1,487 research outputs found
Survey on Current State-of-the-Art in Needle Insertion Robots: Open Challenges for Application in Real Surgery
AbstractMinimally invasive percutaneous treatment robots have become a popular area in medical robotics. Minimally invasive treatments are an important part of modern surgery; however percutaneous treatments are a difficult procedure for surgeons. They must carry out a procedure that has limited visibility, tool maneuverability and where the target and tissue surrounding it move because of the tool. Robot technology can overcome those limitations and increase the success of minimally invasive percutaneous treatment. In this paper we will present a review of the current state-of-the-art in robotic insertion needle for minimally invasive treatments, focusing on the limitations and challenges still open for their use in clinical application
Robot-Assisted Prostate Brachytherapy
Abstract: In contemporary brachytherapy procedures, needle placement at the desired target is challenging due to a variety of reasons. A robot-assisted brachytherapy system can potentially improve needle placement and seed delivery, resulting in enhanced therapeutic delivery. In this paper we present a 16 DOF (degrees-of-freedom) robotic system (9DOF positioning module and 7DOF surgery module) developed and fabricated for prostate brachytherapy. Strategies to reduce needle deflection and target movement were incorporated after extensive experimental validation. Provisions for needle motion and force feedback were included into the system for improving robot control and seed delivery. Preliminary experimental results reveal that the prototype system is sufficiently accurate in placing brachytherapy needles
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
Autonomous Medical Needle Steering In Vivo
The use of needles to access sites within organs is fundamental to many
interventional medical procedures both for diagnosis and treatment. Safe and
accurate navigation of a needle through living tissue to an intra-tissue target
is currently often challenging or infeasible due to the presence of anatomical
obstacles in the tissue, high levels of uncertainty, and natural tissue motion
(e.g., due to breathing). Medical robots capable of automating needle-based
procedures in vivo have the potential to overcome these challenges and enable
an enhanced level of patient care and safety. In this paper, we show the first
medical robot that autonomously navigates a needle inside living tissue around
anatomical obstacles to an intra-tissue target. Our system leverages an aiming
device and a laser-patterned highly flexible steerable needle, a type of needle
capable of maneuvering along curvilinear trajectories to avoid obstacles. The
autonomous robot accounts for anatomical obstacles and uncertainty in living
tissue/needle interaction with replanning and control and accounts for
respiratory motion by defining safe insertion time windows during the breathing
cycle. We apply the system to lung biopsy, which is critical in the diagnosis
of lung cancer, the leading cause of cancer-related death in the United States.
We demonstrate successful performance of our system in multiple in vivo porcine
studies and also demonstrate that our approach leveraging autonomous needle
steering outperforms a standard manual clinical technique for lung nodule
access.Comment: 22 pages, 6 figure
Optical Fiber-Based Needle Shape Sensing in Real Tissue: Single Core vs. Multicore Approaches
Flexible needle insertion procedures are common for minimally-invasive
surgeries for diagnosing and treating prostate cancer. Bevel-tip needles
provide physicians the capability to steer the needle during long insertions to
avoid vital anatomical structures in the patient and reduce post-operative
patient discomfort. To provide needle placement feedback to the physician,
sensors are embedded into needles for determining the real-time 3D shape of the
needle during operation without needing to visualize the needle
intra-operatively. Through expansive research in fiber optics, a plethora of
bio-compatible, MRI-compatible, optical shape-sensors have been developed to
provide real-time shape feedback, such as single-core and multicore fiber Bragg
gratings. In this paper, we directly compare single-core fiber-based and
multicore fiber-based needle shape-sensing through identically constructed,
four-active area sensorized bevel-tip needles inserted into phantom and \exvivo
tissue on the same experimental platform. In this work, we found that for
shape-sensing in phantom tissue, the two needles performed identically with a
-value of , but in \exvivo real tissue, the single-core fiber
sensorized needle significantly outperformed the multicore fiber configuration
with a -value of . This paper also presents the experimental
platform and method for directly comparing these optical shape sensors for the
needle shape-sensing task, as well as provides direction, insight and required
considerations for future work in constructively optimizing sensorized needles
Towards a procedure-optimised steerable catheter for deep-seated neurosurgery
In recent years, steerable needles have attracted significant interest in relation to minimally invasive surgery (MIS). Specifically, the flexible, programmable bevel-tip needle (PBN) concept was successfully demonstrated in vivo in an evaluation of the feasibility of convection-enhanced delivery (CED) for chemotherapeutics within the ovine model with a 2.5 mm PBN prototype. However, further size reductions are necessary for other diagnostic and therapeutic procedures and drug delivery operations involving deep-seated tissue structures. Since PBNs have a complex cross-section geometry, standard production methods, such as extrusion, fail, as the outer diameter is reduced further. This paper presents our first attempt to demonstrate a new manufacturing method for PBNs that employs thermal drawing technology. Experimental characterisation tests were performed for the 2.5 mm PBN and the new 1.3 mm thermally drawn (TD) PBN prototype described here. The results show that thermal drawing presents a significant advantage in miniaturising complex needle structures. However, the steering behaviour was affected due to the choice of material in this first attempt, a limitation which will be addressed in future work
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