Surgeons performing highly skilled microsurgery tasks can benefit from information and manual assistance to overcome technological and physiological limitations to make surgery safer, efficient, and more successful. Vitreoretinal surgery is particularly difficult due to inherent micro-scale and fragility of human eye anatomy. Additionally, surgeons are challenged by physiological hand tremor, poor visualization, lack of force sensing, and significant cognitive load while executing high-risk procedures inside the eye, such as epiretinal membrane peeling. This dissertation presents the architecture and the design principles for a Surgical Augmentation Environment , which is used to develop innovative functionality to address these fundamental limitations in vitreoretinal surgery. It is an inherently information driven modular system incorporating robotics, sensors, and multimedia components. The integrated nature of the system is leveraged to create intuitive and relevant human-machine interferences and generate a particular system behavior to provide active physical assistance and present relevant sensory information to the surgeon. These include basic manipulation assistance, audio-visual and haptic feedback, intraoperative imaging and force sensing. The resulting functionality, and the proposed architecture and design methods generalize to other microsurgical procedures. The system’s performance is demonstrated and evaluated using phantoms and in-vivo experiments.
Marcin Balicki received a BSc in Interdisciplinary Engineering (2001) and Masters in Mechanical Engineering from Cooper Union (2004), where he was also an Adjunct Professor, teaching courses in engineering design and prototyping, engineering graphics, and product development. While teaching, he became interested in medical devices and joined the Minimally Invasive Surgery Lab, NYU School of Medicine. There he led software and hardware development of a novel navigation system for knee replacement surgery. For his PhD at The Johns Hopkins University, he has been working with a bioengineering research team under the direction of Russell H. Taylor to develop a breakthrough microsurgical system that incorporates new robotic manipulators, intra-ocular sensing devices, and visualization techniques to address the extreme challenges of vitreoretinal surgery. The goal of this system is to enable surgeons to perform currently impossible treatments, while also improving the safety and success rates of existing vitreoretinal procedures. Its ultimate benefit will be the millions of patients who suffer from blindness and difficult-to-treat eye conditions.