Towards Fluorescence-Guided Autonomous Robotic Partial Nephrectomy on Novel Tissue-Mimicking Hydrogel Phantoms

Kilmer, Ethan, Chen, Joseph, Ge, Jiawei, Sarda, Preksha, Cha, Richard, Cleary, Kevin, Shepard, Lauren, Ghazi, Ahmed Ezzat, Scheikl, Paul Maria, Krieger, Axel

arXiv.org Artificial Intelligence 

Autonomous robotic systems hold potential for improving renal tumor resection accuracy and patient outcomes. We present a fluorescence-guided robotic system capable of planning and executing incision paths around exophytic renal tumors with a clinically relevant resection margin. Leveraging point cloud observations, the system handles irregular tumor shapes and distinguishes healthy from tumorous tissue based on near-infrared imaging, akin to indocyanine green staining in partial nephrectomy. Tissue-mimicking phantoms are crucial for the development of autonomous robotic surgical systems for interventions where acquiring ex-vivo animal tissue is infeasible, such as cancer of the kidney and renal pelvis. To this end, we propose novel hydrogel-based kidney phantoms with exophytic tumors that mimic the physical and visual behavior of tissue, and are compatible with electrosurgical instruments, a common limitation of silicone-based phantoms. In contrast to previous hydrogel phantoms, we mix the material with near-infrared dye to enable fluorescence-guided tumor segmentation. Autonomous real-world robotic experiments validate our system and phantoms, achieving an average margin accuracy of 1.44 mm in a completion time of 69 sec.