Vision-Based Surgical Suture Looping Through Trajectory Planning for Wound Suturing

Robot-assisted surgery has revolutionized the field of surgery over the past few decades. Despite many successes, achieving full automation in these surgeries remains a challenging task. In this paper, a dynamic approach is proposed to automate knot tying with an in-house robot vision system. Through efficient path planning and coordination between two grippers, the workspace required for constructing the suture loop can be reduced while issues such as suture slippage and collisions between instruments can be eliminated. Visual images were employed to monitor the two grippers in real time and their positions were evaluated using transformation matrices obtained experimentally. A linear quadratic control scheme was applied to optimize the tracking performance of the two grippers. From the experiments, this visual evaluation method can achieve a position accuracy of 1 mm in the workspace. The proposed algorithm was evaluated and automatic suture looping operation was successfully performed in all six trials. Different parameters in the control scheme were also examined by introducing external impulse disturbances during the knot-tying process. This proposed knot-tying approach demonstrates a simple and efficient way to construct a suture knot in a minimal workspace. Note to Practitioners - A surgical operation usually takes several hours to complete, which is a test of surgeon's endurance. To better assist surgeons, several repetitive surgical tasks can be performed automatically with a robotic system. This paper presents a new method for robot-assisted surgical knot tying in a confined environment. Through simultaneous manipulation and trajectory planning of the two surgical grippers, suture loops were constructed while keeping the suture in tension. Images were employed to guide the gripers in completing the knot-tying process with high precision. Experiments were conducted to demonstrate the automated suture looping operation with the system and the proposed method. The robustness of the method was also examined by introducing impulse disturbances and occlusions during the experiments. This proposed method does not require complicated hardware setup, allowing easy implementations on various surgical systems.