Proceedings of The 15th Hamlyn Symposium on Medical Robotics 2023最新文献

{"title":"Magnetic Anchored and Cable Driven Endoscope for Minimally Invasive Surgery","authors":"Jixiu Li, T. Zhang, T. Cheng, Calvin Sze Hang Ng, P. Chiu, Zheng Li","doi":"10.31256/hsmr2023.21","DOIUrl":"https://doi.org/10.31256/hsmr2023.21","url":null,"abstract":"Globally, the minimally invasive surgery (MIS) has been applied to more and more medical fields. MIS can provide many benefits for the patient, such as reduced pain, faster recovery, and better cosmesis [1]. But it also causes many challenges to the doctor and assistant during the long surgery. The most prominent problem is how to get the desired view through the narrow incision and the current solution is to insert a rigid endoscope into the surgical cavity of the patient. But this method will also bring about many problems and magnify the difficulty of the surgery. Firstly, the motion of the endoscope is limited by the incision especially when sharing the same port with other instruments, leading to the insufficient field of view (FOV) during the surgery. Also, the frequent collisions between the endoscope and other instruments will also interfere the adjustment of FOV. To address the above issues, the magnetic anchored and guided system (MAGS) is proposed [2]. Due to there is no rigid shaft and the endoscope is attached on the inner wall of the surgical cavity, the problems of port-crowing and instrument-fencing can be significantly alleviated, as shown in Fig.1. But how to arrange and control additional degrees of freedom (DOF) on MAGS to make it can cover the full FOV for surgeon is still a challenging problem. Here, we introduce the cable-driven mechanism to combine with the magnetic actuation method, providing a feasible solution for clinical application.","PeriodicalId":129686,"journal":{"name":"Proceedings of The 15th Hamlyn Symposium on Medical Robotics 2023","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129730056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TOWARDS CELLULAR LEVEL MICROSURGERY: DESIGN AND TESTING OF A HIGH PRESISION DELTA ROBOT FOR MEDICAL APLICATIONS","authors":"Xiaoyu Huang, E. Rendon-Morales, R. Aviles-Espinosa","doi":"10.31256/hsmr2023.9","DOIUrl":"https://doi.org/10.31256/hsmr2023.9","url":null,"abstract":"The development of future surgical therapies has driven the efforts to increase the precision of robot-guided manipulators beyond sub-millimetre accuracies. Medical applications such as reconstructive microsurgery, vitreoretinal eye surgery and cellular level neurosurgery still require achieving precision comparable to the size of human cells [1]. Most commercially available systems can achieve millimetre accuracies with a few examples of higher precision instruments including ophthalmic and reconstructive microsurgery robots achieving accuracies within the range of hundreds of microns [1]. A parallel robot is a closed-loop mechanism where the end-effector is coupled to the base via multiple sequences of links. These devices are mostly used in industrial pick and place applications due their advantages including high precision, stiffness, speed, and low moving inertia [2]. However, a major disadvantage is their limited workspace and rotational capabilities. In the context of cellular level surgical applications, having a reduced workspace does not represent a disadvantage given that, as in most of the cases, the surgical procedure is to be performed within a reduced manipulation volume. This paper presents an integrated methodology outlining the design and testing of a delta robot based on linear actuators achieving micron level end effector positioning accuracy. The main application of the here presented design is to perform superficial tissue optical biopsy with future prospects of being able to conduct cellular level surgeries. The design methodology considers two parameters determining the robot geometry and dimensions these are: the end-effector workspace (~ 5 mm3) and the end-effector motion resolution (1 μm). The robot performance was evaluated using a non-contact metrology approach based on bright field microscopy (BFM) to characterize the precision and kinematic performance. Our results demonstrate that the presented methodology can be used for designing high precision robots achieving accuracies <1 μm.","PeriodicalId":129686,"journal":{"name":"Proceedings of The 15th Hamlyn Symposium on Medical Robotics 2023","volume":"2013 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132575568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonically-Lubricated Catheters: A Proof of Concept","authors":"Mostafa A. Atalla, Jeroen J. Tuijp, Michael Wiertlewski, A. Sakes","doi":"10.31256/hsmr2023.12","DOIUrl":"https://doi.org/10.31256/hsmr2023.12","url":null,"abstract":"Over the past few decades, minimally-invasive en- dovascular interventions have proved its benefits over conventional open heart surgeries, leading to shorter recovery times and lower infection rates. In a typical endovascular procedure, the interventionist inserts a catheter in the radial or femoral artery and navigates it through the arteries to the heart, where the intervention is performed. In order to safely reach the heart, the catheters (and guidewires) used during these procedures need to easily follow the curves in the vascular system, while creating as little friction as possible with the blood vessel wall. If these devices exhibit high friction, there is a risk of damage to the mucous membranes or the intima of the blood vessels, which may lead to infectious diseases or thrombus formation [1], [2]. While low friction is beneficial to avoid damage to the membranes and blood vessel wall, it makes holding a specific location in open spaces, such as inside the heart, difficult. This is particularly true when high forces need to be applied, such as when cutting or puncturing tissues. This suggests the need for new advanced catheters whose frictional properties are controllable and can be adjusted depending on the phase of the catheterization proce- dure; for instance, having low friction while navigating through the vasculature and switching to a high friction state while executing the surgical task. In this work, we propose a novel concept of a variable friction catheter, which comprises discrete modules for friction control. We hereby present the proof-of-concept of the friction control modules, which we characterized in simulation and experimentally. Finally, we present the preliminary results of the sliding friction experiments.","PeriodicalId":129686,"journal":{"name":"Proceedings of The 15th Hamlyn Symposium on Medical Robotics 2023","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133704451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incident Angle Study for Designing an Endoscopic Tool for Intraoperative Brain Tumor Detection","authors":"K. Yamamoto, Tanner J. Zachem, Weston A. Ross, P. Codd","doi":"10.31256/hsmr2023.58","DOIUrl":"https://doi.org/10.31256/hsmr2023.58","url":null,"abstract":"Surgery is one of the most prevalent methods of control- ling and eradicating tumor growth in the human body, with a projection of 45 million surgical procedures per year by 2030 [1]. In brain tumor resection surgeries, pre- operative images used for the detection and localization of the cancer regions become less reliable throughout surgery when used intraoperatively due to the brain moving during the procedure, referred to as brain shift. To solve the brain shift problem, intraoperative MRI (iMRI) has been used, but it is costly, time intensive, and only available at the most advanced care facilities [2]. Intraoperative fluorescence-guided methods, both exoge- nous (introducing foreign fluorophore molecules into the body) and endogenous (utilizing innate fluorophores within the body), have been investigated as an alternative to iMRI to circumvent the brain shift problem. This paper introduces the proposed design, shown in Fig. 1(a), of an endoscopic tool for intraoperative brain tumor detection incorporating a laser-based endogenous fluorescence method previously explored by [3], called TumorID, depicted in Fig. 1(b). The device has also been deployed on ex-vivo pituitary adenoma tissue by [4] for intraoperative pituitary adenoma identification and subtype classification. This study explores whether a non-perpendicular angle of incidence (AoI) will sig- nificantly affect the emitted spectral data. With a better understanding of the relationship between AoI and col- lected spectra, the results can help shed light on the potential steering modality ( optical [5] or fiber [6]) and end-effector movement profile for the proposed optics- based endoscopic tool.","PeriodicalId":129686,"journal":{"name":"Proceedings of The 15th Hamlyn Symposium on Medical Robotics 2023","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114079748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Soft Continuum Robot with Multi-Modal Shape and Contact Force Sensing for Minimally Invasive Surgery","authors":"Max McCandless, Frank Juliá Wise, S. Russo","doi":"10.31256/hsmr2023.46","DOIUrl":"https://doi.org/10.31256/hsmr2023.46","url":null,"abstract":"Minimally invasive surgery (MIS), e.g., interventional endoscopy and single-incision laparoscopy, has paved the way toward increased patient safety, fewer postop- erative complications, and shorter recovery times [1]. The inherent compliant nature of soft robots makes them suitable for addressing current limitations in MIS, such as the lack of dexterity of rigid robotic devices; however, soft robots often lack adequate shape and contact sensing which makes them difficult to control [2], [3]. The future of laparoscopic surgical tools is moving toward flexible and soft robotic solutions for safer interaction with hu- man tissue [4]. However, newly developed technologies lack effective embedded sensing [5]. This work presents a fully soft robot combining i) a soft optical sensorized multi-modal gripper for tip tracking and contact force sensing with ii) a multi-directional bending module with integrated 3D shape sensing (Fig. 1, a-b). The gripper embeds two soft pneumatic actuators to deploy the jaws, two soft pneumatic actuators to control grasping, and two fully soft optical waveguide sensors (WG) (one in each jaw) with tuned roughness to monitor both actuator tip positions and subsequent contact force on an object.","PeriodicalId":129686,"journal":{"name":"Proceedings of The 15th Hamlyn Symposium on Medical Robotics 2023","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127836879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-Guided Robotic Prostate Biopsy","authors":"Haipeng Liang, Wanli Zuo, Dimitri A. Kessler, T. Barrett, Z. T. Tse","doi":"10.31256/hsmr2023.6","DOIUrl":"https://doi.org/10.31256/hsmr2023.6","url":null,"abstract":"Prostate cancer is one of the most common malignancies and the second leading cause of cancer death in men [1]. Approximately 52,300 new cases of prostate cancer are detected in the UK every year, that’s more than 140 every day. Magnetic resonance imaging (MRI) has been widely used in the diagnosis of prostate cancer, as it can offer high-resolution tissue imaging at arbitrary orientations and monitor therapeutic agents, surgical tools, and tissue properties. Therefore, a robot - under the guidance of MRI - can target the tumor regions with high accuracy to obtain the biopsy samples for diagnosis, thus reducing unnecessary gland punctures and maximizing the utility of a minimally invasive system. However, as MR scanners require a strong magnetic field, ferromagnetic materials are precluded as they can cause a hazard to the device and patients, and paramagnetic materials can generate their own magnetic field which will distort the image quality. As a result, MR-safe actuators are required to power the robot. Plus, due to the limited size of the MR bores, the robot operating inside should be as compact as possible [2]. In this paper, a robotic system for MRI-guided prostate biopsy is proposed. Comparing with the existing designs, it has a compact size, with the workspace covering the whole prostate. The use of pneumatically powered actuators can avoid the influence of electromagnetic interference. The working principle, mathematical model, and mechanism design are presented. The needle insertion experiment under an MR environment was conducted.","PeriodicalId":129686,"journal":{"name":"Proceedings of The 15th Hamlyn Symposium on Medical Robotics 2023","volume":"478 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123395683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An application of SlicerROS2: Haptic latency evaluation for virtual fixture guidance in breast conserving surgery","authors":"Laura Connolly, A. Deguet, T. Ungi, Aravind Kumar, A. Lasso, K. Sunderland, A. Krieger, S. Léonard, G. Fichtinger, P. Mousavi, R. Taylor","doi":"10.31256/hsmr2023.64","DOIUrl":"https://doi.org/10.31256/hsmr2023.64","url":null,"abstract":"Breast conserving surgery (BCS) is a surgical intervention for breast cancer where the surgeon resects the primary tumor and preserves the surrounding healthy tissue. These procedures have a high failure rate because it is often difficult to localize breast tumor boundaries intraoperatively. Emerging surgical robotic technology demonstrates promise for addressing such challenges. Hand-over-hand control is a design concept that involves cooperative handling of a surgical instrument by the surgeon and a robot. These systems can be used to reduce hand-tremor, improve dexterity, and implement virtual guidance [1]. One way to do this is with a virtual fixture (VF) which is a computer-generated constraint that is communicated from robotic devices to human operators via force and position signals [2]. A forbidden region VF can be used to enforce a safety region or “no-go zone” that can prevent the operator from damaging delicate or critical anatomy. In this paper, we use an Omni Bundle robot (formerly known as a Phantom Omni) to introduce haptic feedback in BCS. In doing so, we demonstrate a new and simplified approach to implementing a VF using open-source software tools such as 3D Slicer and robot operating system (ROS). We also make use of an existing surgical navigation platform that is used for BCS and describe how to deploy this system to encourage adaptation to other clinical applications.","PeriodicalId":129686,"journal":{"name":"Proceedings of The 15th Hamlyn Symposium on Medical Robotics 2023","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124551801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meshless Modelling for Heat-based Robotic Navigation of Radio Frequency Catheter Ablation","authors":"Konstantinos A. Mountris, R. Schilling, A. Casals, H. Wurdemann","doi":"10.31256/hsmr2023.27","DOIUrl":"https://doi.org/10.31256/hsmr2023.27","url":null,"abstract":"Radio frequency catheter ablation (RFCA) of cardiac arrhythmia is commonly performed by navigating the catheter manually. Nevertheless, remote navigation tech- niques where catheter steering is performed using either a magnetic field or robotically are available. Clinical ex- perience with these techniques demonstrated that higher contact forces can be achieved with robotic compared to magnetic field navigation [1]. This translates into more effective ablation lesions, but if excessive contact force is applied it may lead to higher risk of cardiac perforation [2]. However, the robotic navigation system is no longer commercially available and advancements have been stalled. To ensure high effectiveness and low complica- tion risk in next-gen robotic navigation systems, tissue heat distribution should be taken into account. Compu- tational models for heat distribution simulation predict lesion formation effectively [3]. However, their clinical application is limited since they have been developed for single-site ablation and numerical accuracy depends on the quality of mesh discretization. In this work, we propose a novel meshless model to simulate tissue heat distribution during robotic navigation assisted ablation. The model accounts for non-zero initial conditions and time dependent boundary conditions to simulate multi- site ablation. The meshless Fragile Points Method (FPM) is employed for the numerical solution of the model to ensure its suitability for clinical application, since FPM does not require the definition of a mesh [4], [5].","PeriodicalId":129686,"journal":{"name":"Proceedings of The 15th Hamlyn Symposium on Medical Robotics 2023","volume":"381 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132877217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pop-Up Soft Robot Driven by Hydraulic Folded Actuators for Minimally Invasive Surgery","authors":"Jianlin Yang, M. Runciman, J. Avery, Zhi-lian Sun, G. Mylonas","doi":"10.31256/hsmr2023.52","DOIUrl":"https://doi.org/10.31256/hsmr2023.52","url":null,"abstract":"The incidence rate of colorectal cancer ranks third among all cancers, which is a serious threat to human health [1]. Endoscopic submucosal dissection (ESD) is an effective endoscopic surgical method for early gastric and colorectal cancers [2]. However, ESD is a procedure with high technical requirements, which brings a higher risk of complications and requires long training for clinicians [3]. Robots are expected to simplify ESD procedures and reduce training time. But there is no standard flexible robotic endoscope at present. Soft robots can potentially offer better adaptability and safer interaction with the environment. As such, they hold great potential in solving the technical challenges of the current minimally invasive surgery (MIS), which are difficult to be solved by rigid robots. Here we demonstrate an inflatable robot which is largely made of flexible plastic film. In the deflated state, it is easy to collapse, fold and roll into a small size, promising easier delivery by a carrier endoscope to the proximal colon. After reaching the target site, the robot is inflated and the surgery is performed. This work is based on the inflatable Cyclops robot [4][5]. However, small folded hydraulic actuators are used to replace the contraction-based pouch actuators used in [5], which have a larger size. The anchor points of the cables with planar layout replace the spatial layout in [4], which reduces the axial size of the robot, allowing it to pass through the colon bends more easily. Folded actuators made of an airbag are flexible and adaptable [6]. The actuator volume is very small under deflated condition, but it can achieve large deformation after inflation. The proposed actuator uses a folded chamber to pull the cable to produce a large displacement without the need of displacement amplification mechanisms. In the deflated state, the length of soft scaffold of the robot is about 65mm, and the overall size of the robot is 100mm ×6mm×20mm. In the state of inflation, the soft scaffold deploys into a hexagonal prism with a length of 55mm, and the bottom side length of the prism is 30mm. The tip workspace of the robot can reach 40mm in all three directions of the local coordinate system.","PeriodicalId":129686,"journal":{"name":"Proceedings of The 15th Hamlyn Symposium on Medical Robotics 2023","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124931644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmented Reality-based Surgical Guidance for Anterior and Posterior Cruciate Ligament Reconstruction","authors":"Deokgi Jeung, Hyun-Joo Lee, Hee-June Kim, Jaesung Hong","doi":"10.31256/hsmr2023.26","DOIUrl":"https://doi.org/10.31256/hsmr2023.26","url":null,"abstract":"Anterior and posterior cruciate ligament (ACL and PCL) reconstructions are common knee arthroscopic surgeries. ACL and PCL reconstruction have small incision sites, thus enabling fast recovery of the patient. However, an arthroscope provides a limited view due to the small size of the camera lens, and a small incision restricts the motion of surgical instruments. As a result, finding the exact bone drilling position that was preoperatively determined to connect a new ligament between the femur and tibia is challenging during surgery. A previous study verified that the complication ratio of ACL and PCL reconstruction is 9.0 % and 20.1 %, respectively, which are particularly high compared to other knee arthroscopic surgeries [1]. Augmented reality (AR)-based surgical guidance can assist in difficult ACL and PCL reconstruction. Hu et al. [2] proposed AR-based non-invasive drilling guidance for the femur in open knee surgery. To implement the non-invasive system, they performed the registration between the depth data of the femur obtained from RGBD sensors and the pre-scanned femur model. However, this method is suitable for open knee surgery and is not for arthroscopic surgeries such as ACL and PCL reconstruction. Recently, Chen et al. [3] introduced non-invasive AR for knee arthroscopy. However, to reflect knee movements occurring during surgery in AR, it is necessary to manually select four anatomical landmarks in the arthroscopic view. Manual selection is inconvenient and may be inconsistent, interfering with surgical procedures. In this study, we propose a non-invasive AR-based surgical guidance for ACL and PCL reconstruction with compensation of the intraoperative knee movement. Unlike preoperative CT and MR, which are taken under the extension state, the knee is under the flexion state during surgery, which requires compensation for the knee movement. The proposed method estimates knee movement without direct bone exposure or manual intervention by exploring the correlation between the knee surface and the internal bones (femur and tibia) based on a finite element method. The proposed method can enhance the AR for knee arthroscopic procedures, leading to more accurate bone drilling for ACL or PCL reconstruction.","PeriodicalId":129686,"journal":{"name":"Proceedings of The 15th Hamlyn Symposium on Medical Robotics 2023","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125066081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}