Researchers at Swiss Federal Institute of Technology Lausanne (EPFL) have developed a robotic system that allows surgeons to perform surgeries with four arms by using their feet on an interface. The results, published in The International Journal of Robotics Research, specify the device is designed to help with laparoscopy operations, which are used to examine the abdomen and pelvic region.
The research was a collaboration between the research group REHAssist and the Learning Algorithms and Systems Laboratory. Led by EPFL Ph.D. Jacob Hernandez and Walid Amanhoud, the pedal-like interface allows surgeons to control two robotic arms using haptic foot interfaces with five degrees of freedom. This allows each of the surgeon’s hands to control an instrument to carry out the procedure while using the additional arms – one foot controls an actuated gripper while the other controls an endoscope or camera – as auxiliaries.
“Actuators in the foot pedals give haptic feedback to the user, guiding the foot towards the target as if following an invisible field-of-forces, and also limit force and movement to ensure that erroneous feet movements do not endanger the patient,” said Mohamed Bouri, Head of REHAssist. “Our system opens up new possibilities for surgeons to perform four-handed laparoscopic procedures, allowing a single person to do a task that is usually performed by two, sometimes three people.”
In addition to reducing reliance on a number of staff, the team has also claimed the robot can enhance the user’s performance by sometimes predicting the surgeon’s movements, assisting in the motion and helping to minimise fatigue.
“Controlling four arms simultaneously, moreover with one’s feet, is far from routine and can be quite tiring,” said Aude Billard, Head of LASA. “To reduce the complexity of the control, the robots actively assist the surgeon by coordinating their movements with the surgeons through active prediction of the surgeon’s intent and adaptive visual tracking of laparoscopic instruments with the camera. Additionally, assistance is offered for more accurate grasping of the tissues.”
The system has already seen successful operation by specialists, and clinical trials are ongoing in Geneva to bring it into commercialisation.
The idea of increasing a surgeon’s limbic system to aid in surgery has long been an area of research. As early as 2016, tests in the US of the Intuitive Surgical’s da Vinci system has allowed surgeons the use of four arms, although that system’s operation meant that all arms were robotic.