Toward autonomous robotic-assisted interventions: the value of proximally placed audio-sensors for surface and event characterization

This article combines a holistic look at needed developments toward autonomous robotic-assisted surgeries combined with a presentation on a novel sensor and analysis technology using vibroacoustic audio signals as a tool for guiding, sensing, and supporting technology. Healthcare will experience many changes in the next 10 years. Intentional technology-based disruptions will have an effect on actual delivery but also come with novel health business models. This article will initially present some of the upcoming developments and subsequently focus on the use of artificial intelligence (AI) and intelligent sensing for application in robotic assisted surgery (RAS). The combination of these technologies will lead to dedicated RASs in the near future with reduced cost and complexity and higher precision and prediction capabilities. While the procedures have significant advantages for the patient, they also have problems, as the navigation/guidance of the devices to a target location is based on either preoperatively acquired images and then performed freehand or accompanied by intraoperative imaging, such as MRI or CT, which is expensive and complicated and can produce artifacts or video-based technologies that only allow direct visualization. Using robotic systems for moving and guiding these interventional and therapeutic devices adds additional issues, such as a lack of palpation sensation and/or tissue feedback. While it is possible to add sensors to the distal tip, this creates other obstacles concerning reduced functionality, need for cables, sterility issues and added complexity and cost. We propose the use of a proximally attached audio sensor to record tissue tool interactions and provide real-time feedback to clinicians. This paper reports initial attempts to use this technology with robotic arms for surface characterization and interventional vascular procedures, which have recently gained increased attention in combination with robotic devices. Advanced sensors and AI will be powerful combinations not only for guiding and supporting robotic procedures but also for enabling surgical outcome prediction, which could theoretically increase the safety of RASs.