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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Inductive learning of surgical task knowledge from intra-operative expert feedback</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Daniele Meli</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Marco Bombieri</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Diego Dall'Alba</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Paolo Fiorini</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Department of Computer Science, University of Verona</institution>
          ,
          <addr-line>strada Le Grazie 15, 37134, Verona</addr-line>
          ,
          <country country="IT">Italy</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>Knowledge-based and particularly logic-based systems for task planning and execution guarantee trustability and safety of robotic systems interacting with humans. However, domain knowledge is usually incomplete. This paper proposes a novel framework for task knowledge refinement from realtime user feedback, based on inductive logic programming. The user feedback is used to generate cumulative examples which allow a learner to iteratively refine logic rules describing the task. Validated in a benchmark surgical training task, our system is also able to execute and learn unknown actions within reasonable time.</p>
      </abstract>
      <kwd-group>
        <kwd>eol&gt;Inductive Logic Programming</kwd>
        <kwd>Incremental learning</kwd>
        <kwd>Autonomous robots</kwd>
        <kwd>Surgical robotics</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>
        (a)
(b)
particular, we consider the training task of peg transfer (described in Section 2.1) from the
fundamentals of laparoscopic surgery [
        <xref ref-type="bibr" rid="ref8">8</xref>
        ], executed with da Vinci Research Kit (dVRK) [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ].
      </p>
      <p>
        ILP has been used by an international research community in diferent domains, particularly
to learn logic programs in AI [
        <xref ref-type="bibr" rid="ref10 ref11">10, 11</xref>
        ] and surgical robotics [
        <xref ref-type="bibr" rid="ref12 ref13">12, 13</xref>
        ]. It requires few example
executions, thanks to semantic generalization, so it outperforms neural networks and probabilistic
approaches in safety-critic scenarios with little data. ILP is mostly used for ofline learning,
while online knowledge refinement is only a recent trend [
        <xref ref-type="bibr" rid="ref14">14</xref>
        ], with no applications to robotics
to the best of our knowledge.
      </p>
    </sec>
    <sec id="sec-2">
      <title>2. Background</title>
      <sec id="sec-2-1">
        <title>2.1. The peg transfer task</title>
        <p>The setup for peg transfer (Figure 1a) consists of 2 patient-side manipulators (PSMs) of dVRK
equipped with graspers, and an external vision sensor (RGB-D camera). The grasping arms
operate on up to four colored rings, with the goal to place them on the same-colored pegs. This
task is subject to geometric constraints, e.g., each PSM can move only to reachable rings and
pegs (depending on the relative distance among them). For instance, in Figure 1a, the red-dashed
line defines regions of reachability for objects, e.g., the red ring and peg can be reached by
PSM1, while PSM2 needs to pick the blue ring and transfer it to PSM1 before placement on the
peg. Furthermore, rings may be initially placed on grey pegs, thus extraction may be required.</p>
      </sec>
      <sec id="sec-2-2">
        <title>2.2. Answer Set Programming (ASP)</title>
        <p>
          ASP [
          <xref ref-type="bibr" rid="ref3">3</xref>
          ] is a state-of-the-art logic programming formalism for task planning. Following standard
syntax from [
          <xref ref-type="bibr" rid="ref15">15</xref>
          ], an ASP program represents a domain of interest with a signature and axioms.
The signature is the alphabet of the domain, defining variables, i.e., main entities of the domain
(Arm, Object, Color1 for peg transfer), and atoms, i.e., predicates of variables (e.g., reachable(A,
O, C), to represent reachability of objects in peg transfer, or actions). Values of variables are
constants (either integers, Booleans, or strings, e.g., possible colors for C). A term whose value is
assigned is ground, and an atom is ground if its terms are ground. Axioms define logical relations
between atoms. In the peg transfer scenarios, these are task specifications. For instance,
grasp(A, ring, C, t) :- at(A, ring, C, t).
        </p>
        <p>:- closed_gripper(A, t), grasp(A, ring, C, t).
state that a ring can be grasped if an arm is close to it (normal axiom) and that an arm with
a closed gripper cannot grasp (constraint), respectively. t is a variable for temporal planning,
representing a discrete time step. Symbol :- is ASP syntax for logic implication ← .</p>
      </sec>
      <sec id="sec-2-3">
        <title>2.3. Inductive Logic Programming (ILP) for ASP</title>
        <p>
          This section provides salient concepts from the Inductive Learning of Answer Set Program
(ILASP), the state-of-the-art tool for learning axioms explaining answer sets [
          <xref ref-type="bibr" rid="ref16">16</xref>
          ].
        </p>
        <p>A generic ILP problem  under the ASP semantics is defined as the tuple  = ⟨,  , ⟩,
where  is the background knowledge, i.e. a set of axioms, atoms and variables in ASP syntax;
 is the search space, i.e. the set of candidate ASP axioms that can be learned; finally,  =
+ ∪ − is a set of examples. The goal of  is to find a subset  ⊆  such that  ∪
 |= . Examples are Context-Dependent Partial Interpretations (CDPIs), i.e., couples ⟨, ⟩,
being  a partial interpretation and  the context. A partial interpretation is a set of ground
atoms, corresponding to actions for the purpose of this paper. Similarly, the context is a set
of ground atoms representing environmental variables. Examples may be positive (∈ +), i.e.,
partial interpretations possibly generated solving  ∪  ∪ , or negative (∈ − ), i.e., partial
interpretations never generated solving  ∪  ∪ . This means that positive examples typically
induce normal axioms (e.g., preconditions and efects of actions), while negative examples
generate constraints (cautious induction).</p>
        <p>ILASP finds the minimal hypothesis, i.e., with the least number of axioms and atoms, covering
examples.</p>
      </sec>
    </sec>
    <sec id="sec-3">
      <title>3. The framework</title>
      <p>
        We propose a framework for refining (surgical) robotic task knowledge during execution, thanks
to continuous feedback by human experts supervising the autonomous behavior (see Figure 1b).
The basic workflow is the following:
1. a task/domain knowledge base  is initialized with available prior information (e.g., main
task resources and specifications) in ASP formalism; for complex tasks, prior information
can be extracted from domain books [
        <xref ref-type="bibr" rid="ref17">17, 18, 19</xref>
        ], or obtained with interviews to experts.
      </p>
      <sec id="sec-3-1">
        <title>1From now on, we will denote Arm, Object, Color as A, R, C, respectively, for brevity.</title>
        <p>(a) Grasping. (A)
(b) Extraction. (U,L).</p>
        <p>(c) Go to peg. (U,L)
(d) End of task. (A)
2. an autonomous planning/execution module, e.g., the one proposed in [20, 21, 22], interprets
sensor information in order to ground environmental atoms (context ) in ASP, and
reason on task knowledge to generate a sequence of actions. This module is also in charge
of motion planning and execution according to each specific action;
3. before executing each action planned by the reasoner, feedback is asked to an expert user,
in order to preserve safety. The user may either confirm or reject the proposed action.
The user can also propose a specific action to be executed, in case the autonomous planner
is not able to find one in the current context;
4. the human feedback, the action, and the context from the planning/execution module,
generate a CDPI stored in a list of examples. Specifically, each accepted/proposed action
corresponds to is saved in +, while rejected actions are in − . For computational
convenience, we store examples for each action separately;
5. when a negative example is generated, say for action a, an ILASP-based learning module
considers all examples for a and , except for axioms including a. In fact, these axioms
have generated a wrong plan according to the expert user, so they are probably incorrect.
Hence, new axioms are generated for a and added to . Discarding axioms for a does not
afect the computational burden of learning since ILASP complexity depends on the size
of  , hence the number of context atoms.</p>
      </sec>
    </sec>
    <sec id="sec-4">
      <title>4. Experimental results</title>
      <p>We perform a preliminary validation of our framework in a simulated environment in
CoppeliaSim2 replicating the dVRK setup for peg transfer and autonomous planning/execution
framework with Clingo [23] for ASP solving (plan computation) as in [20]. The human feedback
is given to the system via the command line, with the user typing either yes/no for confirmation
of every single action, or a specific action to be executed as a predicate in ASP syntax. The goal
is to refine axioms defining preconditions of actions and constraints.</p>
      <p>We assume that the autonomous system is not aware of extract(A, ring, C) action,
needed when a ring is on a peg before moving it away. We consider the initial scenario in Figure</p>
      <sec id="sec-4-1">
        <title>2https://www.coppeliarobotics.com/</title>
        <p>2a. After grasping, the autonomous planner proposes move(psm2, peg, yellow). However,
the action is infeasible, so the user forbids it and commands extract(psm2, ring, yellow).
At this moment, the list of examples contains only a positive example for extraction and one
negative for moving to peg. Corresponding ASP axioms are removed from the task knowledge
base, and ILASP runs two parallel learning tasks, leading to an empty hypothesis for moving to
peg (no positive examples) and the following axiom as a precondition for extraction:
extract(A, ring, C, t) :- in_hand(A, ring, C, t).</p>
        <p>After extraction (Figure 2b), the autonomous system should plan move(psm2, peg, yellow),
but axioms for this action have been removed at the previous learning stage. Hence, the user is
required to input the action to be executed (Figure 2c), introducing a new positive example for
it. Hence, the following axioms can be learned:
move(A, peg, C, t) :- reachable(A, peg, C, t).</p>
        <p>:- in_hand(A, ring, C, t), on(ring, C, peg, C2, t), move(A, peg, C3, t).
with the latter constraints specifying that moving to the peg is not possible when the ring is on
another peg. Finally, in Figure 2d the autonomous system can complete the task for the blue ring
(executing extraction correctly) with the newly learned axioms. A video of the execution can
be found at https://bit.ly/AIRO2022. Overall, the learner is invoked 3 times, with a maximum
learning time of ≈ 6 s. For each action,  includes ≈ 400 axioms.</p>
      </sec>
    </sec>
    <sec id="sec-5">
      <title>5. Conclusion</title>
      <p>We have presented a system based on user’s feedback to refine existing task knowledge, in the
form of a logic program (e.g., an ASP program). Preliminary results in a paradigmatic training
task for robotic surgery show that our system is able to propose actions to an expert, execute
them only in case of approval (supervised autonomy for safety), accept commands of possibly
unknown actions from the expert and exploit them to iteratively refine task knowledge for
future re-use in autonomous execution.</p>
      <p>Future research will focus on the improvement of the existing system, in order to adopt it in a
real robotic setup. In particular, learning of motion primitives associated with unknown actions
shown by the user will be needed, e.g., with dynamic movement primitives [24]. Moreover, in
order to increase the usability of the framework in a real surgical setup, the user should be able
to provide feedback via vocal commands. For instance, with reference to Figure 2a the user
could state extract the yellow ring, then move it to the yellow peg, which could then be interpreted
with natural language processing based on ad-hoc linguistic resources (e.g., [18]), and translated
to ASP syntax for knowledge refinement. Finally, we remark that learning times with ILASP
can be further improved with, e.g., ad-hoc incremental solvers [25].</p>
    </sec>
    <sec id="sec-6">
      <title>Acknowledgments</title>
      <p>This project has received funding from the European Research Council (ERC) under the European
Union’s Horizon 2020 research and innovation programme (grant agreement No. 742671 “ARS”).
s11548-021-02370-9.
[18] M. Bombieri, M. Rospocher, S. P. Ponzetto, P. Fiorini, The robotic surgery procedural
framebank, in: Proceedings of the Thirteenth Language Resources and Evaluation
Conference, European Language Resources Association, Marseille, France, 2022, pp. 3950–3959.</p>
      <p>URL: https://aclanthology.org/2022.lrec-1.420.
[19] M. Bombieri, M. Rospocher, S. P. Ponzetto, P. Fiorini, Machine understanding surgical
actions from intervention procedure textbooks, Comput. Biol. Medicine 152 (2023) 106415.
URL: https://doi.org/10.1016/j.compbiomed.2022.106415. doi:10.1016/j.compbiomed.
2022.106415.
[20] M. Ginesi, D. Meli, A. Roberti, N. Sansonetto, P. Fiorini, Autonomous task planning
and situation awareness in robotic surgery, in: IEEE/RSJ International Conference on
Intelligent Robots and Systems, IEEE, 2020, pp. 3144–3150.
[21] D. Meli, et al., Autonomous tissue retraction with a biomechanically informed logic based
framework, in: 2021 IEEE Int. Symp. on Medical Robotics (ISMR) [in press], IEEE, 2021,
pp. 0–7.
[22] E. Tagliabue, D. Meli, D. Dall’alba, P. Fiorini, Deliberation in autonomous robotic surgery:
a framework for handling anatomical uncertainty, in: Proceedings - IEEE International
Conference on Robotics and Automation, 2022, pp. 11080–11086.
[23] M. Gebser, R. Kaminski, B. Kaufmann, M. Ostrowski, T. Schaub, P. Wanko, Theory
solving made easy with clingo 5, in: Technical Communications of the 32nd International
Conference on Logic Programming (ICLP 2016), Schloss Dagstuhl-Leibniz-Zentrum fuer
Informatik, 2016, pp. 2:1–2:15.
[24] M. Ginesi, D. Meli, A. Roberti, N. Sansonetto, P. Fiorini, Dynamic movement primitives:
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Robotic Systems 101 (2021) 1–20.
[25] M. Law, K. Broda, A. Russo, Search space expansion for eficient incremental inductive logic
programming from streamed data, International Joint Conference on Artificial Intelligence
(2022).</p>
    </sec>
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