. CONCLUSION: This study suggests that RZV reduces the risk of herpes zoster infection in immunocompromised individuals. This vaccine should be routinely offered to immunocompromised individuals, preferably before chemotherapy or treatment.

A major source of endoscopic tissue tracking errors during deformations stems from wrong data association between observed sensor measurements with previously tracked scene. To mitigate this issue, we present a surgical perception framework, SuPerPM, that leverages learning-based non-rigid point cloud matching for data association, thus accommodating larger deformations than previous approaches which relied on Iterative Closest Point (ICP) for point associations. The learning models typically require training data with ground truth point cloud correspondences, which is challenging or even impractical to collect in surgical environments. Thus, for tuning the learning model, we gather endoscopic data of soft tissue being manipulated by a surgical robot and then establish correspondences between point clouds at different time points to serve as ground truth. This was achieved by employing a position-based dynamics (PBD) simulation to ensure that the correspondences adhered to physical constraints. The proposed framework is demonstrated on several challenging surgical datasets that are characterized by large deformations, achieving superior performance over advanced surgical scene tracking algorithms. <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">1</sup>

Inaccurate tool localization is one of the main reasons for failures in automating surgical tasks. Imprecise robot kinematics and noisy observations caused by the poor visual acuity of an endoscopic camera make tool tracking challenging. Previous works in surgical automation adopt environment-specific setups or hard-coded strategies instead of explicitly considering motion and observation uncertainty of tool tracking in their policies. In this work, we present SURESTEP, an uncertainty-aware trajectory optimization framework for robust surgical automation.We model the uncertainty in tool tracking by considering noise sources that are typical in surgical environments.Using a Gaussian assumption to propagate our uncertainty models through a given tool trajectory, SURESTEP provides a general framework that minimizes the upper bound on the entropy of the final estimated tool distribution.We showcase our method by performing the first-ever, to our knowledge, needle regrasping with a moving endoscopic camera.We compare SURESTEP with a baseline method on a real-world suture needle regrasping task under challenging environmental conditions, such as poor lighting and a moving endoscopic camera. The results over 60 regrasps on the da Vinci Research Kit (dVRK) demonstrate that our optimized trajectories significantly outperform the un-optimized baseline.

Depth perception is essential for a robot's spatial and geometric understanding of its environment, with many tasks traditionally relying on hardware-based depth sensors like RGB-D or stereo cameras. However, these sensors face practical limitations, including issues with transparent and reflective objects, high costs, calibration complexity, spatial and energy constraints, and increased failure rates in compound systems. While monocular depth estimation methods offer a cost-effective and simpler alternative, their adoption in robotics is limited due to their output of relative rather than metric depth, which is crucial for robotics applications. In this paper, we propose a method that utilizes a single calibrated camera, enabling the robot to act as a "measuring stick" to convert relative depth estimates into metric depth in real-time as tasks are performed. Our approach employs an LSTM-based metric depth regressor, trained online and refined through probabilistic filtering, to accurately restore the metric depth across the monocular depth map, particularly in areas proximal to the robot's motion. Experiments with real robots demonstrate that our method significantly outperforms current state-of-the-art monocular metric depth estimation techniques, achieving a 22.1% reduction in depth error and a 52% increase in success rate for a downstream task.

Surgical automation holds immense potential to improve the outcome and accessibility of surgery. Recent studies use reinforcement learning to learn policies that automate different surgical tasks. However, these policies are developed independently and are limited in their reusability when the task changes, making it more time-consuming when robots learn to solve multiple tasks. Inspired by how human surgeons build their expertise, we train surgical automation policies through Surgical Incremental Reinforcement Learning (SurgIRL). SurgIRL aims to (1) acquire new skills by referring to external policies (knowledge) and (2) accumulate and reuse these skills to solve multiple unseen tasks incrementally (incremental learning). Our SurgIRL framework includes three major components. We first define an expandable knowledge set containing heterogeneous policies that can be helpful for surgical tasks. Then, we propose Knowledge Inclusive Attention Network with mAximum Coverage Exploration (KIAN-ACE), which improves learning efficiency by maximizing the coverage of the knowledge set during the exploration process. Finally, we develop incremental learning pipelines based on KIAN-ACE to accumulate and reuse learned knowledge and solve multiple surgical tasks sequentially. Our simulation experiments show that KIAN-ACE efficiently learns to automate ten surgical tasks separately or incrementally. We also evaluate our learned policies on the da Vinci Research Kit (dVRK) and demonstrate successful sim-to-real transfers.

Chronic wounds, including diabetic ulcers, pressure ulcers, and ulcers secondary to venous hypertension, affects more than 6.5 million patients and a yearly cost of more than $25 billion in the United States alone. Chronic wound treatment is currently a manual process, and we envision a future where robotics and automation will aid in this treatment to reduce cost and improve patient care. In this work, we present the development of the first robotic system for wound dressing removal which is reported to be the worst aspect of living with chronic wounds. Our method leverages differentiable physics-based simulation to perform gradient-based Model Predictive Control (MPC) for optimized trajectory planning. By integrating fracture mechanics of adhesion, we are able to model the peeling effect inherent to dressing adhesion. The system is further guided by carefully designed objective functions that promote both efficient and safe control, reducing the risk of tissue damage. We validated the efficacy of our approach through a series of experiments conducted on both synthetic skin phantoms and real human subjects. Our results demonstrate the system's ability to achieve precise and safe dressing removal trajectories, offering a promising solution for automating this essential healthcare procedure.

Human-robot physical interaction (pHRI) is a rapidly evolving research field with significant implications for physical therapy, search and rescue, and telemedicine. However, a major challenge lies in accurately understanding human constraints and safety in human-robot physical experiments without an IRB and physical human experiments. Concerns regarding human studies include safety concerns, repeatability, and scalability of the number and diversity of participants. This paper examines whether a physical approximation can serve as a stand-in for human subjects to enhance robot autonomy for physical assistance. This paper introduces the SHULDRD (Shoulder Haptic Universal Limb Dynamic Repositioning Device), an economical and anatomically similar device designed for real-time testing and deployment of pHRI planning tasks onto robots in the real world. SHULDRD replicates human shoulder motion, providing crucial force feedback and safety data. The device's open-source CAD and software facilitate easy construction and use, ensuring broad accessibility for researchers. By providing a flexible platform able to emulate infinite human subjects, ensure repeatable trials, and provide quantitative metrics to assess the effectiveness of the robotic intervention, SHULDRD aims to improve the safety and efficacy of human-robot physical interactions.

Camera-to-robot calibration is crucial for vision-based robot control and requires effort to make it accurate. Recent advancements in markerless pose estimation methods have eliminated the need for time-consuming physical setups for camera-to-robot calibration. While the existing markerless pose estimation methods have demonstrated impressive accuracy without the need for cumbersome setups, they rely on the assumption that all the robot joints are visible within the camera's field of view. However, in practice, robots usually move in and out of view, and some portion of the robot may stay out-of-frame during the whole manipulation task due to real-world constraints, leading to a lack of sufficient visual features and subsequent failure of these approaches. To address this challenge and enhance the applicability to vision-based robot control, we propose a novel framework capable of estimating the robot pose with partially visible robot manipulators. Our approach leverages the Vision-Language Models for fine-grained robot components detection, and integrates it into a keypoint-based pose estimation network, which enables more robust performance in varied operational conditions. The framework is evaluated on both public robot datasets and self-collected partial-view datasets to demonstrate our robustness and generalizability. As a result, this method is effective for robot pose estimation in a wider range of real-world manipulation scenarios.

Automating suturing during robotically-assisted surgery reduces the burden on the operating surgeon, enabling them to focus on making higher-level decisions rather than fatiguing themselves in the numerous intricacies of a surgical procedure. Accurate suture thread reconstruction and grasping are vital prerequisites for suturing, particularly for avoiding entanglement with surgical tools and performing complex thread manipulation. However, such methods must be robust to heavy perceptual degradation resulting from heavy noise and thread feature sparsity from endoscopic images. We develop a reconstruction algorithm that utilizes quadratic programming optimization to fit smooth splines to thread observations, satisfying reliability bounds estimated from measured observation noise. Additionally, we craft a grasping policy that generates gripper trajectories that maximize the probability of a successful grasp. Our full image-to-grasp pipeline is rigorously evaluated with over 400 grasping trials, exhibiting state-of-the-art accuracy. We show that this strategy can be applied to the various techniques in autonomous suture needle manipulation to achieve autonomous surgery in a generalizable way.

The ability to predict future states is crucial to informed decision-making while interacting with dynamic environments. With cameras providing a prevalent and information-rich sensing modality, the problem of predicting future states from image sequences has garnered a lot of attention. Current state-of-the-art methods typically train large parametric models for their predictions. Though often able to predict with accuracy these models often fail to provide interpretable confidence metrics around their predictions. Additionally these methods are reliant on the availability of large training datasets to converge to useful solutions. In this paper, we focus on the problem of predicting future images of an image sequence with interpretable confidence bounds from very little training data. To approach this problem, we use non-parametric models to take a probabilistic approach to image prediction. We generate probability distributions over sequentially predicted images, and propagate uncertainty through time to generate a confidence metric for our predictions. Gaussian Processes are used for their data efficiency and ability to readily incorporate new training data online. Our method’s predictions are evaluated on a smooth fluid simulation environment. We showcase the capabilities of our approach on real world data by predicting pedestrian flows and weather patterns from satellite imagery.

Fig

Implicit neural representations have become pivotal in robotic perception, enabling robots to comprehend 3D environments from 2D images. Given a set of camera poses and associated images, the models can be trained to synthesize novel, unseen views. To successfully navigate and interact in dynamic settings, robots require the understanding of their spatial surroundings driven by unassisted reconstruction of 3D scenes and camera poses from real-time video footage. Existing approaches like COLMAP and bundle-adjusting neural radiance field methods take hours to days to process due to the high computational demands of feature matching, dense point sampling, and training of a multi-layer perceptron structure with a large number of parameters. To address these challenges, we propose a framework called bundle-adjusting accelerated neural graphics primitives (BAA-NGP) which leverages accelerated sampling and hash encoding to expedite automatic pose refinement/estimation and 3D scene reconstruction. Experimental results demonstrate 10 to 20 × speed improvement compared to other bundle-adjusting neural radiance field methods without sacrificing the quality of pose estimation. The github repository can be found here https://github.com/IntelLabs/baa-ngp.

Hemorrhaging occurs in surgeries of all types, forcing surgeons to quickly adapt to the visual interference that results from blood rapidly filling the surgical field. Intro-ducing automation into the crucial surgical task of hemostasis management would offload mental and physical tasks from the surgeon and surgical assistants while simultaneously increasing the efficiency and safety of the operation. The first step in automation of hemostasis management is detection of blood in the surgical field. To propel the development of blood detection algorithms in surgeries, we present HemoSet, the first blood segmentation dataset based on bleeding during a live animal robotic surgery. Our dataset features vessel hemorrhage scenarios where turbulent flow leads to abnormal pooling geometries in surgical fields. These pools are formed in conditions endemic to surgical procedures - uneven heterogeneous tissue, under glossy lighting conditions and rapid tool movement. We benchmark several state-of-the-art segmentation models and provide insight into the difficulties specific to blood detection. We intend for HemoSet to spur development of autonomous blood suction tools by providing a platform for training and refining blood segmentation models, addressing the precision needed for such robotics.<sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">1</sup><sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">1</sup>Our dataset and code are available at https://arclab-hernoset.github.io

Surgical automation can improve the accessibility and consistency of life saving procedures. Most surgeries require separating layers of tissue to access the surgical site, and suturing to reattach incisions. These tasks involve deformable manipulation to safely identify and alter tissue attachment (boundary) topology. Due to poor visual acuity and frequent occlusions, surgeons tend to carefully manipulate the tissue in ways that enable inference of the tissue's attachment points without causing unsafe tearing. In a similar fashion, we propose JIGGLE, a framework for estimation and interactive sensing of unknown boundary parameters in deformable surgical environments. This framework has two key components: (1) a probabilistic estimation to identify the current attachment points, achieved by integrating a differentiable soft-body simulator with an extended Kalman filter (EKF), and (2) an optimization-based active control pipeline that generates actions to maximize information gain of the tissue attachments, while simultaneously minimizing safety costs. The robustness of our estimation approach is demonstrated through experiments with real animal tissue, where we infer sutured attachment points using stereo endoscope observations. We also demonstrate the capabilities of our method in handling complex topological changes such as cutting and suturing.

Accurate deformable object manipulation (DOM) is essential for achieving autonomy in robotic surgery, where soft tissues are being displaced, stretched, and dissected. Many DOM methods can be powered by simulation, which ensures realistic deformation by adhering to the governing physical constraints and allowing for model prediction and control. However, real soft objects in robotic surgery, such as membranes and soft tissues, have complex, anisotropic physical parameters that a simulation with simple initialization from cameras may not fully capture. To use the simulation techniques in real surgical tasks, the real-to-sim gap needs to be properly compensated. In this work, we propose an online, adaptive parameter tuning approach for simulation optimization that (1) bridges the real-to-sim gap between a physics simulation and observations obtained 3D perceptions through estimating a residual mapping and (2) optimizes its stiffness parameters online. Our method ensures a small residual gap between the simulation and observation and improves the simulation’s predictive capabilities. The effectiveness of the proposed mechanism is evaluated in the manipulation of both a thin-shell and volumetric tissue, representative of most tissue scenarios. This work contributes to the advancement of simulation-based deformable tissue manipulation and holds potential for improving surgical autonomy.

Constrained robot motion planning is a ubiquitous need for robots interacting with everyday environments, but it is a notoriously difficult problem to solve. Many sampled points in a sample-based planner need to be rejected as they fall outside the constraint manifold, or require significant iterative effort to correct. Given this, few solutions exist that present a constraint-satisfying trajectory for robots, in reasonable time and of low path cost. In this work, we present a transformer-based model for motion planning with task space constraints for manipulation systems. Vector Quantized-Motion Planning Transformer (VQ-MPT) is a recent learning-based model that reduces the search space for unconstrained planning for sampling-based motion planners. We propose to adapt a pre-trained VQMPT model to reduce the search space for constraint planning without retraining or finetuning the model. We also propose to update the neural network output to move sampling regions closer to the constraint manifold. Our experiments show how VQ-MPT improves planning times and accuracy compared to traditional planners in simulated and real-world environments. Unlike previous learning methods, which require task-related data, our method uses pre-trained neural network models and requires no additional data for training and finetuning the model making this a one-shot process. We also tested our method on a physical Franka Panda robot with real-world sensor data, demonstrating the generalizability of our algorithm. We anticipate this approach to be an accessible and broadly useful for transfering learned neural planners to various robotic-environment interaction scenarios.

Robot navigation within complex environments requires precise state estimation and localization to ensure robust and safe operations. For ambulating mobile robots like robot snakes, traditional methods for sensing require multiple embedded sensors or markers, leading to increased complexity, cost, and increased points of failure. Alternatively, deploying an external camera in the environment is very easy to do, and marker-less state estimation of the robot from this camera’s images is an ideal solution: both simple and cost-effective. However, the challenge in this process is in tracking the robot under larger environments where the cameras may be moved around without extrinsic calibration, or maybe when in motion (e.g., a drone following the robot). The scenario itself presents a complex challenge: single-image reconstruction of robot poses under noisy observations. In this paper, we address the problem of tracking ambulatory mobile robots from a single camera. The method combines differentiable rendering with the Kalman filter. This synergy allows for simultaneous estimation of the robot’s joint angle and pose while also providing state uncertainty which could be used later on for robust control. We demonstrate the efficacy of our approach on a snake-like robot in both stationary and non-stationary (moving) cameras, validating its performance in both structured and unstructured scenarios. The results achieved show an average error of 0.05 m in localizing the robot’s base position and 6 degrees in joint state estimation. We believe this novel technique opens up possibilities for enhanced robot mobility and navigation in future exploratory and search-and-rescue missions.

Cloth manipulation is a category of deformable object manipulation of great interest to the robotics community, from applications of automated laundry-folding and home organizing to textiles and flexible manufacturing. Despite the desire for automated cloth manipulation, the thin-shell dynamics and under-actuation nature of cloth present significant challenges for robots to effectively interact with them. Many recent works omit explicit modeling in favor of learning-based methods that may yield control policies directly. However, these methods require large training sets that must be collected and curated. In this regard, we create a framework for differentiable modeling of cloth dynamics leveraging an Extended Position-based Dynamics (XPBD) algorithm. Together with the desired control objective, physics-aware regularization terms are designed for better results, including trajectory smoothness and elastic potential energy. In addition, safety constraints, such as avoiding obstacles, can be specified using signed distance functions (SDFs). We formulate the cloth manipulation task with safety constraints as a constrained optimization problem, which can be effectively solved by mainstream gradient-based optimizers thanks to the end-to-end differentiability of our framework. Finally, we assess the framework with various safety thresholds and demonstrate the feasibility of result trajectories on a surgical robot. The effects of the regularization terms are analyzed in an additional ablation study.