Robotic assistance allows surgeons to perform dexterous and tremor-free procedures, but robotic aid is still under-represented in procedures with constrained workspaces, such as deep brain neurosurgery and endonasal surgery. In these procedures, surgeons have restricted vision to areas near the surgical tooltips, which increases the risk of unexpected collisions between the shafts of the instruments and their surroundings. In this paper, our vector-field-inequalities method is extended to provide dynamic active-constraints to any number of robots and moving objects sharing the same workspace. The method is evaluated with experiments and simulations in which robot tools have to avoid collisions autonomously and in real-time, in a constrained endonasal surgical environment. Simulations show that with our method the combined trajectory error of two robotic systems is optimal. Experiments using a real robotic system show that the method can autonomously prevent collisions between the moving robots themselves and between the robots and the environment. Moreover, the framework is also successfully verified under teleoperation with tool-tissue interactions.

Background: Integrating simulators with robotic surgical procedures could assist in designing and testing of novel robotic control algorithms and further enhance patient‐specific pre‐operative planning and training for robotic surgeries.Methods: A virtual reality simulator, developed to perform the transsphenoidal resection of pituitary gland tumours, tested the usability of robotic interfaces and control algorithms. It used position‐based dynamics to allow soft‐tissue deformation and resection with haptic feedback; dynamic motion scaling control was also incorporated into the simulator.Results: Neurosurgeons and residents performed the surgery under constant and dynamic motion scaling conditions (CMS vs DMS). DMS increased dexterity and reduced the risk of damage to healthy brain tissue. Post‐experimental questionnaires indicated that the system was well‐evaluated by experts.Conclusion: The simulator was intuitively and realistically operated. It increased the safety and accuracy of the procedure without affecting intervention time. Future research can investigate incorporating this simulation into a real micro‐surgical robotic system.

Vitreoretinal surgery is challenging even for expert surgeons owing to the delicate target tissues and the diminutive workspace in the retina. In addition to improved dexterity and accuracy, robot assistance allows for (partial) task automation. In this work, we propose a strategy to automate the motion of the light guide with respect to the surgical instrument. This automation allows the instrument’s shadow to always be inside the microscopic view, which is an important cue for the accurate positioning of the instrument in the retina. We show simulations and experiments demonstrating that the proposed strategy is effective in a 700-point grid in the retina of a surgical phantom. Furthermore, we integrated the proposed strategy with image processing and succeeded in positioning the surgical instrument’s tip in the retina, relying on only the robot’s geometric information and microscopic images.