Design and validation of looping assistance methods in robotic‐assisted neonatal surgical suturing in a chest model

Neonate patients have a reduced thoracic cavity, making thoracoscopic procedures even more challenging than their adult counterparts.We evaluated five control strategies for robot-assisted thoracoscopic surgical looping in simulations and experiments with a physical robotic system in a neonate surgical phantom. The strategies are composed of state-of-the-art constrained optimization and a novel looping force feedback term.All control strategies allowed users to successfully perform looping. A user study in simulation showed that the proposed strategy was superior in terms of Physical demand p<0.05$\left(p< 0.05\right)$ and task duration p<0.05$\left(p< 0.05\right)$ . The cumulative sum analysis of inexperienced users shows that the proposed looping force feedback can speed up the learning. Results with surgeons did not show a significant difference among control strategies.Assistive strategies in looping show promise and further work is needed to extend these benefits to other subtasks in robot-aided surgical suturing.