221 research outputs found

    The biomechanical structure of the seahorse tail as a source of inspiration for industrial design

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    Flexible tactile digital feedback for clinical applications

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    Trauma and damage to the delicate structures of the inner ear frequently occurs during insertion of electrode array into the cochlea. This is strongly related to the excessive manual insertion force of the surgeon without any tool/tissue interaction feedback. The research is examined tool-tissue interaction of large prototype scale (12.5:1) digit embedded with distributive tactile sensor based upon cochlear electrode and large prototype scale (4.5:1) cochlea phantom for simulating the human cochlear which could lead to small scale digit requirements. This flexible digit classified the tactile information from the digit-phantom interaction such as contact status, tip penetration, obstacles, relative shape and location, contact orientation and multiple contacts. The digit, distributive tactile sensors embedded with silicon-substrate is inserted into the cochlea phantom to measure any digit/phantom interaction and position of the digit in order to minimize tissue and trauma damage during the electrode cochlear insertion. The digit is pre-curved in cochlea shape so that the digit better conforms to the shape of the scala tympani to lightly hug the modiolar wall of a scala. The digit have provided information on the characteristics of touch, digit-phantom interaction during the digit insertion. The tests demonstrated that even devices of such a relative simple design with low cost have potential to improve cochlear implants surgery and other lumen mapping applications by providing tactile feedback information by controlling the insertion through sensing and control of the tip of the implant during the insertion. In that approach, the surgeon could minimize the tissue damage and potential damage to the delicate structures within the cochlear caused by current manual electrode insertion of the cochlear implantation. This approach also can be applied diagnosis and path navigation procedures. The digit is a large scale stage and could be miniaturized in future to include more realistic surgical procedures

    Investigation of pattern generating mechanisms during atrial fibrillation based on the FitzHugh Nagumo equations

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    Die häufigste Arrhythmie des Herzens im klinischen Alltag ist Vorhofflimmern. Sie ist die Ursache von einem Drittel aller Behandlungen von Herzrhythmusstörungen. Obwohl das Phänomen des Vorhofflimmerns seit Anfang des letzten Jahrhunderts bekannt ist, sind die zugrunde liegenden Mechanismen noch nicht ausreichend verstanden. Als mögliche generierende Mechanismen werden in dieser Arbeit ektopische Zentren und Spiralwellen auf der Grundlage der FitzHugh-Nagumo- Gleichungen untersucht. Zur Darstellung von lokalen Gewebeveränderungen und der mit ihnen verbundenen Entstehung von ektopischen Zentren und Spiralwellen werden Zelleigenschaften wie die Anregbarkeit und die Stabilität des Ruhezustandes in räumlich begrenzten Gebieten variiert. Das Auftreten von Aktivitätsmustern in Abhängigkeit der linearen Ausdehnung der modifizierten Zellbereiche und der Stärke der Modifikation wird in dynamischen Phasendiagrammen erfasst und die mit den verschiedenen Mustern verbundenen Eigenschaften werden analysiert. Der abschließende Teil betrifft die Untersuchung von Mustern, welche durch Interferenz von regelmässigen, periodisch angeregten Wellen im rechten Vorhof mit Wellen ausgehend von einer stabilen Spiralwelle im linken Vorhof entstehen. Es wird gezeigt, dass diese Interferenz Ursache eines Flimmerzustandes im rechten Vorhof sein kann. Dabei führt insbesondere eine hohe Anregungsrate zu einem irregulären, flimmerähnlichen Zustand im rechten Vorhof. Sie erweist sich als Schlüsselfaktor für das Auftreten von Flimmerepisoden.Atrial fibrillation is the most important arrhythmia in clinical practice, accounting for one third of hospitalisations for cardiac disrhythms. Although it is known since the beginning of the last century, the underlying mechanisms are still under disucssion. In this work two proposed mechanisms are investigated, ectopic activity and spiral waves, with focus on their generating conditions, characteristic properties and wether they can be a possible cause of atrial fibrillation. Thereby, the cell properties like excitability and resting state stability are spatially varied to model possible generating conditions. The calculations are carried out on the basis of the FitzHugh Nagumo model. Dynamical phase diagrams are constructed for the ectopic activity as well as for the spiral waves, which classify the behaviour of the system in dependence on the properties of the spatial variation of the cell properties. The fibrillation rate is analysed and a transition from anatomical to functional reentry is observed for the spiral waves. Moreover, interference patterns of waves are studied in comparison to patterns found in recent experiments. The interference of waves from a stable spiral wave in the left atrium with regular paced waves in the right atrium, as a model of the sinus node, is shown to be a possible cause of fibrillation in the right atrium. A high pacing rate can yield an irregular, fibrillatory state, which describes the generation of fibrillation episodes and is seen as a key factor for the occurrence of fibrillation episodes.Ilmenau, Techn. Univ., Diplomarbeit, 200

    A Robotic System for Transanal Endoscopic Microsurgery: Design, Dexterity Optimization, and Prototyping

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    This article proposes a master–slave operated robotic system that features the novel slave manipulator with a modular distal continuum section to address the shortcomings of traditional transanal endoscopic microsurgery (TEM). The slave manipulator consists of two seven degrees-of-freedom (7-DoF) surgical instruments and a 5-DoF endoscopic arm that are designed with distal continuum structures and unfolded with a Y configuration after inserting through a transanal port to enhance hand–eye coordination and instrument triangulation. The proposed robot is designed for adaptation in narrow and shallow rectal spaces, facilitating intuitive hand–eye coordination and enhanced operational dexterity with reduced obstruction of the field of view

    Development of A Kinetic Model For Loop-Free Colonoscopy Technology

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    The colonoscope is an important tool in diagnosis and management of diseases of the colon. One of the ongoing challenges with this device is that the colonoscope may form a loop together with the colon during the procedure. The result of the loop is that further insertion of the scope in the colon may not be possible. The loop may also cause risks of perforation of the colon and pain in the patient. There are currently several existing devices to overcome loop formation in colonoscopy, some of which have been introduced in clinical work. However, empirical assessment shows that these devices do not work very well. This is the motivation for the research presented in this thesis. In this thesis, a new paradigm of thinking, “doctor-assisted colonoscopy,” is proposed to overcome loop formation. In this new approach, the physician’s role is enhanced with new information that is acquired by sensors outside the human body and inferred from the mathematical model. It is referred to as a kinetic model due to the fact that this model describes the kinetic behaviour of the scope. This thesis is devoted to development of this kinetic model. In this study, the model of the colonoscope and the model of the colon are developed based on the Timoshenko beam theory, and parameters in both models are determined by the experiments. The following conclusions then are made: (1) self-locking of the colonoscope is the most basic cause for a loop to occur, while structural instability of the colonsocope is dependent on the self-locking; (2) both the scope and the colon can be well represented with the Timoshenko beam elements and the Linear Complementary Problem (LCP) formulation derived from Signorini’s law, and Coulom’s law for representation of interactions between the colon and scope is adequate; (3) there are effects from the location, looping, and tip deflection of the scope on flexural rigidity of the scope. Approximately, the flexural rigidity of the CF-Q160L colonoscope ranges from 300 to 650 N•cm2, and its accuracy is proven by a good agreement between the model predicted result and experimental result; (4) Rayleigh damping for the CF-Q160L colonoscope depends more on the mass matrix [M] of the colonoscope than the stiffness matrix [K], which is evident by the large coefficient value of “alpha” (0.3864) and the small coefficient value of “beta” (0.0164). The contributions of this thesis are: (1) the finding that the main cause of the loop is not structural instability of the colonoscope but rather self-locking of the colonoscope, which could lead to design of a “new-generation” colonoscope to avoid the loop; (2) a systematic evaluation of the existing colonoscopy technologies based on the well-proven Axiomatic Design Theory (ADT), which will serve as a guideline for the development of future new colonoscopes in future; (3) an approach to developing a kinetic model of the colonoscope useful to modeling similar objects such as a catheter guide-wire; (4) a novel ex-vivo colonoscopy test-bed with the kinetic and kinematic measurements useful for validation of new designs in colonoscopy technology and also useful for training physicians who perform the colonoscopy procedure; and (5) a new paradigm of thinking for colonoscopy called “doctor-assisted colonoscopy,” which has potential applications to other medical procedures such as catheter-based procedures

    Fluid mechanical modeling of the upper urinary tract

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    The upper urinary tract (UUT) consists of kidneys and ureters, and is an integral part of the human urogenital system. Yet malfunctioning and complications of the UUT can happen at all stages of life, attributed to reasons such as congenital anomalies, urinary tract infections, urolithiasis and urothelial cancers, all of which require urological interventions and significantly compromise patients' quality of life. Therefore, many models have been developed to address the relevant scientific and clinical challenges of the UUT. Of all approaches, fluid mechanical modeling serves a pivotal role and various methods have been employed to develop physiologically meaningful models. In this article, we provide an overview on the historical evolution of fluid mechanical models of UUT that utilize theoretical, computational, and experimental approaches. Descriptions of the physiological functionality of each component are also given and the mechanical characterizations associated with the UUT are provided. As such, it is our aim to offer a brief summary of the current knowledge of the subject, and provide a comprehensive introduction for engineers, scientists, and clinicians who are interested in the field of fluid mechanical modeling of UUT

    Robotic Assistant Systems for Otolaryngology-Head and Neck Surgery

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    Recently, there has been a significant movement in otolaryngology-head and neck surgery (OHNS) toward minimally invasive techniques, particularly those utilizing natural orifices. However, while these techniques can reduce the risk of complications encountered with classic open approaches such as scarring, infection, and damage to healthy tissue in order to access the surgical site, there remain significant challenges in both visualization and manipulation, including poor sensory feedback, reduced visibility, limited working area, and decreased precision due to long instruments. This work presents two robotic assistance systems which help to overcome different aspects of these challenges. The first is the Robotic Endo-Laryngeal Flexible (Robo-ELF) Scope, which assists surgeons in manipulating flexible endoscopes. Flexible endoscopes can provide superior visualization compared to microscopes or rigid endoscopes by allowing views not constrained by line-of-sight. However, they are seldom used in the operating room due to the difficulty in precisely manually manipulating and stabilizing them for long periods of time. The Robo-ELF Scope enables stable, precise robotic manipulation for flexible scopes and frees the surgeon’s hands to operate bimanually. The Robo-ELF Scope has been demonstrated and evaluated in human cadavers and is moving toward a human subjects study. The second is the Robotic Ear Nose and Throat Microsurgery System (REMS), which assists surgeons in manipulating rigid instruments and endoscopes. There are two main types of challenges involved in manipulating rigid instruments: reduced precision from hand tremor amplified by long instruments, and difficulty navigating through complex anatomy surrounded by sensitive structures. The REMS enables precise manipulation by allowing the surgeon to hold the surgical instrument while filtering unwanted movement such as hand tremor. The REMS also enables augmented navigation by calculating the position of the instrument with high accuracy, and combining this information with registered preoperative imaging data to enforce virtual safety barriers around sensitive anatomy. The REMS has been demonstrated and evaluated in user studies with synthetic phantoms and human cadavers

    Virtuelle endovaskuläre Versorgung von abdominalen Aortenaneurysmen

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    This thesis is focused on computational methods that predict the outcome of endovascular repair of abdominal aortic aneurysms. Novelties include improvements of the aneurysm model, the stent-graft model as well as the in-silico stent-graft placement methodology. The newly developed methods are applied to patient-specific cases and are validated against real-world postinterventional data. Further, directions for using the in-silico model of endovascular aneurysm repair as personalized preinterventional planning tool in clinical practice are provided.Die vorliegende Arbeit beschäftigt sich mit numerischen Methoden um den Ausgang einer endovaskulären Versorgung von abdominalen Aortenaneurysmen vorherzusagen. Neuheiten umfassen Verbesserungen des Aneurysmenmodells, des Stentgraftmodells sowie der virtuellen Platzierungsmethode des Stentgrafts. Die neu entwickelten Methoden werden auf patientenspezifische Fälle angewandt und werden mit realen postoperativen Daten validiert. Weiterhin werden klinische Anwendungen des Modells der endovaskulären Aneurysmenversorgung als personalisiertes präoperatives Planungswerkzeug präsentiert

    Medical SLAM in an autonomous robotic system

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    One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-operative morphology and motion of soft-tissues. This information is prerequisite to the registration of multi-modal patient-specific data for enhancing the surgeon’s navigation capabilities by observing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted instruments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This thesis addresses the ambitious goal of achieving surgical autonomy, through the study of the anatomical environment by Initially studying the technology present and what is needed to analyze the scene: vision sensors. A novel endoscope for autonomous surgical task execution is presented in the first part of this thesis. Which combines a standard stereo camera with a depth sensor. This solution introduces several key advantages, such as the possibility of reconstructing the 3D at a greater distance than traditional endoscopes. Then the problem of hand-eye calibration is tackled, which unites the vision system and the robot in a single reference system. Increasing the accuracy in the surgical work plan. In the second part of the thesis the problem of the 3D reconstruction and the algorithms currently in use were addressed. In MIS, simultaneous localization and mapping (SLAM) can be used to localize the pose of the endoscopic camera and build ta 3D model of the tissue surface. Another key element for MIS is to have real-time knowledge of the pose of surgical tools with respect to the surgical camera and underlying anatomy. Starting from the ORB-SLAM algorithm we have modified the architecture to make it usable in an anatomical environment by adding the registration of the pre-operative information of the intervention to the map obtained from the SLAM. Once it has been proven that the slam algorithm is usable in an anatomical environment, it has been improved by adding semantic segmentation to be able to distinguish dynamic features from static ones. All the results in this thesis are validated on training setups, which mimics some of the challenges of real surgery and on setups that simulate the human body within Autonomous Robotic Surgery (ARS) and Smart Autonomous Robotic Assistant Surgeon (SARAS) projects
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