1,486 research outputs found

    Optical techniques for 3D surface reconstruction in computer-assisted laparoscopic surgery

    Get PDF
    One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-opera- tive 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 capabilites by observ- ing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted in- struments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This paper reviews the state-of-the-art methods for optical intra-operative 3D reconstruction in laparoscopic surgery and discusses the technical challenges and future perspectives towards clinical translation. With the recent paradigm shift of surgical practice towards MIS and new developments in 3D opti- cal imaging, this is a timely discussion about technologies that could facilitate complex CAS procedures in dynamic and deformable anatomical regions

    Kinematic design of a non-parasitic 2R1T parallel mechanism with remote center of motion to be used in minimally invasive surgery applications

    Get PDF
    In minimally invasive surgery applications, the use of robotic manipulators is becoming more and more common to enhance the precision of the operations and post-operative processes. Such operations are often performed through an incision port (a pivot point) on the patient's body. Since the end-effector (the handled surgical tool) move about the pivot point, the manipulator has to move about a remote center of motion. In this study, a 3-degrees-of-freedom parallel mechanism with 2R1T (R: rotation, T: translation) remote center of motion capability is presented for minimally invasive surgery applications. First, its kinematic structure is introduced. Then, its kinematic analysis is carried out by using a simplified kinematic model which consists of three intersecting planes. Then the dimensional design is done for the desired workspace and a simulation test is carried out to verify the kinematic formulations. Finally, the prototype of the final design is presented.Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK

    Cable-driven parallel mechanisms for minimally invasive robotic surgery

    Get PDF
    Minimally invasive surgery (MIS) has revolutionised surgery by providing faster recovery times, less post-operative complications, improved cosmesis and reduced pain for the patient. Surgical robotics are used to further decrease the invasiveness of procedures, by using yet smaller and fewer incisions or using natural orifices as entry point. However, many robotic systems still suffer from technical challenges such as sufficient instrument dexterity and payloads, leading to limited adoption in clinical practice. Cable-driven parallel mechanisms (CDPMs) have unique properties, which can be used to overcome existing challenges in surgical robotics. These beneficial properties include high end-effector payloads, efficient force transmission and a large configurable instrument workspace. However, the use of CDPMs in MIS is largely unexplored. This research presents the first structured exploration of CDPMs for MIS and demonstrates the potential of this type of mechanism through the development of multiple prototypes: the ESD CYCLOPS, CDAQS, SIMPLE, neuroCYCLOPS and microCYCLOPS. One key challenge for MIS is the access method used to introduce CDPMs into the body. Three different access methods are presented by the prototypes. By focusing on the minimally invasive access method in which CDPMs are introduced into the body, the thesis provides a framework, which can be used by researchers, engineers and clinicians to identify future opportunities of CDPMs in MIS. Additionally, through user studies and pre-clinical studies, these prototypes demonstrate that this type of mechanism has several key advantages for surgical applications in which haptic feedback, safe automation or a high payload are required. These advantages, combined with the different access methods, demonstrate that CDPMs can have a key role in the advancement of MIS technology.Open Acces

    Soft Robot-Assisted Minimally Invasive Surgery and Interventions: Advances and Outlook

    Get PDF
    Since the emergence of soft robotics around two decades ago, research interest in the field has escalated at a pace. It is fuelled by the industry's appreciation of the wide range of soft materials available that can be used to create highly dexterous robots with adaptability characteristics far beyond that which can be achieved with rigid component devices. The ability, inherent in soft robots, to compliantly adapt to the environment, has significantly sparked interest from the surgical robotics community. This article provides an in-depth overview of recent progress and outlines the remaining challenges in the development of soft robotics for minimally invasive surgery

    Snake-Like Robots for Minimally Invasive, Single Port, and Intraluminal Surgeries

    Full text link
    The surgical paradigm of Minimally Invasive Surgery (MIS) has been a key driver to the adoption of robotic surgical assistance. Progress in the last three decades has led to a gradual transition from manual laparoscopic surgery with rigid instruments to robot-assisted surgery. In the last decade, the increasing demand for new surgical paradigms to enable access into the anatomy without skin incision (intraluminal surgery) or with a single skin incision (Single Port Access surgery - SPA) has led researchers to investigate snake-like flexible surgical devices. In this chapter, we first present an overview of the background, motivation, and taxonomy of MIS and its newer derivatives. Challenges of MIS and its newer derivatives (SPA and intraluminal surgery) are outlined along with the architectures of new snake-like robots meeting these challenges. We also examine the commercial and research surgical platforms developed over the years, to address the specific functional requirements and constraints imposed by operations in confined spaces. The chapter concludes with an evaluation of open problems in surgical robotics for intraluminal and SPA, and a look at future trends in surgical robot design that could potentially address these unmet needs.Comment: 41 pages, 18 figures. Preprint of article published in the Encyclopedia of Medical Robotics 2018, World Scientific Publishing Company www.worldscientific.com/doi/abs/10.1142/9789813232266_000

    Augmented navigation

    Get PDF
    Spinal fixation procedures have the inherent risk of causing damage to vulnerable anatomical structures such as the spinal cord, nerve roots, and blood vessels. To prevent complications, several technological aids have been introduced. Surgical navigation is the most widely used, and guides the surgeon by providing the position of the surgical instruments and implants in relation to the patient anatomy based on radiographic images. Navigation can be extended by the addition of a robotic arm to replace the surgeon’s hand to increase accuracy. Another line of surgical aids is tissue sensing equipment, that recognizes different tissue types and provides a warning system built into surgical instruments. All these technologies are under continuous development and the optimal solution is yet to be found. The aim of this thesis was to study the use of Augmented Reality (AR), Virtual Reality (VR), Artificial Intelligence (AI), and tissue sensing technology in spinal navigation to improve precision and prevent surgical errors. The aim of Paper I was to develop and validate an algorithm for automatizing the intraoperative planning of pedicle screws. An AI algorithm for automatic segmentation of the spine, and screw path suggestion was developed and evaluated. In a clinical study of advanced deformity cases, the algorithm could provide correct suggestions for 86% of all pedicles—or 95%, when cases with extremely altered anatomy were excluded. Paper II evaluated the accuracy of pedicle screw placement using a novel augmented reality surgical navigation (ARSN) system, harboring the above-developed algorithm. Twenty consecutively enrolled patients, eligible for deformity correction surgery in the thoracolumbar region, were operated on using the ARSN system. In this cohort, we found a pedicle screw placement accuracy of 94%, as measured according to the Gertzbein grading scale. The primary goal of Paper III was to validate an extension of the ARSN system for placing pedicle screws using instrument tracking and VR. In a porcine cadaver model, it was demonstrated that VR instrument tracking could successfully be integrated with the ARSN system, resulting in pedicle devices placed within 1.7 ± 1.0 mm of the planed path. Paper IV examined the feasibility of a robot-guided system for semi-automated, minimally invasive, pedicle screw placement in a cadaveric model. Using the robotic arm, pedicle devices were placed within 0.94 ± 0.59 mm of the planned path. The use of a semi-automated surgical robot was feasible, providing a higher technical accuracy compared to non-robotic solutions. Paper V investigated the use of a tissue sensing technology, diffuse reflectance spectroscopy (DRS), for detecting the cortical bone boundary in vertebrae during pedicle screw insertions. The technology could accurately differentiate between cancellous and cortical bone and warn the surgeon before a cortical breach. Using machine learning models, the technology demonstrated a sensitivity of 98% [range: 94-100%] and a specificity of 98% [range: 91-100%]. In conclusion, several technological aids can be used to improve accuracy during spinal fixation procedures. In this thesis, the advantages of adding AR, VR, AI and tissue sensing technology to conventional navigation solutions were studied

    A Literature Review of Renal Surgical Anatomy and Surgical Strategies for Partial Nephrectomy

    Get PDF
    CONTEXT: A detailed understanding of renal surgical anatomy is necessary to optimize preoperative planning and operative technique and provide a basis for improved outcomes. OBJECTIVE: To evaluate the literature regarding pertinent surgical anatomy of the kidney and related structures, nephrometry scoring systems, and current surgical strategies for partial nephrectomy (PN). EVIDENCE ACQUISITION: A literature review was conducted. EVIDENCE SYNTHESIS: Surgical renal anatomy fundamentally impacts PN surgery. The renal artery divides into anterior and posterior divisions, from which approximately five segmental terminal arteries originate. The renal veins are not terminal. Variations in the vascular and lymphatic channels are common; thus, concurrent lymphadenectomy is not routinely indicated during PN for cT1 renal masses in the setting of clinically negative lymph nodes. Renal-protocol contrast-enhanced computed tomography or magnetic resonance imaging is used for standard imaging. Anatomy-based nephrometry scoring systems allow standardized academic reporting of tumor characteristics and predict PN outcomes (complications, remnant function, possibly histology). Anatomy-based novel surgical approaches may reduce ischemic time during PN; these include early unclamping, segmental clamping, tumor-specific clamping (zero ischemia), and unclamped PN. Cancer cure after PN relies on complete resection, which can be achieved by thin margins. Post-PN renal function is impacted by kidney quality, remnant quantity, and ischemia type and duration. CONCLUSIONS: Surgical renal anatomy underpins imaging, nephrometry scoring systems, and vascular control techniques that reduce global renal ischemia and may impact post-PN function. A contemporary ideal PN excises the tumor with a thin negative margin, delicately secures the tumor bed to maximize vascularized remnant parenchyma, and minimizes global ischemia to the renal remnant with minimal complications. PATIENT SUMMARY: In this report we review renal surgical anatomy. Renal mass imaging allows detailed delineation of the anatomy and vasculature and permits nephrometry scoring, and thus precise, patient-specific surgical planning. Novel off-clamp techniques have been developed that may lead to improved outcomes

    Multi-objective particle swarm optimization for the structural design of concentric tube continuum robots for medical applications

    Get PDF
    Concentric tube robots belong to the class of continuum robotic systems whose morphology is described by continuous tangent curvature vectors. They are composed of multiple, interacting tubes nested inside one another and are characterized by their inherent flexibility. Concentric tube continuum robots equipped with tools at their distal end have high potential in minimally invasive surgery. Their morphology enables them to reach sites within the body that are inaccessible with commercial tools or that require large incisions. Further, they can be deployed through a tight lumen or follow a nonlinear path. Fundamental research has been the focus during the last years bringing them closer to the operating room. However, there remain challenges that require attention. The structural synthesis of concentric tube continuum robots is one of these challenges, as these types of robots are characterized by their large parameter space. On the one hand, this is advantageous, as they can be deployed in different patients, anatomies, or medical applications. On the other hand, the composition of the tubes and their design is not a straightforward task but one that requires intensive knowledge of anatomy and structural behavior. Prior to the utilization of such robots, the composition of tubes (i.e. the selection of design parameters and application-specific constraints) must be solved to determine a robotic design that is specifically targeted towards an application or patient. Kinematic models that describe the change in morphology and complex motion increase the complexity of this synthesis, as their mathematical description is highly nonlinear. Thus, the state of the art is concerned with the structural design of these types of robots and proposes optimization algorithms to solve for a composition of tubes for a specific patient case or application. However, existing approaches do not consider the overall parameter space, cannot handle the nonlinearity of the model, or multiple objectives that describe most medical applications and tasks. This work aims to solve these fundamental challenges by solving the parameter optimization problem by utilizing a multi-objective optimization algorithm. The main concern of this thesis is the general methodology to solve for patient- and application-specific design of concentric tube continuum robots and presents key parameters, objectives, and constraints. The proposed optimization method is based on evolutionary concepts that can handle multiple objectives, where the set of parameters is represented by a decision vector that can be of variable dimension in multidimensional space. Global optimization algorithms specifically target the constrained search space of concentric tube continuum robots and nonlinear optimization enables to handle the highly nonlinear elasticity modeling. The proposed methodology is then evaluated based on three examples that include cooperative task deployment of two robotic arms, structural stiffness optimization under the consideration of workspace constraints and external forces, and laser-induced thermal therapy in the brain using a concentric tube continuum robot. In summary, the main contributions are 1) the development of an optimization methodology that describes the key parameters, objectives, and constraints of the parameter optimization problem of concentric tube continuum robots, 2) the selection of an appropriate optimization algorithm that can handle the multidimensional search space and diversity of the optimization problem with multiple objectives, and 3) the evaluation of the proposed optimization methodology and structural synthesis based on three real applications
    • …
    corecore