MEDiC: Autonomous Surgical Robotic Assistance to Maximizing Exposure for Dissection and Cautery

Surgical automation has the capability to improve the consistency of patient outcomes and broaden access to advanced surgical care in underprivileged communities. Shared autonomy, where the robot automates routine subtasks while the surgeon retains partial teleoperative control, offers great potential to make an impact. In this paper we focus on one important skill within surgical shared autonomy: Automating robotic assistance to maximize visual exposure and apply tissue tension for dissection and cautery. Ensuring consistent exposure to visualize the surgical site is crucial for both efficiency and patient safety. However, achieving this is highly challenging due to the complexities of manipulating deformable volumetric tissues that are prevalent in surgery. To address these challenges we propose MEDiC, a framework for autonomous surgical robotic assistance to Maximizing Exposure for Dissection and Cautery. We integrate a differentiable physics model with perceptual feedback to achieve our two key objectives: 1) Maximizing tissue exposure and applying tension for a specified dissection site through visual-servoing control and 2) Selecting optimal control positions for a dissection target based on deformable Jacobian analysis. We quantitatively assess our method through repeated real robot experiments on a tissue phantom. Our visual-servoing and optimal control position selection achieve success rate of 100% and 82% respectively in ablation study. We also showcase our framework's capabilities through dissection experiments using shared autonomy on real animal tissue.