A disposable continuum endoscope using piston-driven parallel bellow actuator

This paper presents a novel low cost disposable continuum endoscope based on a piston-driven parallel bellow actuator design. The parallel bellow actuator achieves motion by being pressurized via displacement-controlled pistons. The displacements are generated by rack-and-pinion mechanisms using inexpensive stepper motors. The design concept provides a potential alternative solution to upper gastrointestinal (UGI) diagnosis. The modularity and the use of inexpensive components allow for low fabrication costs and disposability. The use of robotic assistance could facilitate the development of an easier interface for the gastroenterologists, avoiding the nonintuitive manipulation mapping of the traditional UGI endoscopes. We adapt existing kinematic solutions of multi-backbone continuum robots to model continuum parallel bellow actuators. An actuation compensation strategy is presented and validated to address the pneumatic compressibility through the transmission lines. The design concept was prototyped and tested with a custom control platform. The experimental validation shows that the actuation compensation was demonstrated to significantly improve orientation control of the endoscope end-effector. This paper shows the feasibility of the proposed design and lays the foundation toward clinical scenarios

Dual-Continuum Design Approach for Intuitive and Low-Cost Upper Gastrointestinal Endoscopy

Objective: This paper introduces a methodology to design intuitive, low-cost, and portable devices for visual inspection of the upper gastrointestinal tract. Methods: The proposed approach mechanically couples a multi-backbone continuum structure, as the user interface, and a parallel bellows actuator, as the endoscopic tip. Analytical modeling techniques derived from continuum robotics were adopted to describe the endoscopic tip motion from user input, accounting for variations in component size and pneumatic compressibility. The modeling framework was used to improve intuitiveness of user-to-task mapping. This was assessed against a 1:1 target, while ease-of-use was validated using landmark identification tasks performed in a stomach simulator by one expert and ten non-expert users; benchmarked against conventional flexible endoscopy. Pre-clinical validation consisted of comparative trials in in-vivo porcine and human cadaver models. Results: Target mapping was achieved with an average error of $5^\circ$ in bending angle. Simulated endoscopies were performed by an expert user successfully, within a time comparable to conventional endoscopy ( $<$ 1 min difference). Non-experts using the proposed device achieved visualization of the stomach in a shorter time (9 s faster on average) than with a conventional endoscope. The estimated cost is $<$ 10 USD and $<$ 30 USD for disposable and reusable parts, respectively. Significance and Conclusions: Flexible endoscopes are complex and expensive devices, actuated via non-intuitive cable-driven mechanisms. They frequently break, requiring costly repair, and necessitate a dedicated reprocessing facility to prevent cross contamination. The proposed solution is portable, inexpensive, and easy to use, thus lending itself to disposable use by personnel without formal training in flexible endoscopy

A continuum robotic platform for endoscopic non-contact laser surgery: design, control, and preclinical evaluation

The application of laser technologies in surgical interventions has been accepted in the clinical domain due to their atraumatic properties. In addition to manual application of fibre-guided lasers with tissue contact, non-contact transoral laser microsurgery (TLM) of laryngeal tumours has been prevailed in ENT surgery. However, TLM requires many years of surgical training for tumour resection in order to preserve the function of adjacent organs and thus preserve the patient’s quality of life. The positioning of the microscopic laser applicator outside the patient can also impede a direct line-of-sight to the target area due to anatomical variability and limit the working space. Further clinical challenges include positioning the laser focus on the tissue surface, imaging, planning and performing laser ablation, and motion of the target area during surgery. This dissertation aims to address the limitations of TLM through robotic approaches and intraoperative assistance. Although a trend towards minimally invasive surgery is apparent, no highly integrated platform for endoscopic delivery of focused laser radiation is available to date. Likewise, there are no known devices that incorporate scene information from endoscopic imaging into ablation planning and execution. For focusing of the laser beam close to the target tissue, this work first presents miniaturised focusing optics that can be integrated into endoscopic systems. Experimental trials characterise the optical properties and the ablation performance. A robotic platform is realised for manipulation of the focusing optics. This is based on a variable-length continuum manipulator. The latter enables movements of the endoscopic end effector in five degrees of freedom with a mechatronic actuation unit. The kinematic modelling and control of the robot are integrated into a modular framework that is evaluated experimentally. The manipulation of focused laser radiation also requires precise adjustment of the focal position on the tissue. For this purpose, visual, haptic and visual-haptic assistance functions are presented. These support the operator during teleoperation to set an optimal working distance. Advantages of visual-haptic assistance are demonstrated in a user study. The system performance and usability of the overall robotic system are assessed in an additional user study. Analogous to a clinical scenario, the subjects follow predefined target patterns with a laser spot. The mean positioning accuracy of the spot is 0.5 mm. Finally, methods of image-guided robot control are introduced to automate laser ablation. Experiments confirm a positive effect of proposed automation concepts on non-contact laser surgery.Die Anwendung von Lasertechnologien in chirurgischen Interventionen hat sich aufgrund der atraumatischen Eigenschaften in der Klinik etabliert. Neben manueller Applikation von fasergeführten Lasern mit Gewebekontakt hat sich die kontaktfreie transorale Lasermikrochirurgie (TLM) von Tumoren des Larynx in der HNO-Chirurgie durchgesetzt. Die TLM erfordert zur Tumorresektion jedoch ein langjähriges chirurgisches Training, um die Funktion der angrenzenden Organe zu sichern und damit die Lebensqualität der Patienten zu erhalten. Die Positionierung des mikroskopis chen Laserapplikators außerhalb des Patienten kann zudem die direkte Sicht auf das Zielgebiet durch anatomische Variabilität erschweren und den Arbeitsraum einschränken. Weitere klinische Herausforderungen betreffen die Positionierung des Laserfokus auf der Gewebeoberfläche, die Bildgebung, die Planung und Ausführung der Laserablation sowie intraoperative Bewegungen des Zielgebietes. Die vorliegende Dissertation zielt darauf ab, die Limitierungen der TLM durch robotische Ansätze und intraoperative Assistenz zu adressieren. Obwohl ein Trend zur minimal invasiven Chirurgie besteht, sind bislang keine hochintegrierten Plattformen für die endoskopische Applikation fokussierter Laserstrahlung verfügbar. Ebenfalls sind keine Systeme bekannt, die Szeneninformationen aus der endoskopischen Bildgebung in die Ablationsplanung und -ausführung einbeziehen. Für eine situsnahe Fokussierung des Laserstrahls wird in dieser Arbeit zunächst eine miniaturisierte Fokussieroptik zur Integration in endoskopische Systeme vorgestellt. Experimentelle Versuche charakterisieren die optischen Eigenschaften und das Ablationsverhalten. Zur Manipulation der Fokussieroptik wird eine robotische Plattform realisiert. Diese basiert auf einem längenveränderlichen Kontinuumsmanipulator. Letzterer ermöglicht in Kombination mit einer mechatronischen Aktuierungseinheit Bewegungen des Endoskopkopfes in fünf Freiheitsgraden. Die kinematische Modellierung und Regelung des Systems werden in ein modulares Framework eingebunden und evaluiert. Die Manipulation fokussierter Laserstrahlung erfordert zudem eine präzise Anpassung der Fokuslage auf das Gewebe. Dafür werden visuelle, haptische und visuell haptische Assistenzfunktionen eingeführt. Diese unterstützen den Anwender bei Teleoperation zur Einstellung eines optimalen Arbeitsabstandes. In einer Anwenderstudie werden Vorteile der visuell-haptischen Assistenz nachgewiesen. Die Systemperformanz und Gebrauchstauglichkeit des robotischen Gesamtsystems werden in einer weiteren Anwenderstudie untersucht. Analog zu einem klinischen Einsatz verfolgen die Probanden mit einem Laserspot vorgegebene Sollpfade. Die mittlere Positioniergenauigkeit des Spots beträgt dabei 0,5 mm. Zur Automatisierung der Ablation werden abschließend Methoden der bildgestützten Regelung vorgestellt. Experimente bestätigen einen positiven Effekt der Automationskonzepte für die kontaktfreie Laserchirurgie

Soft pneumatic devices for blood circulation improvement

The research activity I am presenting in this thesis lies within the framework of a cooperation between the University of Cagliari (Applied Mechanics and Robotics lab, headed by professor Andrea Manuello Bertetto, and the research group of physicians referencing to professor Alberto Concu at the Laboratory of Sports Physiology, Department of Medical Sciences), and the Polytechnic of Turin (professor Carlo Ferraresi and his equipe at the Group of Automation and Robotics, Department of Mechanical and Aerospace Engineering) This research was also funded by the Italian Ministry of Research (MIUR – PRIN 2009). My activity has been mainly carried on at the Department of Mechanics, Robotics lab under the supervision of prof. Manuello; I have also spent one year at the Control Lab of the School of Electrical Engineering at Aalto University (Helsinki, Finland). The tests on the patients were taken at the Laboratory of Sports Physiology, Cagliari. I will be describing the design, development and testing of some soft pneumatic flexible devices meant to apply an intermittent massage and to restore blood circulation in lower limbs in order to improve cardiac output and wellness in general. The choice of the actuators, as well as the pneumatic circuits and air distribution system and PLC control patterns will be outlined. The trial run of the devices have been field--‐tested as soon a prototype was ready, so as to tune its features step--‐by--‐ step. I am also giving a characterization of a commercial thin force sensor after briefly reviewing some other type of thin pressure transducer. It has been used to gauge the contact pressure between the actuator and the subject’s skin in order to correlate the level of discomfort to the supply pressure, and to feed this value back to regulate the supply air flow. In order for the massage to be still effective without causing pain or distress or any cutoff to the blood flow, some control objective have been set, consisting in the regulation of the contact force so that it comes to the constant set point smoothly and its value holds constant until unloading occurs. The targets of such mechatronic devices range from paraplegic patients lacking of muscle tone because of their spinal cord damage, to elite endurance athletes needing a circulation booster when resting from practicing after serious injuries leading to bed rest. Encouraging results have been attained for both these two categories, based on the monitored hemodynamic variables

Low-Cost Technologies for Flexible Endoscopy: Design, Control and Autonomy for a Water-Jet Actuated Soft Continuum Endoscope

Despite the outstanding diagnostic performance brought by new technologies in medicine, cancer remains a significant burden worldwide. In addition to prevention strategies, the ability to detect malignancy early is crucial in enabling effective treatment and dramatically increasing the survival rate of patients. In the case of gastric cancer, diagnosis is generally performed using Flexible Endoscopy (or Endoscope) (FE). The FE has been proven to be a powerful, reliable and cost-effective tool in the fight against gastric cancer. However, its effectiveness strongly depends on the skills of trained Gastro Enterologists (GE) who perform the procedures. Moreover, accessibility and availability of such tools are often limited to people residing in major cities, while remote and rural areas remain poorly served by their health systems. The advent of robotics in medicine offers a new solution to these problems. When possible, automating diagnostic procedures or surgical tasks has the potential to deliver reliable, repeatable and cost-effective alternatives to standard human-in-the-loop procedures. Embedding autonomous capabilities into a machine, optimally designed to execute a specific task, could enable the device to automatically adapt to different conditions and non-skilled personnel to perform the procedure by supervising the actions of the robotic platform. In these scenarios, safety represents a major concern and in the majority of the cases, a safe interaction between the robot and the tissues can be guaranteed by building compliant robots made of soft materials. However, if the possibility of using compliant devices offers a number of advantages to the final user or patient, it defines a series of technical challenges that have to be addressed to deliver a stable and reliable control of the platform. Finally, by adopting low-cost designs, single-use solutions can be realised to address the issue and complication of sterilisation. This dissertation discusses the research effort targeted at the development of a water-jet actuated low-cost, disposable gastroscopy platform to offer a safe, cost-effective, fault-free alternative to standard FE

Soft pneumatic actuators: a review of design, fabrication, modeling, sensing, control and applications

Soft robotics is a rapidly evolving field where robots are fabricated using highly deformable materials and usually follow a bioinspired design. Their high dexterity and safety make them ideal for applications such as gripping, locomotion, and biomedical devices, where the environment is highly dynamic and sensitive to physical interaction. Pneumatic actuation remains the dominant technology in soft robotics due to its low cost and mass, fast response time, and easy implementation. Given the significant number of publications in soft robotics over recent years, newcomers and even established researchers may have difficulty assessing the state of the art. To address this issue, this article summarizes the development of soft pneumatic actuators and robots up until the date of publication. The scope of this article includes the design, modeling, fabrication, actuation, characterization, sensing, control, and applications of soft robotic devices. In addition to a historical overview, there is a special emphasis on recent advances such as novel designs, differential simulators, analytical and numerical modeling methods, topology optimization, data-driven modeling and control methods, hardware control boards, and nonlinear estimation and control techniques. Finally, the capabilities and limitations of soft pneumatic actuators and robots are discussed and directions for future research are identified

Advanced Strategies for Robot Manipulators

Amongst the robotic systems, robot manipulators have proven themselves to be of increasing importance and are widely adopted to substitute for human in repetitive and/or hazardous tasks. Modern manipulators are designed complicatedly and need to do more precise, crucial and critical tasks. So, the simple traditional control methods cannot be efficient, and advanced control strategies with considering special constraints are needed to establish. In spite of the fact that groundbreaking researches have been carried out in this realm until now, there are still many novel aspects which have to be explored

Proceedings of the 2018 Canadian Society for Mechanical Engineering (CSME) International Congress

Published proceedings of the 2018 Canadian Society for Mechanical Engineering (CSME) International Congress, hosted by York University, 27-30 May 2018