IEEE Robotics & Automation Magazine - December 2021 - 66

augmentations to training protocols accordingly. The
general paradigm being investigated appears to center
around personalizing training experiences to the trainee
and tailoring protocols and feedback. Further efforts are
needed to fully understand how such systems will impact
current clinical training for robotic surgery, especially
with more advances in AI and objective mentoring support
systems [267].
High-fidelity simulators are
also key to effective clinical
training programs and the
development of robotic
surgery skills.
Hardware Implementation and Integration
Hardware implementation and integration is quite a heterogenous
category. It includes the works that have contributed
to the development of
the dVRK system and
further modifications of
the software and hardware
as well as new
instruments that make
the surgery more affordable
and capable of
interface with other surgical
equipment. Hence,
the highest number of
publications (99) belong
to this group. We subdivide
the section according to which components were
modified and the goals of these modifications.
dVRK Platform Implementation and Integration
This category includes papers published during the development
of the dVRK. Both the hardware and software components
are described in [5], [6], [12], [22], [25], [33], [34], and
[37]-[40]. Recently, a few integrations were published in
[253], where a new control strategy for gravity compensation
of the MTMs was proposed to compensate for nonlinear disturbance
forces. This gravity compensation strategy was then
integrated into the software architecture of the dVRK and
publicly released.
Haptics and Pseudohaptics
Several research groups investigated how to overcome the
lack of haptic feedback in the current da Vinci system.
Numerous hardware and software developments [65]-[67],
[79], [80], [106], [107], [114], [124], [193] worked on
implementing haptics or force-sensing integration with the
dVRK. The researchers also explored how such systems can
link to automation [118], [212], [213], [224], [228]. The use
of virtual fixtures, previously mentioned in the " Training,
Skill Assessment, and Gesture Recognition " section as an
intraoperative guidance tool, were investigated in [26]-
[28], [77], [84], [167], [168], [205], [208], and [209] by providing
constraints on the instruments' workspace. The use
of force information within augmented reality to provide
the surgeons with visual feedback about forces (the socalled
pseudohaptics) was also explored [29], [30], [32],
[105], [227], [254].
66 * IEEE ROBOTICS & AUTOMATION MAGAZINE * DECEMBER 2021
New Surgical Tools
In this category, publications include works focusing on the
design and integration of new tools compatible with the
dVRK: new surgical instruments [108]-[112], [115], [116],
[123], [129], [130], [160], [194], [206], [207], [214], [249],
[250], [252], and new sensing systems [73], [74], [180], [198],
[248]. New flexible endoscopes and vision devices have also
recently been proposed in [244] and [245].
New Control Interfaces
Some articles reported the development of novel control
interfaces of the endoscopic camera by using head-mounted
displays [127], [148] as well as integrating the console viewer
[126] or the manipulators [128] with additional sensing technologies
to simultaneously control the surgical tools and the
camera. Additional studies tried to improve' the ergonomics
and the portability of the master console [166], [169], [170].
Surgical Workflow Optimization
The final category of publications relates to technologies that
can enhance the surgeon's awareness [31], [211] and perception
from a visual point of view; for example, using eye-gaze
trackers [76], [78] to personalize a surgeon's experience or
combining different imaging techniques, such as ultrasounds
[72], [181], to provide more intraoperative visual information
but also from tactile sensing [120]-[122], [160], [251]. A significant
research effort also targeted improving the teleoperation
capabilities of the dVRK, taking into account time delay
[23], possible master-slave misalignment [64], constrained
workspace [35], shared control [41], or incorporating virtual
environment guidance [55].
Other
Additional works investigated the use of the dVRK as a
means of exploring clinical indications beyond its current
intent or for nonsurgical applications. For example, retinal
surgery [24], heart surgery [75], and portable simulators [210]
were addressed. Several studies included using the master
controllers to drive vehicles in simulations [136] or cutting
the satellite insulation [36].
In summary, this research field highlights how research
teams are taking advantage of an open platform like the
dVRK to easily integrate and test novel technologies. Modified
end effectors, such as flexible instrumentation and devices
like new imaging probes or tools interacting with tissue
using ultrasound, can benefit from the dVRK by using it as a
platform that allows for rapid testing in user studies. The
main advantage of the dVRK controllers is the potential to
break the master-slave link and the capability to use and control
each one of the components independently, thus enabling
experimentation with new applications.
System Simulation and Modeling
This smaller field of seven publications contains studies that
focused on the integration of the dVRK into surgical simulation
environments. We note however that the small size of
IEEE Robotics & Automation Magazine - December 2021

Table of Contents for the Digital Edition of IEEE Robotics & Automation Magazine - December 2021
