Use of a micromanipulator system (NeuRobot) in endoscopic neurosurgery

NeuRobot, a micromanipulator system with a rigid neuroendoscope and three micromanipulators, was developed for less invasive and telecontrolled neurosurgery. This system can be used to perform sophisticated surgical procedures through a small, 10-mm-diameter, window. The present study was performed to evaluate the feasibility of using NeuRobot in neuroendoscopy. Four different intraventricular neurosurgical procedures were simulated in three fixed cadaver heads using NeuRobot: (1) fenestration of the floor of the third ventricle; (2) fenestration of the septum pellucidum; (3) biopsy of the thalamus; and (4) biopsy of the choroid plexus of the lateral ventricle. Each procedure required less than 2 min, and all procedures were performed accurately. After these surgical simulations, a third ventriculostomy was carried out safely and adequately in a patient with obstructive hydrocephalus due to a midbrain venous angioma. Our results confirmed that NeuRobot is applicable to lesions in which conventional endoscopic neurosurgery is indicated. Furthermore, NeuRobot can perform more complex surgical procedures than a conventional neuroendoscope because of its maneuverability and stability. NeuRobot will become a useful neurosurgical tool for dealing with lesions that are difficult to treat by conventional neuroendoscopic surgery.ArticleJOURNAL OF CLINICAL NEUROSCIENCE. 19(11):1553-1557 (2012)journal articl

Haptic threshold for pulling force feedback on surgeon\u27s fingertip in medical robotic systems

The human fingertip has very high density of the receptor to accept sense of touch stimulation. The corresponding somatic sensory area in a brain is very large, and considered to be a specialized part for palpation. A lot of haptic display system then have been developed with the investigation of human haptic perception. However, the researches about the human perception for pulling force at grasping, namely static frictional force are limited. This paper investigated it, aiming at a future development of pulling and grasping force feedback system for neurosurgical robotic systems. For the purpose, this paper explored the possibility of displaying pulling force to an index finger during grasping. The absolute and difference thresholds for pulling sense were the targets. The results showed that grasping disturbs the pulling sense, and the sides of index fingertip can be used to display pulling sense, relatively large force, namely scaled force feedback is required for the perception. The results provide an important insight at a hardware and controller design of force feedback systems. © 2016 IEEE.42nd Conference of the Industrial Electronics Society, IECON 2016; Palazzo dei CongressiFlorence; Italy; 24 October 2016 through 27 October 2016; Category numberCFP16IEC-ART; Code 12554

Image-Guided Robot-Assisted Techniques with Applications in Minimally Invasive Therapy and Cell Biology

There are several situations where tasks can be performed better robotically rather than manually. Among these are situations (a) where high accuracy and robustness are required, (b) where difficult or hazardous working conditions exist, and (c) where very large or very small motions or forces are involved. Recent advances in technology have resulted in smaller size robots with higher accuracy and reliability. As a result, robotics is fi nding more and more applications in Biomedical Engineering. Medical Robotics and Cell Micro-Manipulation are two of these applications involving interaction with delicate living organs at very di fferent scales.Availability of a wide range of imaging modalities from ultrasound and X-ray fluoroscopy to high magni cation optical microscopes, makes it possible to use imaging as a powerful means to guide and control robot manipulators. This thesis includes three parts focusing on three applications of Image-Guided Robotics in biomedical engineering, including: Vascular Catheterization: a robotic system was developed to insert a catheter through the vasculature and guide it to a desired point via visual servoing. The system provides shared control with the operator to perform a task semi-automatically or through master-slave control. The system provides control of a catheter tip with high accuracy while reducing X-ray exposure to the clinicians and providing a more ergonomic situation for the cardiologists. Cardiac Catheterization: a master-slave robotic system was developed to perform accurate control of a steerable catheter to touch and ablate faulty regions on the inner walls of a beating heart in order to treat arrhythmia. The system facilitates touching and making contact with a target point in a beating heart chamber through master-slave control with coordinated visual feedback. Live Neuron Micro-Manipulation: a microscope image-guided robotic system was developed to provide shared control over multiple micro-manipulators to touch cell membranes in order to perform patch clamp electrophysiology. Image-guided robot-assisted techniques with master-slave control were implemented for each case to provide shared control between a human operator and a robot. The results show increased accuracy and reduced operation time in all three cases

The Development of an in Vivo Spinal Fusion Monitor Using Microelectromechanical (Mems) Technology to Create Implantable Microsensors

Surgical fusion of the spine is a conventional approach, and often last alternative, to the correction of a degenerative painful spinal segment. The procedure involves the surgical removal of the intervertebral disc at the problematic site, and the placement of a bone graft that is commonly harvested from the patients iliac crest and placed within the discectomized space. The surrounding bone is expected to incorporate and remodel into the bone graft to eventually provide an immobilized site. Spinal instrumentation often accompanies the bone graft to provide further immobility to the targeted site, thus augmenting the fusion process. However, the status of a fusion and the incorporation of bone across a destabilized spinal segment are often difficult for the surgeon to assess. Radiographic methods provide static views of the fusion site that possess excessive limitations. The radiographic image cannot provide the surgeon with information regarding fusion integrity when the patient is mobile and the spine is exposed to multiple motions. Fortunately, technological advances utilizing microelectromechanical system technology (MEMS) have provided insight into the development of miniature devices that exhibit high resolution, electronic accuracy, miniature sizing, and have the capacity to monitor long-term, real-time in vivo pressures and forces for a variety of situations. However, numerous challenges exist with the utilization of MEMS devices for in vivo applications.This work investigated the feasibility of utilizing implantable microsensors to monitor the pressure and force patterns of bone incorporation and healing of a spine fusion in vivo. The knowledge obtained from this series of feasibility tests using commercially available transducers to monitor pressures and forces, will be applied towards the development of miniature sensors that utilize MEMS technology to monitor real-time, long-term spine fusion in living subjects. The packaging, radiographic, and sterilization characteristics of MEMS sensors were eva

The Development of an in Vivo Spinal Fusion Monitor Using Microelectromechanical (Mems) Technology to Create Implantable Microsensors

Surgical fusion of the spine is a conventional approach, and often last alternative, to the correction of a degenerative painful spinal segment. The procedure involves the surgical removal of the intervertebral disc at the problematic site, and the placement of a bone graft that is commonly harvested from the patients iliac crest and placed within the discectomized space. The surrounding bone is expected to incorporate and remodel into the bone graft to eventually provide an immobilized site. Spinal instrumentation often accompanies the bone graft to provide further immobility to the targeted site, thus augmenting the fusion process. However, the status of a fusion and the incorporation of bone across a destabilized spinal segment are often difficult for the surgeon to assess. Radiographic methods provide static views of the fusion site that possess excessive limitations. The radiographic image cannot provide the surgeon with information regarding fusion integrity when the patient is mobile and the spine is exposed to multiple motions. Fortunately, technological advances utilizing microelectromechanical system technology (MEMS) have provided insight into the development of miniature devices that exhibit high resolution, electronic accuracy, miniature sizing, and have the capacity to monitor long-term, real-time in vivo pressures and forces for a variety of situations. However, numerous challenges exist with the utilization of MEMS devices for in vivo applications.This work investigated the feasibility of utilizing implantable microsensors to monitor the pressure and force patterns of bone incorporation and healing of a spine fusion in vivo. The knowledge obtained from this series of feasibility tests using commercially available transducers to monitor pressures and forces, will be applied towards the development of miniature sensors that utilize MEMS technology to monitor real-time, long-term spine fusion in living subjects. The packaging, radiographic, and sterilization characteristics of MEMS sensors were eva

The Development of an in Vivo Spinal Fusion Monitor Using Microelectromechanical (Mems) Technology to Create Implantable Microsensors

Surgical fusion of the spine is a conventional approach, and often last alternative, to the correction of a degenerative painful spinal segment. The procedure involves the surgical removal of the intervertebral disc at the problematic site, and the placement of a bone graft that is commonly harvested from the patients iliac crest and placed within the discectomized space. The surrounding bone is expected to incorporate and remodel into the bone graft to eventually provide an immobilized site. Spinal instrumentation often accompanies the bone graft to provide further immobility to the targeted site, thus augmenting the fusion process. However, the status of a fusion and the incorporation of bone across a destabilized spinal segment are often difficult for the surgeon to assess. Radiographic methods provide static views of the fusion site that possess excessive limitations. The radiographic image cannot provide the surgeon with information regarding fusion integrity when the patient is mobile and the spine is exposed to multiple motions. Fortunately, technological advances utilizing microelectromechanical system technology (MEMS) have provided insight into the development of miniature devices that exhibit high resolution, electronic accuracy, miniature sizing, and have the capacity to monitor long-term, real-time in vivo pressures and forces for a variety of situations. However, numerous challenges exist with the utilization of MEMS devices for in vivo applications.This work investigated the feasibility of utilizing implantable microsensors to monitor the pressure and force patterns of bone incorporation and healing of a spine fusion in vivo. The knowledge obtained from this series of feasibility tests using commercially available transducers to monitor pressures and forces, will be applied towards the development of miniature sensors that utilize MEMS technology to monitor real-time, long-term spine fusion in living subjects. The packaging, radiographic, and sterilization characteristics of MEMS sensors were eva

Inducing Neural Plasticity and Modulation Using Multisensory Stimulation: Techniques for Sensory Disorder Treatment

University of Minnesota Ph.D. dissertation. June 2017. Major: Biomedical Engineering. Advisor: Hubert Lim. 1 computer file (PDF); xvi, 245 pages.In this dissertation, we characterized the modulatory and plasticity effects of paired multisensory stimulation on neural firing in sensory systems across the brain. In the auditory system, we discovered that electrical somatosensory stimulation can either suppress or facilitate neural firing in the inferior colliculus (IC) and primary auditory cortex (A1) depending stimulation location. We also tested plasticity effects in A1 in response to paired somatosensory and acoustic stimulation with different inter-stimulus delays in anesthetized guinea pigs, and found that plasticity induced by paired acoustic and right mastoid stimulation was consistently suppressive regardless of delay, but paired acoustic and pinna stimulation was timing-dependent, where one inter-stimulus delay was consistently suppressive while other delays induced random changes. These experiments were repeated in awake animals with paired acoustic and pinna stimulation, and two animal groups of different stress levels were used to assess stress effects on plasticity. We found that in low-stress animals, the same inter-stimulus delay was consistently suppressive and a neighboring delay was consistently facilitative across all animals, which matches previous invasive spike-timing dependent plasticity studies (anesthesia may have affected these trends). Meanwhile, high-stress animal results were not consistent with expected time dependence and exhibited no trends across inter-stimulus delays, indicating that stress can have adverse effects on neuromodulation plasticity outcomes. In all other primary sensory cortices, we found that differential effects can be induced with paired sensory stimulation such that the location, amount, type, and timing of plasticity can be controlled by strategically choosing sensory stimulation parameters for modulation of each sensory cortex. We also investigated the ability to target subpopulations of neurons within a brain region and found that by stimulating at levels near activation thresholds, specific subpopulations of IC neurons can be targeted by varying somatosensory stimulation location. Furthermore, acoustic stimulation can excite or modulate specific areas of somatosensory cortex, and we mapped the guinea pig homunculus to characterize this. Overall, these findings illustrate the immense interconnectivity between sensory systems, and multisensory stimulation may provide a noninvasive neuromodulation approach for inducing controlled plasticity to disrupt pathogenic neural activity in neural sensory disorders, such as tinnitus and pain