Real-time Error Control for Surgical Simulation

International audienceObjective: To present the first real-time a poste-riori error-driven adaptive finite element approach for real-time simulation and to demonstrate the method on a needle insertion problem. Methods: We use corotational elasticity and a frictional needle/tissue interaction model. The problem is solved using finite elements within SOFA 1. The refinement strategy relies upon a hexahedron-based finite element method, combined with a posteriori error estimation driven local h-refinement, for simulating soft tissue deformation. Results: We control the local and global error level in the mechanical fields (e.g. displacement or stresses) during the simulation. We show the convergence of the algorithm on academic examples, and demonstrate its practical usability on a percutaneous procedure involving needle insertion in a liver. For the latter case, we compare the force displacement curves obtained from the proposed adaptive algorithm with that obtained from a uniform refinement approach. Conclusions: Error control guarantees that a tolerable error level is not exceeded during the simulations. Local mesh refinement accelerates simulations. Significance: Our work provides a first step to discriminate between discretization error and modeling error by providing a robust quantification of discretization error during simulations. Index Terms—Finite element method, real-time error estimate, adaptive refinement, constraint-based interaction

Real-time Error Control for Surgical Simulation

Objective: To present the first real-time a posteriori error-driven adaptive finite element approach for real-time simulation and to demonstrate the method on a needle insertion problem. Methods: We use corotational elasticity and a frictional needle/tissue interaction model. The problem is solved using finite elements within SOFA. The refinement strategy relies upon a hexahedron-based finite element method, combined with a posteriori error estimation driven local $h$-refinement, for simulating soft tissue deformation. Results: We control the local and global error level in the mechanical fields (e.g. displacement or stresses) during the simulation. We show the convergence of the algorithm on academic examples, and demonstrate its practical usability on a percutaneous procedure involving needle insertion in a liver. For the latter case, we compare the force displacement curves obtained from the proposed adaptive algorithm with that obtained from a uniform refinement approach. Conclusions: Error control guarantees that a tolerable error level is not exceeded during the simulations. Local mesh refinement accelerates simulations. Significance: Our work provides a first step to discriminate between discretization error and modeling error by providing a robust quantification of discretization error during simulations.Comment: 12 pages, 16 figures, change of the title, submitted to IEEE TBM

Controlling the Error on Target Motion through Real-time Mesh Adaptation: Applications to Deep Brain Stimulation

We present an error-controlled mesh refinement procedure for needle insertion simulation and apply it to the simulation of electrode implantation for deep brain stimulation, including brain shift. Our approach enables to control the error in the computation of the displacement and stress fields around the needle tip and needle shaft by suitably refining the mesh, whilst maintaining a coarser mesh in other parts of the domain. We demonstrate through academic and practical examples that our approach increases the accuracy of the displacement and stress fields around the needle without increasing the computational expense. This enables real-time simulations. The proposed methodology has direct implications to increase the accuracy and control the computational expense of the simulation of percutaneous procedures such as biopsy, brachytherapy, regional anesthesia, or cryotherapy and can be essential to the development of robotic guidance.Comment: 21 pages, 14 figure

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

A mechanics-based model for simulation and control of flexible needle insertion in soft tissue

AbstractIn needle-based medical procedures, beveled-tip exible needles are steered inside soft tissue with the aim of reaching pre-dened target locations. The efciency of needle-based interventions depends on accurate control of the needle tip. This paper presents a comprehensive mechanics-based model for simulation of planar needle insertion in soft tissue. The proposed model for needle deection is based on beam theory, works in real-time, and accepts the insertion velocity as an input that can later be used as a control command for needle steering. The model takes into account the effects of tissue deformation, needle-tissue friction, tissue cutting force, and needle bevel angle on needle deection. Using a robot that inserts a exible needle into a phantom tissue, various experiments are conducted to separately identify different subsets of the model parameters. The validity of the proposed model is veried by comparing the simulation results to the empirical data. The results demonstrate the accuracy of the proposed model in predicting the needle tip deection for different insertion velocities. I

Realistic tool-tissue interaction models for surgical simulation and planning

Surgical simulators present a safe and potentially effective method for surgical training, and can also be used in pre- and intra-operative surgical planning. Realistic modeling of medical interventions involving tool-tissue interactions has been considered to be a key requirement in the development of high-fidelity simulators and planners. The soft-tissue constitutive laws, organ geometry and boundary conditions imposed by the connective tissues surrounding the organ, and the shape of the surgical tool interacting with the organ are some of the factors that govern the accuracy of medical intervention planning.\ud \ud This thesis is divided into three parts. First, we compare the accuracy of linear and nonlinear constitutive laws for tissue. An important consequence of nonlinear models is the Poynting effect, in which shearing of tissue results in normal force; this effect is not seen in a linear elastic model. The magnitude of the normal force for myocardial tissue is shown to be larger than the human contact force discrimination threshold. Further, in order to investigate and quantify the role of the Poynting effect on material discrimination, we perform a multidimensional scaling study. Second, we consider the effects of organ geometry and boundary constraints in needle path planning. Using medical images and tissue mechanical properties, we develop a model of the prostate and surrounding organs. We show that, for needle procedures such as biopsy or brachytherapy, organ geometry and boundary constraints have more impact on target motion than tissue material parameters. Finally, we investigate the effects surgical tool shape on the accuracy of medical intervention planning. We consider the specific case of robotic needle steering, in which asymmetry of a bevel-tip needle results in the needle naturally bending when it is inserted into soft tissue. We present an analytical and finite element (FE) model for the loads developed at the bevel tip during needle-tissue interaction. The analytical model explains trends observed in the experiments. We incorporated physical parameters (rupture toughness and nonlinear material elasticity) into the FE model that included both contact and cohesive zone models to simulate tissue cleavage. The model shows that the tip forces are sensitive to the rupture toughness. In order to model the mechanics of deflection of the needle, we use an energy-based formulation that incorporates tissue-specific parameters such as rupture toughness, nonlinear material elasticity, and interaction stiffness, and needle geometric and material properties. Simulation results follow similar trends (deflection and radius of curvature) to those observed in macroscopic experimental studies of a robot-driven needle interacting with gels

Position-based Dynamics Simulator of Brain Deformations for Path Planning and Intra-Operative Control in Keyhole Neurosurgery

Many tasks in robot-assisted surgery require planning and controlling manipulators' motions that interact with highly deformable objects. This study proposes a realistic, time-bounded simulator based on Position-based Dynamics (PBD) simulation that mocks brain deformations due to catheter insertion for pre-operative path planning and intra-operative guidance in keyhole surgical procedures. It maximizes the probability of success by accounting for uncertainty in deformation models, noisy sensing, and unpredictable actuation. The PBD deformation parameters were initialized on a parallelepiped-shaped simulated phantom to obtain a reasonable starting guess for the brain white matter. They were calibrated by comparing the obtained displacements with deformation data for catheter insertion in a composite hydrogel phantom. Knowing the gray matter brain structures' different behaviors, the parameters were fine-tuned to obtain a generalized human brain model. The brain structures' average displacement was compared with values in the literature. The simulator's numerical model uses a novel approach with respect to the literature, and it has proved to be a close match with real brain deformations through validation using recorded deformation data of in-vivo animal trials with a mean mismatch of 4.73$\pm$2.15%. The stability, accuracy, and real-time performance make this model suitable for creating a dynamic environment for KN path planning, pre-operative path planning, and intra-operative guidance.Comment: 8 pages, 8 figures. This article has been accepted for publication in a future issue of IEEE Robotics and Automation Letters, but has not been fully edited. Content may change prior to final publication. 2377-3766 (c) 2021 IEEE. Personal use is permitted, but republication/redistribution requires IEEE permission. A. Segato and C. Di Vece equally contribute

Computational fluid-structure interaction study of the aeroelastic behavior of a wire in transonic and supersonic flows

Air flow is employed in many textile processes to transport or to excite yarns to move in specific directions. Air flows cannot be controlled completely, which leads to some deviations or unexpected behaviour of the guided objects like a yarn. In this research, the interaction between a yarn and the surrounding air flow is studied in two applications: yarn splicing and yarn weaving. Both applications involve compressible flow and it is found that the compressibility effects on the turbulence have to be taken into account. In the first application, yarn splicing is studied based on air flow simulations. The CFD results are linked to experiments and the best flow characteristics are determined. The second application focuses on the main nozzle, which is an essential part of an air jet weaving machine. The geometry of the main nozzle is optimized to give the highest axial aerodynamic force, thus the highest weft yarn speed. The motion of a weft yarn inside a main nozzle is modelled by coupling a 2D axisymmetric fluid model and 3D structure one. The effects of the yarn motion on the air flow are added by a source term to avoid the problems of employing a dynamic mesh which is proven to be complex with a flexible object like a yarn