985 research outputs found
Robot Autonomy for Surgery
Autonomous surgery involves having surgical tasks performed by a robot
operating under its own will, with partial or no human involvement. There are
several important advantages of automation in surgery, which include increasing
precision of care due to sub-millimeter robot control, real-time utilization of
biosignals for interventional care, improvements to surgical efficiency and
execution, and computer-aided guidance under various medical imaging and
sensing modalities. While these methods may displace some tasks of surgical
teams and individual surgeons, they also present new capabilities in
interventions that are too difficult or go beyond the skills of a human. In
this chapter, we provide an overview of robot autonomy in commercial use and in
research, and present some of the challenges faced in developing autonomous
surgical robots
Soft Robot-Assisted Minimally Invasive Surgery and Interventions: Advances and Outlook
Since the emergence of soft robotics around two decades ago, research interest in the field has escalated at a pace. It is fuelled by the industry's appreciation of the wide range of soft materials available that can be used to create highly dexterous robots with adaptability characteristics far beyond that which can be achieved with rigid component devices. The ability, inherent in soft robots, to compliantly adapt to the environment, has significantly sparked interest from the surgical robotics community. This article provides an in-depth overview of recent progress and outlines the remaining challenges in the development of soft robotics for minimally invasive surgery
ADVANCED IMAGING AND ROBOTICS TECHNOLOGIES FOR MEDICAL APPLICATIONS
Due to the importance of surgery in the medical field, a large amount of research has been conducted in this area. Imaging and robotics technologies provide surgeons with the advanced eye and hand to perform their surgeries in a safer and more accurate manner. Recently medical images have been utilized in the operating room as well as in the diagnostic stage. If the image to patient registration is done with sufficient accuracy, medical images can be used as "a map" for guidance to the target lesion. However, the accuracy and reliability of the surgical navigation system should be sufficiently verified before applying it to the patient. Along with the development of medical imaging, various medical robots have also been developed. In particular, surgical robots have been researched in order to reach the goal of minimal invasiveness. The most important factors to consider are determining the demand, the strategy for their use in operating procedures, and how it aids patients. In addition to the above considerations, medical doctors and researchers should always think from the patient's point of view. In this article, the latest medical imaging and robotic technologies focusing on surgical applications are reviewed based upon the factors described in the above. © 2011 Copyright Taylor and Francis Group, LLC.1
A Novel Flexible and Steerable Probe for Minimally Invasive Soft Tissue Intervention
Current trends in surgical intervention favour a minimally invasive (MI) approach,
in which complex procedures are performed through increasingly small incisions.
Specifically, in neurosurgery, there is a need for minimally invasive keyhole access,
which conflicts with the lack of maneuverability of conventional rigid instruments. In
an attempt to address this fundamental shortcoming, this thesis describes the concept
design, implementation and experimental validation of a novel flexible and steerable
probe, named “STING” (Soft Tissue Intervention and Neurosurgical Guide),
which is able to steer along curvilinear trajectories within a compliant medium.
The underlying mechanism of motion of the flexible probe, based on the reciprocal
movement of interlocked probe segments, is biologically inspired and was
designed around the unique features of the ovipositor of certain parasitic wasps.
Such insects are able to lay eggs by penetrating different kinds of “host” (e.g. wood,
larva) with a very thin and flexible multi-part channel, thanks to a micro-toothed
surface topography, coupled with a reciprocating “push and pull” motion of each segment.
This thesis starts by exploring these foundations, where the “microtexturing”
of the surface of a rigid probe prototype is shown to facilitate probe insertion into
soft tissue (porcine brain), while gaining tissue purchase when the probe is tensioned
outwards. Based on these findings, forward motion into soft tissue via a reciprocating
mechanism is then demonstrated through a focused set of experimental trials in
gelatine and agar gel. A flexible probe prototype (10 mm diameter), composed of
four interconnected segments, is then presented and shown to be able to steer in a
brain-like material along multiple curvilinear trajectories on a plane. The geometry
and certain key features of the probe are optimised through finite element models,
and a suitable actuation strategy is proposed, where the approach vector of the tip is
found to be a function of the offset between interlocked segments. This concept of a
“programmable bevel”, which enables the steering angle to be chosen with virtually
infinite resolution, represents a world-first in percutaneous soft tissue surgery.
The thesis concludes with a description of the integration and validation of a fully
functional prototype within a larger neurosurgical robotic suite (EU FP7 ROBOCAST),
which is followed by a summary of the corresponding implications for future
work
Healthcare Robotics
Robots have the potential to be a game changer in healthcare: improving
health and well-being, filling care gaps, supporting care givers, and aiding
health care workers. However, before robots are able to be widely deployed, it
is crucial that both the research and industrial communities work together to
establish a strong evidence-base for healthcare robotics, and surmount likely
adoption barriers. This article presents a broad contextualization of robots in
healthcare by identifying key stakeholders, care settings, and tasks; reviewing
recent advances in healthcare robotics; and outlining major challenges and
opportunities to their adoption.Comment: 8 pages, Communications of the ACM, 201
Snake-Like Robots for Minimally Invasive, Single Port, and Intraluminal Surgeries
The surgical paradigm of Minimally Invasive Surgery (MIS) has been a key
driver to the adoption of robotic surgical assistance. Progress in the last
three decades has led to a gradual transition from manual laparoscopic surgery
with rigid instruments to robot-assisted surgery. In the last decade, the
increasing demand for new surgical paradigms to enable access into the anatomy
without skin incision (intraluminal surgery) or with a single skin incision
(Single Port Access surgery - SPA) has led researchers to investigate
snake-like flexible surgical devices. In this chapter, we first present an
overview of the background, motivation, and taxonomy of MIS and its newer
derivatives. Challenges of MIS and its newer derivatives (SPA and intraluminal
surgery) are outlined along with the architectures of new snake-like robots
meeting these challenges. We also examine the commercial and research surgical
platforms developed over the years, to address the specific functional
requirements and constraints imposed by operations in confined spaces. The
chapter concludes with an evaluation of open problems in surgical robotics for
intraluminal and SPA, and a look at future trends in surgical robot design that
could potentially address these unmet needs.Comment: 41 pages, 18 figures. Preprint of article published in the
Encyclopedia of Medical Robotics 2018, World Scientific Publishing Company
www.worldscientific.com/doi/abs/10.1142/9789813232266_000
Planning for steerable needles in neurosurgery
The increasing adoption of robotic-assisted surgery has opened up the possibility to control innovative dexterous tools to improve patient outcomes in a minimally invasive way.
Steerable needles belong to this category, and their potential has been recognised in various surgical fields, including neurosurgery.
However, planning for steerable catheters' insertions might appear counterintuitive even for expert clinicians. Strategies and tools to aid the surgeon in selecting a feasible trajectory to follow and methods to assist them intra-operatively during the insertion process are currently of great interest as they could accelerate steerable needles' translation from research to practical use.
However, existing computer-assisted planning (CAP) algorithms are often limited in their ability to meet both operational and kinematic constraints in the context of precise neurosurgery, due to its demanding surgical conditions and highly complex environment.
The research contributions in this thesis relate to understanding the existing gap in planning curved insertions for steerable needles and implementing intelligent CAP techniques to use in the context of neurosurgery.
Among this thesis contributions showcase (i) the development of a pre-operative CAP for precise neurosurgery applications able to generate optimised paths at a safe distance from brain sensitive structures while meeting steerable needles kinematic constraints; (ii) the development of an intra-operative CAP able to adjust the current insertion path with high stability while compensating for online tissue deformation; (iii) the integration of both methods into a commercial user front-end interface (NeuroInspire, Renishaw plc.) tested during a series of user-controlled needle steering animal trials, demonstrating successful targeting performances. (iv) investigating the use of steerable needles in the context of laser interstitial thermal therapy (LiTT) for maesial temporal lobe epilepsy patients and proposing the first LiTT CAP for steerable needles within this context.
The thesis concludes with a discussion of these contributions and suggestions for future work.Open Acces
Medical robots with potential applications in participatory and opportunistic remote sensing: A review
Among numerous applications of medical robotics, this paper concentrates
on the design, optimal use and maintenance of the related technologies in
the context of healthcare, rehabilitation and assistive robotics, and provides
a comprehensive review of the latest advancements in the foregoing field of
science and technology, while extensively dealing with the possible applications of participatory and opportunistic mobile sensing in the aforementioned domains. The main motivation for the latter choice is the variety
of such applications in the settings having partial contributions to functionalities such as artery, radiosurgery, neurosurgery and vascular intervention.
From a broad perspective, the aforementioned applications can be realized via
various strategies and devices benefiting from detachable drives, intelligent
robots, human-centric sensing and computing, miniature and micro-robots.
Throughout the paper tens of subjects, including sensor-fusion, kinematic,
dynamic and 3D tissue models are discussed based on the existing literature
on the state-of-the-art technologies. In addition, from a managerial perspective, topics such as safety monitoring, security, privacy and evolutionary
optimization of the operational efficiency are reviewed
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