Dexterity enhancement in microsurgery using telemicro-robotics

The presentation will focus on finding the spectrum of dexterity performance while performing microsurgery in various specialties. It will be noted that individuals vary markedly in their performance in the position, velocity, stability, and force domains. There are surgeons who have a tremor who otherwise move very slowly and carefully while there are other surgeons who apply excessive force, but never have a tremor or move excessively fast. There are yet other surgeons who move excessively fast, yet they do not have a tremor. Dexterity enhancement includes position down scaling, tremor filtering, fatigue elimination, and other second-order issues such as confining the work space, velocities, accelerations, or forces. It will be described that the hand's position performance is degraded when it is asked to actuate the tools and that remote actuation alone increases the positioning capabilities. It will be noted that rotary and telescopic functions are far more difficult than writing or engraving-like motions. The safety issues concerning velocities and forces will be discussed and the need for impedance control pointed out. Simplistically, the devices should be made with variable compliance so that they can function rigidly as a robot would or compliantly as a human would, depending on the setting of this parameter. Tool interfaces will be discussed with an emphasis on the overall performance of the position, end effector, and tool as a unit. Space constraints, force, and velocity requirements will be discussed in this section as well. Referencing the coordinate system to pre- or inter-operative imaging systems will be discussed as well as an emphasis on the system architecture.