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Knowledge-Based System for Port Placement and Robot Setup Optimization in Minimally Invasive Surgery

Abstract A new knowledge-based planning system is presented, that optimizes the positions of ports for the instruments and the endoscopic camera in manual and robot assisted laparoscopic surgery. For robot assisted interventions, the initial robot configuration of the da Vinci ® Surgical System is included in the optimization. Modeling of the patient, the intervention and the telemanipulator are described. The patient model is including the pneumoperitoneum. The intervention model is inferred from recorded trajectories of the surgical instruments. The optimization is performed with the Seed Throwing Optimization meta-heuristic. Criteria for optimization are reachability of target areas, collision avoidance and dexterity as well as ergonomic factors. These criteria are modeled as fuzzy sets. The optimized port positions are projected on the patient's abdomen with a new laser-based projection system. The error of the laser-based projection was measured. The advantages and disadvantages of the system are discussed and compared to an existing augmented reality system. First results show that the computed configuration leads to maximum access in the operation field in the narrow pelvis, maximum separation of the telemanipulator's arms and allows an ergonomic completion of the intervention.