Patent Publication Number: US-11660158-B2

Title: Enhanced haptic feedback system

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     The present application is a continuation application of United States application Ser. No.: 16/385,133 filed on Apr. 16, 2019, which claims the benefit of and priority to U.S. Provisional Application Ser. No. 62/682,204, filed on Jun. 8, 2018 the entire contents of each of which are incorporated herein by reference. 
    
    
     BACKGROUND 
     Technical Field 
     The present disclosure relates to monitoring instruments for minimally invasive surgical procedures and, more particularly, to an enhanced haptic feedback system for use with various laparoscopic surgical procedures. 
     Description of Related Art 
     In minimally invasive surgery (MIS) and various percutaneous procedures, limited visibility and limited anatomical feedback can often supersede the advantages of the procedure and put the surgeon at a relative disadvantage compared to open procedures. Moreover, many MIS procedures require additional incisions to accommodate an endoscope to improve visibility. These additional instruments typically do not provide any tactile feedback which may be advantageous during particular types of procedures, e.g., tactile feedback allows a surgeon to appreciate relevant physiological information about biological tissues and allows an interactive experience through a haptic interface while operating. 
     Rudimentary haptic interfaces have been used in gaming, e.g., gaming controllers, however, in the medical field, haptic technology has mostly been limited to simulators for various medical procedures in a virtual environment, for example, for teaching purposes. 
     Medical companies have also implemented haptic feedback systems that provide notification signals and/or vibro-tactile sensations as an alert when too much force is applied or to direct user controlled systems or robotic/tele-surgical operating systems. However, these systems do not provide the operator with tangible sensations that are physiologically relevant or reliable, nor do they provide a corresponding visual user interface that conveys the tactile information along with visual images of the body tissue. 
     SUMMARY 
     As used herein, the term “distal” refers to the portion that is being described which is further from a user, while the term “proximal” refers to the portion that is being described which is closer to a user. 
     In accordance with one aspect of the present disclosure, an enhanced haptic feedback system for medical diagnostics includes a laparoscope configured to be inserted into a body cavity of a patient to view internal tissue and tissue structures, the laparoscope is electrically coupled to a graphical user interface (GUI) configured to display an image of the tissue thereon or obtain an image of the tissue. An imaging device is included and is configured to acquire physiological data about tissue, process the acquired physiological data, and output the processed data to a graphical user haptic interface (GUHI) capable of generating tangible sensations utilizing one or more haptic interfaces. The GUHI is configured to combine the image received from the laparoscope and the processed physiological data received from the imaging device to provide tangible sensations on both a front screen of the GUHI and a rear screen of the GUHI allowing a surgeon the sensation of feeling for abnormal tissue conditions between the surgeon&#39;s hands. Normal tissue properties may be assessed in this fashion as well. 
     In aspects according to the present disclosure, the imaging device is selected from the group consisting of an ultrasound device, a magnetic resonance imaging (MRI) device, a computerized axial tomography (CT) scanner, and a functional magnetic resonance imaging (fMRI) device. In other aspects, the imaging device is a portable ultrasound probe. In still other aspects, the GUHI is portable and is configured to be held between the surgeon&#39;s fingers and thumb. 
     In yet other aspects, the imaging device is configured to acquire and process physiological data about tissue in real time and combine the processed physiological data about tissue with the image received from the laparoscope in real time. In still other aspects, the imaging device is configured to acquire and process physiological data about tissue prior to combining the processed physiological data with the image from the laparoscope. 
     In accordance with another aspect of the present disclosure, an enhanced haptic feedback system for medical diagnostics includes an imaging device configured to acquire physiological data about tissue, process the acquired physiological data, and output the processed data to a graphical user haptic interface (GUHI) capable of generating tangible sensations utilizing one or more haptic interfaces. The GUHI is configured to combine an image received from a laparoscope and the processed physiological data received from the imaging device to provide tangible sensations on both a front screen of the GUHI and a rear screen of the GUHI allowing a surgeon the sensation of feeling for abnormal tissue conditions between the surgeon&#39;s hands. 
     In aspects according to the present disclosure, the imaging device is selected from the group consisting of an ultrasound device, a magnetic resonance imaging (MRI) device, a computerized axial tomography (CT) scanner, and a functional magnetic resonance imaging (fMRI) device. In other aspects, the imaging device is a portable ultrasound probe. In still other aspects, the GUHI is portable and is configured to be held between the surgeon&#39;s fingers and thumb. 
     In yet other aspects, the imaging device is configured to acquire and process physiological data about tissue in real time and combine the processed physiological data about tissue with the image received from the laparoscope in real time. In still other aspects, the imaging device is configured to acquire and process physiological data about tissue prior to combining the processed physiological data with the image from the laparoscope. 
     The present disclosure also relates to a method for assessing tissue maladies ad includes positioning a laparoscopic or camera enabled device into a body cavity of a patient to visualize tissue and display a tissue image on a graphical user interface (GUI). The method also includes: acquiring physiological tissue data from an imaging source, combining both the acquired physiological data and the tissue image on a graphical user haptic interface (GUHI), and generating tangible sensations via one or more haptic interfaces on both a front screen of the GUHI and a rear screen of the GUHI allowing a surgeon to feel and diagnose various tissue maladies. Normal tissue properties may be assessed in this fashion as well. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Various aspects of the present disclosure are described herein with reference to the drawings wherein like reference numerals identify similar or identical elements: 
         FIG.  1    is a schematic view of a surgical system including an enhanced haptic feedback system including a laparoscope, a display and a graphical user haptic interface (GUHI) according to the present disclosure; 
         FIG.  2    is an enlarged view of the GUHI of  FIG.  1   ; and 
         FIG.  3    is an enlarged, schematic view of the GUHI of  FIG.  1    shown in use. 
     
    
    
     DETAILED DESCRIPTION 
     Throughout the description, any particular feature(s) of a particular exemplary embodiment may be equally applied to any other exemplary embodiment(s) of this specification as suitable. In other words, features between the various exemplary embodiments described herein are interchangeable as suitable, and not exclusive. 
     Various embodiments of the presently disclosed system enable surgeons to acquire, read, modify, store, write, and download acquired sensor data in real time and display the information on one or more haptic displays. A haptic display is a device that portrays a visual representation of an object (such as a computer monitor, television, or cell phone display) and combines surface haptics overlayed on the image, producing variable forces on a user&#39;s finger as it interacts with the surface haptics. This can give the illusion of feeling textures and three dimensional shapes as the user touches the image on the screen. 
     CT scans, MRIs, fMRIs and ultrasound probes can detect, among other things, density of tissue. This acquired sensor data can be combined with images of actual tissue in real time. For example, if a laparoscope is used to view the surgical site, the location and orientation of the camera can be tracked so that the focal point has a known location within the patient. Using this known location, density data from a previous scan, e.g., a CT scan or MRI, and even real-time data from a live ultrasound probe (portable or standalone) can be used to overlay haptic data on a screen that the surgeon can then feel with his or her own hands. 
     Referring now to  FIGS.  1  and  2   , an enhanced haptic display system is shown and is generally identified as haptic system  10 . Haptic system  10  includes a surgical camera  20  which may be an endoscope or laparoscope  20  operatively coupled via a cable  21  to a graphical user interface (GUI)  50  for displaying images “T 1 ” of tissue “T” disposed within a body cavity “BC” of a patient. An imaging device  70  is included and includes a probe  60  electrically coupled via cable  65  to the imaging device  70 . Imaging device  70  may be an ultrasound probe  60  that is configured to render images of tissue “T” in real time or imaging device  70  may be CT scan, MRI, FMRI or any other type of imaging device capable of acquiring sensor data relating to tissue or organs either in real time or prior to using the haptic system  10 . Imaging device  70  is configured to measure various tissue properties, e.g., tissue density, blood flow, etc., and convert the acquired sensed data to haptic signal data readable and displayable by a graphical user haptic interface (GUHI)  100 . 
     GUHI  100  is operatively coupled via cable  75  to the GUI  50  and is configured to display images of the tissue “T 3 ” overlapped with acquired sensor data (haptic data) obtained from imaging device  70 . In various embodiments, the haptic system  10  communicates with the operator (e.g., surgeon) using a symbolic language descriptive of biological tissues physical properties and the characteristics of motors and actuators that constitute the interactive components of one or more haptic interfaces. Typically the haptic system  10  includes a touch screen interface, e.g., front screen  110  or rear panel or rear screen  120  ( FIG.  2   ), which can provide haptic signals to the user and is thus an active display with touch and/or feedback that programs the one or more haptic interfaces. The haptic system  10  may include haptic signals that confirm programmable or system features (e.g., a palpable click) and provide additional sensor feedback that is descriptive of the events occurring in the haptic interfaces (e.g., vibro-tactile feedback, haptic rendering of physiologic events, audible and visual cues). 
     In embodiments, modification of the haptic experience of a user may be accomplished in real time (e.g. during procedures). Visual icons  130   a  and secondary notations  130   b  (see  FIG.  3   ) may be included to provide a simplified graphical format and to augment the haptic feedback to further reflect relevant physiological information. The various haptic interfaces provide a way to display acquired sensor data from one or more imaging sources  70 , and control the corresponding actions of one or more corresponding actuators or haptic elements within the screen, e.g., screen  110  and/or screen  120 . 
     The symbolic language communicated by the imaging device  70  provides the acquired sensor data in both frequency and time and enables a user-friendly means for understanding, interacting with and controlling hardware, firmware and programming software in real time. The presently disclosed haptic system  10  provides an open, universally compatible platform capable of sensing or acquiring physiological signals/data (referred to as acquired sensor data) in any format; processing of the acquired sensor data within an operating system; and outputting the processed signals to the GUHI  100  which generates tangible sensations via one or more haptic interfaces. Tangible sensations are able to be felt or modified by the surgeon in real time on the GUHI  100  which allows a surgeon to feel and diagnose various tissue types and tissue maladies, e.g., tumors. Normal tissue properties may be assessed in this fashion as well. 
     The GUHI  100  utilizes various haptic interfaces including motors, actuators, and haptic elements to provide tactile feedback to the surgeon concerning the tissue. For example, the imaging device  70  may provide acquired sensor data to the GUHI  100  concerning tissue density of a liver. During a liver resection, a surgeon may need to feel for lumps in the liver in order to identify the appropriate plane of dissection that will excise an appropriate margin of healthy tissue on the patient side. This is to ensure that all of the cancer is removed, and only healthy tissue is left within the patient. As such, using the haptic system  10 , the surgeon can feel the varying densities of the liver and quickly ascertain lumps or abnormal tissue masses to define an acceptable dissection plane. 
       FIG.  2    shows an enlarged view of the GUHI  100  and includes a front screen  110  and a rear panel or rear screen  120 . The acquired sensor data from the imaging device  70  (and image “T 2 ” if available) along with the image of the tissue “T 1 ” from the laparoscope  20  are combined and displayed on the front screen  110  as tissue image “T 3 ”. More particularly, the image “T 1 ” from the laparoscope is displayed on the front screen  110  and the surface haptics from the acquired sensor data is overlaid on the image “T 2 ” to produce an image “T 3 ” that provides variable forces on a user&#39;s fingers or hand as the user interacts with the surface of the front screen  110 . As a result, the user is given the illusion of feeling textures as the user touches the image “T 3 ” on the front screen  110 . 
     The acquired haptic data can also be combined with images of the actual tissue in real time. For example, the location and orientation of the laparoscope can be tracked so that the focal point has a known location within the patient. Using this known location, density data from a previous CT scan or MRI or even real time data from a live ultrasound probe may be used to overlay surface haptics from the acquired sensor data on the front screen  110 . 
     The surface haptics from the acquired sensor data may also be overlaid on the rear screen  120 . This would give the surgeon the ability to feel three dimensional objects such as a lump more effectively. For example, the surgeon can put his or her hand around the GUHI  100  (around both the front and rear screens  110 ,  120 , respectively) and feel objects between his/her thumb and fingers ( FIG.  3   ). It is contemplated that utilizing both the front screen  110  and the rear screen  120  as haptic surfaces will enhance medical diagnostics, e.g., for more effectively analyzing mammograms. 
     The disclosure also relates to a method for operating a haptic system  10  including positioning a laparoscopic or camera-enabled device  20  into a body cavity “BC” to visualize tissue “T” and displaying a tissue image “T 1 ” on a GUI  50 . The method also includes obtaining imaging information “T 2 ” or physiological tissue data (acquired sensor data) from an imaging source (CT scan, MRI, fMRI, ultrasound, etc.), displaying a tissue image “T 3 ” on a GUHI  100 , overlaying the acquired sensor data on the tissue image “T 3 ”, and generating tangible sensations via one or more haptic interfaces on both the front screen  110  of the GUHI  100  and the rear screen  120  of the GUHI  100  relating to one or more tissue properties, e.g., tissue density. Tangible sensations may be felt by the surgeon in real time on the GUHI  100  which allows a surgeon to feel and diagnose various tissue types and tissue maladies, e.g., tumors. 
     The various embodiments disclosed herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery.” Such systems employ various robotic elements to assist the clinician and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the clinician during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc. 
     The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of clinicians may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another clinician (or group of clinicians) remotely controls the instruments via the robotic surgical system. As can be appreciated, a highly skilled clinician may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients. 
     For a detailed description of exemplary medical work stations and/or components thereof, reference may be made to U.S. Patent Application Publication No. 2012/0116416, and PCT Application Publication No. WO2016/025132, the entire contents of each of which are incorporated by reference herein. 
     Persons skilled in the art will understand that the structures and methods specifically described herein and shown in the accompanying figures are non-limiting exemplary embodiments, and that the description, disclosure, and figures should be construed merely as exemplary of particular embodiments. It is to be understood, therefore, that the present disclosure is not limited to the precise embodiments described, and that various other changes and modifications may be effected by one skilled in the art without departing from the scope or spirit of the disclosure. Additionally, the elements and features shown or described in connection with certain embodiments may be combined with the elements and features of certain other embodiments without departing from the scope of the present disclosure, and that such modifications and variations are also included within the scope of the present disclosure. Accordingly, the subject matter of the present disclosure is not limited by what has been particularly shown and described.