LATIOS: Latency-Aware Telemonitoring for Injection in Ophthalmic Surgery - an Adaptive Motion Scaling Approach
Korab Hoxha, Angelo Henriques, Junjie Yang, Naheen Ahnaf, Mahdi Tavakoli, M. Ali Nasseri
AI summary
Problem
Communication latency in long-distance telerobotic surgery causes dangerous tool overshoots and forceful tissue contact, particularly in high-precision ophthalmic procedures where static motion scaling fails to adapt to dynamic risk.
Approach
The LATIOS framework adaptively modulates the robot's insertion velocity by fusing real-time, shadow-based depth estimation of the tool-to-retina distance with measured communication delay to proactively dampen motion as risk increases.
Key results
- Statistically significant reduction in punctuation forces versus constant control (p=0.005)
- Transatlantic user study validating performance under 150–200 ms natural latency
- Quantified safety-efficiency trade-off demonstrating slower completion for improved safety
- Integration of shadow-based depth estimation with latency-aware velocity scaling
Why it matters
Provides a practical, context-aware safety framework to overcome latency barriers and enable safer clinical adoption of long-distance telerobotic surgery.
Abstract
Communication latency in long-distance teler- obotic surgery poses a critical safety risk, particularly in high- precision procedures like retinal surgery where tool overshoots can cause irreversible patient injury. This paper introduces the Latency-Aware Telemonitoring for Injection in Ophthalmic Surgery (LATIOS) framework, which enhances safety by adap- tively scaling the surgical robot’s velocity along the critical axis of tool insertion. Our core contribution is a control algorithm that dynamically modulates the velocity scaling factor based on two real-time, coupled variables: the tool-tip-to-retina distance, estimated via a non-contact, shadow-based method, and the measured communication delay. We validated this system in a transatlantic user study where six participants in North America teleoperated a surgical robot in Europe to perform a series of simulated retinal punctuation tasks. The results demonstrate that LATIOS provides a statistically significant reduction in applied punctuation forces compared to constant control (p = 0.005). This objective safety improvement is achieved through a deliberate safety-efficiency trade-off, with the system enforcing a more cautious pace under high-latency conditions. Our work presents a robust, context-aware safety framework that addresses a key barrier to the clinical adoption of long-distance telerobotic surgery.