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Haptics with Applications to Cranio-Maxillofacial Surgery Planning
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Virtual surgery planning systems have demonstrated great potential to help surgeons achieve a better functional and aesthetic outcome for the patient, and at the same time reduce time in the operating room resulting in considerable cost savings. However, the two-dimensional tools employed in these systems today, such as a mouse and a conventional graphical display, are difficult to use for interaction with three-dimensional anatomical images. Therefore surgeons often outsource virtual planning which increases cost and lead time to surgery.

Haptics relates to the sense of touch and haptic technology encompasses algorithms, software, and hardware designed to engage the sense of touch. To demonstrate how haptic technology in combination with stereo visualization can make cranio-maxillofacial surgery planning more efficient and easier to use, we describe our haptics-assisted surgery planning (HASP) system. HASP supports in-house virtual planning of reconstructions in complex trauma cases, and reconstructions with a fibula osteocutaneous free flap including bone, vessels, and soft-tissue in oncology cases. An integrated stable six degrees-of-freedom haptic attraction force model, snap-to-fit, supports semi-automatic alignment of virtual bone fragments in trauma cases. HASP has potential beyond this thesis as a teaching tool and also as a development platform for future research.

In addition to HASP, we describe a surgical bone saw simulator with a novel hybrid haptic interface that combines kinesthetic and vibrotactile feedback to display both low frequency contact forces and realistic high frequency vibrations when a virtual saw blade comes in contact with a virtual bone model. 

We also show that visuo-haptic co-location shortens the completion time, but does not improve the accuracy, in interaction tasks performed on two different visuo-haptic displays: one based on a holographic optical element and one based on a half-transparent mirror. 

Finally, we describe two prototype hand-worn haptic interfaces that potentially may expand the interaction capabilities of the HASP system. In particular we evaluate two different types of piezo-electric motors, one walking quasi-static motor and one traveling-wave ultrasonic motor for actuating the interfaces.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. , 79 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and Technology, ISSN 1651-6214 ; 1289
Keyword [en]
medical image processing, haptics, haptic rendering, haptic gripper, visuo-haptic co-location, vibrotactile feedback, surgery simulation, virtual surgery planning, cranio-maxillofacial surgery
National Category
Medical Image Processing Human Computer Interaction
Research subject
Computerized Image Processing
Identifiers
URN: urn:nbn:se:uu:diva-262378ISBN: 978-91-554-9339-4 (print)OAI: oai:DiVA.org:uu-262378DiVA: diva2:853863
Public defence
2015-10-16, Room 2247, Polacksbacken, Lägerhyddsvägen 2, Uppsala, 10:00 (English)
Opponent
Supervisors
Available from: 2015-09-25 Created: 2015-09-14 Last updated: 2015-10-01Bibliographically approved
List of papers
1. Haptics-assisted Virtual Planning of Bone, Soft Tissue, and Vessels in Fibula Osteocutaneous Free Flaps
Open this publication in new window or tab >>Haptics-assisted Virtual Planning of Bone, Soft Tissue, and Vessels in Fibula Osteocutaneous Free Flaps
Show others...
2015 (English)In: Plastic and Reconstructive Surgery - Global Open, ISSN 2169-7574, Vol. 3, no 8, e479Article in journal (Refereed) Published
Abstract [en]

Background: Virtual surgery planning has proven useful for reconstructing head and neck defects by fibula osteocutaneous free flaps (FOFF). Benefits include improved healing, function, and aesthetics, as well as cost savings. But available virtual surgery planning systems incorporating fibula in craniomaxillofacial reconstruction simulate only bone reconstruction without considering vessels and soft tissue.

Methods: The Haptics-Assisted Surgery Planning (HASP) system incorporates bone, vessels, and soft tissue of the FOFF in craniomaxillofacial defect reconstruction. Two surgeons tested HASP on 4 cases they had previously operated on: 3 with composite mandibular defects and 1 with a composite cervical spine defect. With the HASP stereographics and haptic feedback, using patient-specific computed tomography angiogram data, the surgeons planned the 4 cases, including bone resection, fibula design, recipient vessels selection, pedicle and perforator location selection, and skin paddle configuration.

Results: Some problems encountered during the actual surgery could have been avoided as they became evident with HASP. In one case, the fibula reconstruction was incomplete because the fibula had to be reversed and thus did not reach the temporal fossa. In another case, the fibula had to be rotated 180 degrees to correct the plate and screw placement in relation to the perforator. In the spinal case, difficulty in finding the optimal fibula shape and position required extra ischemia time.

Conclusions: The surgeons found HASP to be an efficient planning tool for FOFF reconstructions. The testing of alternative reconstructions to arrive at an optimal FOFF solution preoperatively potentially improves patient function and aesthetics and reduces operating room time.

Place, publisher, year, edition, pages
Wolters Kluwer, 2015
National Category
Medical Image Processing Surgery
Research subject
Computerized Image Processing
Identifiers
urn:nbn:se:uu:diva-260771 (URN)10.1097/GOX.0000000000000447 (DOI)
Available from: 2015-08-24 Created: 2015-08-24 Last updated: 2016-01-20Bibliographically approved
2. A haptics-assisted cranio-maxillofacial surgery planning system for restoring skeletal anatomy in complex trauma cases
Open this publication in new window or tab >>A haptics-assisted cranio-maxillofacial surgery planning system for restoring skeletal anatomy in complex trauma cases
2013 (English)In: International Journal of Computer Assisted Radiology and Surgery, ISSN 1861-6410, E-ISSN 1861-6429, Vol. 8, no 6, 887-894 p.Article in journal (Refereed) Published
Abstract [en]

Cranio-maxillofacial (CMF) surgery to restore normal skeletal anatomy in patients with serious trauma to the face can be both complex and time-consuming. But it is generally accepted that careful pre-operative planning leads to a better outcome with a higher degree of function and reduced morbidity in addition to reduced time in the operating room. However, today's surgery planning systems are primitive, relying mostly on the user's ability to plan complex tasks with a two-dimensional graphical interface. A system for planning the restoration of skeletal anatomy in facial trauma patients using a virtual model derived from patient-specific CT data. The system combines stereo visualization with six degrees-of-freedom, high-fidelity haptic feedback that enables analysis, planning, and preoperative testing of alternative solutions for restoring bone fragments to their proper positions. The stereo display provides accurate visual spatial perception, and the haptics system provides intuitive haptic feedback when bone fragments are in contact as well as six degrees-of-freedom attraction forces for precise bone fragment alignment. A senior surgeon without prior experience of the system received 45 min of system training. Following the training session, he completed a virtual reconstruction in 22 min of a complex mandibular fracture with an adequately reduced result. Preliminary testing with one surgeon indicates that our surgery planning system, which combines stereo visualization with sophisticated haptics, has the potential to become a powerful tool for CMF surgery planning. With little training, it allows a surgeon to complete a complex plan in a short amount of time.

National Category
Medical Image Processing Surgery
Identifiers
urn:nbn:se:uu:diva-198977 (URN)10.1007/s11548-013-0827-5 (DOI)000326455900002 ()23605116 (PubMedID)
Available from: 2013-04-21 Created: 2013-04-30 Last updated: 2017-12-06Bibliographically approved
3. Visuohaptic bone saw simulator: Combining vibrotactile and kinesthetic feedback
Open this publication in new window or tab >>Visuohaptic bone saw simulator: Combining vibrotactile and kinesthetic feedback
Show others...
2015 (English)In: Proc. 8th ACM SIGGRAPH Asia Technical Briefs, New York: ACM Press, 2015, 10:1-4 p.Conference paper, Published paper (Refereed)
Place, publisher, year, edition, pages
New York: ACM Press, 2015
National Category
Computer Vision and Robotics (Autonomous Systems)
Research subject
Computerized Image Processing
Identifiers
urn:nbn:se:uu:diva-262369 (URN)10.1145/2820903.2820925 (DOI)978-1-4503-3930-8 (ISBN)
Conference
ACM SIGGRAPH Asia 2015, November 2–5, Kobe, Japan
Available from: 2015-11-02 Created: 2015-09-14 Last updated: 2016-01-20Bibliographically approved
4. Snap-to-fit, a Haptic 6 DOF Alignment Tool for Virtual Assembly
Open this publication in new window or tab >>Snap-to-fit, a Haptic 6 DOF Alignment Tool for Virtual Assembly
2013 (English)In: Proc. World Haptics (WHC), 2013 IEEE, 2013, 205-210 p.Conference paper, Published paper (Refereed)
Abstract [en]

Virtual assembly of complex objects has application in domains ranging from surgery planning to archaeology. In these domains the objective is to plan the restoration of skeletal anatomy or archaeological artifacts to achieve an optimal reconstruction without causing further damage. While graphical modeling plays a central role in virtual assembly, visual feedback alone is often insufficient since object contact and penetration is difficult to discern due to occlusion. Haptics can improve an assembly task by giving feedback when objects collide, but precise fitting of fractured objects guided by delicate haptic cues similar to those present in the physical world requires haptic display transparency beyond the performance of today’s systems. We propose a haptic alignment tool that combines a 6 Degrees of Freedom (DOF) attraction force with traditional 6 DOF contact forces to pull a virtual object towards a local stable fit with a fixed object. The object forces are integrated into a virtual coupling framework yielding a stable haptic tool. We demonstrate the use of our system on applications from both cranio-maxillofacial surgery and archaeology, and show that we can achieve haptic rates for fractured surfaces with over 5000 points.

Keyword
Virtual Assembly, Force Feedback, Haptic Rendering, Fractured Object, Virtual Environments, 3D puzzle
National Category
Human Computer Interaction Interaction Technologies Medical Image Processing
Identifiers
urn:nbn:se:uu:diva-209551 (URN)10.1109/WHC.2013.6548409 (DOI)000325187400035 ()978-1-4799-0087-9 (ISBN)
Conference
IEEE World Haptics Conference (WHC), 14-18 April, 2013, Daejeon, SOUTH KOREA
Available from: 2013-10-21 Created: 2013-10-21 Last updated: 2015-09-25Bibliographically approved
5. Comparison of walking and traveling-wave piezoelectric motors as actuators in kinesthetic haptic devices
Open this publication in new window or tab >>Comparison of walking and traveling-wave piezoelectric motors as actuators in kinesthetic haptic devices
2016 (English)In: IEEE Transactions on Haptics, ISSN 1939-1412, E-ISSN 2329-4051, Vol. 9, no 3, 427-431 p.Article in journal (Refereed) Published
Abstract [en]

Piezoelectric motors offer an attractive alternative to electromagnetic actuators in portable haptic interfaces: they are compact, have a high force-to-volume ratio, and can operate with limited or no gearing. However, the choice of a piezoelectric motor type is not obvious due to differences in performance characteristics. We present our evaluation of two commercial, operationally different, piezoelectric motors acting as actuators in two kinesthetic haptic grippers, a walking quasi-static motor and a traveling wave ultrasonic motor. We evaluate each gripper's ability to display common virtual objects including springs, dampers, and rigid walls, and conclude that the walking quasi-static motor is superior at low velocities. However, for applications where high velocity is required, traveling wave ultrasonic motors are a better option.

National Category
Human Computer Interaction Robotics
Research subject
Computerized Image Processing; Engineering Science with specialization in Microsystems Technology
Identifiers
urn:nbn:se:uu:diva-262371 (URN)10.1109/TOH.2016.2537803 (DOI)000384670000012 ()27046907 (PubMedID)
Funder
Vårdal FoundationVINNOVA
Available from: 2016-03-30 Created: 2015-09-14 Last updated: 2017-12-04Bibliographically approved
6. Rendering stiffness with a prototype haptic glove actuated by an integrated piezoelectric motor
Open this publication in new window or tab >>Rendering stiffness with a prototype haptic glove actuated by an integrated piezoelectric motor
2012 (English)In: Haptics: Perception, Devices, Mobility, and Communication: Part I, Springer Berlin/Heidelberg, 2012, 361-372 p.Conference paper, Published paper (Refereed)
Place, publisher, year, edition, pages
Springer Berlin/Heidelberg, 2012
Series
Lecture Notes in Computer Science, 7282
National Category
Human Computer Interaction Interaction Technologies
Identifiers
urn:nbn:se:uu:diva-183878 (URN)10.1007/978-3-642-31401-8_33 (DOI)978-3-642-31400-1 (ISBN)
Conference
EuroHaptics 2012, Tampere, Finland, June 13-15
Projects
Whole Hand Haptics
Available from: 2012-05-30 Created: 2012-11-05 Last updated: 2015-09-25Bibliographically approved
7. Physically Co-Located Haptic Interaction with 3D Displays
Open this publication in new window or tab >>Physically Co-Located Haptic Interaction with 3D Displays
2012 (English)In: Proc. Haptics Symposium (HAPTICS), 2012 IEEE, 2012, 267-272 p.Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Studies indicate that haptic interaction with a computer generated virtual scene may become more intuitive by aligning (co-locating) the visual and haptic workspaces so that the visual and haptic feedback coincide as they do in the real world. Co-located haptics may gain importance when more advanced haptic interfaces, such as high-fidelity whole hand devices, become available. We describe a user study that investigates the pros and cons with physically co-located versus non-collocated haptics on two different display types: a commercial half-transparent mirror 3D display with shutter glasses and a prototype autostereoscopic display based on a Holographic Optical Element (HOE). We use two accuracy tasks with spatial accuracy as the dependent variable and one manipulation task with time as the dependent variable. The study shows that on both displays co-location significantly improves completion time in the manipulation task. However, the study shows that co-location does not improve the accuracy in the spatial accuracy tasks.

Keyword
Haptics, Co-Location, 3D displays, Stereoscopy
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:uu:diva-175446 (URN)10.1109/HAPTIC.2012.6183801 (DOI)
Conference
Haptics Symposium (HAPTICS), 2012 IEEE
Projects
Whole Hand Haptics
Available from: 2012-06-07 Created: 2012-06-07 Last updated: 2016-01-19

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