A team of researchers at Swiss École polytechnique fédérale de Lausanne (EPFL) has designed a system that allows four-arm laparoscopic surgery by controlling two additional robotic arms through haptic foot interfaces.

The team combined multi-limb manipulation with advanced shared control augmentation to advance in the laparoscopic surgery field.

According to EPFL, the findings have demonstrated the feasibility of the setup for reducing surgeon workload and enhancing precision and safety.

Developed in a partnership between the REHAssist research group and the Learning Algorithms and Systems Laboratory (LASA), the system is said to have five degrees of freedom.

In the setup, each hand controls a manipulative instrument, one foot operates an endoscope/camera, and another foot controls an actuated gripper. This system’s shared control between the surgeon and the robotic aides shows its key innovation.

The researchers’ control architecture guarantees that the surgeon and robots can cooperate in a contemporaneous workspace while achieving the precision and safety requirements of laparoscopic surgery, Switzerland-based EPFL said.

REHAssist group head Mohamed Bouri said: “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.”

“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.”

The robotics, known as shared control, can also take the lead in the surgeon’s control of the tool by anticipating where the surgeon wishes to proceed.

Furthermore, the shared-control strategies reduced task load, improved performance, increased fluency, and enhanced coordination during laparoscopic tasks.

Additionally, a user study with practising surgeons was conducted to assess the system’s ease of use and effectiveness.

LASA head Aude Billard said: “Controlling four arms simultaneously, moreover with one’s feet, is far from routine and can be quite tiring.

“To reduce the complexity of the control, the robots actively assist the surgeon by coordinating their movements with the surgeon’s through active prediction of the surgeon’s intent and adaptive visual tracking of laparoscopic instruments with the camera.’’