Enhancing Ultrasound Scanning Skills in a Leader-Follower Robotic System through Expert Hand Impedance Regulation.

Abstract

Traditional breast cancer surgeries require collaboration between ultrasound (US) doctors and surgeons, making the procedure complex and treating physicians prone to fatigue. In leader-follower robotic surgery, a surgeon controls an US robotic arm and an instrument robotic arm with their left and right hands, enabling independent surgical performance. However, the lack of US scanning skills among surgeons, as well as the physical separation in leader-follower operations, can negatively impact both the scanning and surgical outcomes. This paper proposes a robot-assisted scheme based on dynamic arm impedance compensation (IC) that references expert arm stiffness to compensate for novice arm stiffness. The impedance compensator adjusts the compensation strategy according to the scanning area and scanning stage. The impedance force generator estimates the scanning direction via Kalman filtering and applies stiffness and damping forces in the vertical direction to suppress tremors and other involuntary movements. The experimental results revealed that during the coarse and fine scanning phases, the probe position variance decreased by 57.9% and 73.6%, the contact force variance decreased by 55.2% and 42.5%, and the US image confidence increased by 22.0% and 23.8%, respectively. Compared with traditional filtering compensation (FC) schemes, this approach reduces the average position variance and contact force variance by 32.0% and 25.3%, respectively, and increases confidence by 7.3%. In a no-compensation test, the IC training group outperformed the FC group. This scheme can assist leader-follower US scanning and rapidly improve surgical skills.