Design of a Haptic Interface for Medical Applications using Magneto-Rheological Fluid based Actuators

This thesis reports on the design, construction, and evaluation of a prototype two degrees-of-freedom (DOF) haptic interface, which takes advantage of Magneto-Rheological Fluid (MRF) based clutches for actuation. Haptic information provides important cues in teleoperated systems and enables the user to feel the interaction with a remote or virtual environment during teleoperation. The two main objectives in designing a haptic interface are stability and transparency. Indeed, deficiencies in these factors in haptics-enabled telerobotic systems has the introduction of haptics in medical environments where safety and reliability are prime considerations. An actuator with poor dynamics, high inertia, large size, and heavy weight can significantly undermine the stability and transparency of a teleoperated system. In this work, the potential benefits of MRF-based actuators to the field of haptics in medical applications are studied. Devices developed with such fluids are known to possess superior mechanical characteristics over conventional servo systems. These characteristics significantly contribute to improved stability and transparency of haptic devices. This idea is evaluated and verified through both theoretical and experimental points of view. The design of a small-scale MRF-based clutch, suitable for a multi-DOF haptic interface, is discussed and its performance is compared with conventional servo systems. This design is developed into four prototype clutches. In addition, a closed-loop torque control strategy is presented. The feedback signal used in this control scheme comes from the magnetic field acquired from embedded Hall sensors in the clutch. The controller uses this feedback signal to compensate for the nonlinear behavior using an estimated model, based on Artificial Neural Networks. Such a control strategy eliminates the need for torque sensors for providing feedback signals. The performance of the developed design and the effectiveness of the proposed modeling and control techniques are experimentally validated. Next, a 2-DOF haptic interface based on a distributed antagonistic configuration of MRF-based clutches is constructed for a class of medical applications. This device is incorporated in a master-slave teleoperation setup that is used for applications involving needle insertion and soft-tissue palpation. Phantom and in vitro animal tissue were used to assess the performance of the haptic interface. The results show a great potential of MRF-based actuators for integration in haptic devices for medical interventions that require reliable, safe, accurate, highly transparent, and stable force reflection

Modeling, Analysis, Force Sensing and Control of Continuum Robots for Minimally Invasive Surgery

This dissertation describes design, modeling and application of continuum robotics for surgical applications, specifically parallel continuum robots (PCRs) and concentric tube manipulators (CTMs). The introduction of robotics into surgical applications has allowed for a greater degree of precision, less invasive access to more remote surgical sites, and user-intuitive interfaces with enhanced vision systems. The most recent developments have been in the space of continuum robots, whose exible structure create an inherent safety factor when in contact with fragile tissues. The design challenges that exist involve balancing size and strength of the manipulators, controlling the manipulators over long transmission pathways, and incorporating force sensing and feedback from the manipulators to the user. Contributions presented in this work include: (1) prototyping, design, force sensing, and force control investigations of PCRs, and (2) prototyping of a concentric tube manipulator for use in a standard colonoscope. A general kinetostatic model is presented for PCRs along with identification of multiple physical constraints encountered in design and construction. Design considerations and manipulator capabilities are examined in the form of matrix metrics and ellipsoid representations. Finally, force sensing and control are explored and experimental results are provided showing the accuracy of force estimates based on actuation force measurements and control capabilities. An overview of the design requirements, manipulator construction, analysis and experimental results are provided for a CTM used as a tool manipulator in a traditional colonoscope. Currently, tools used in colonoscopic procedures are straight and exit the front of the scope with 1 DOF of operation (jaws of a grasper, tightening of a loop, etc.). This research shows that with a CTM deployed, the dexterity of these tools can be increased dramatically, increasing accuracy of tool operation, ease of use and safety of the overall procedure. The prototype investigated in this work allows for multiple tools to be used during a single procedure. Experimental results show the feasibility and advantages of the newly-designed manipulators

Implantable Microsystem Technologies For Nanoliter-Resolution Inner Ear Drug Delivery

Advances in protective and restorative biotherapies have created new opportunities to use site-directed, programmable drug delivery systems to treat auditory and vestibular disorders. Successful therapy development that leverages the transgenic, knock-in, and knock-out variants of mouse models of human disease requires advanced microsystems specifically designed to function with nanoliter precision and with system volumes suitable for implantation. The present work demonstrates a novel biocompatible, implantable, and scalable microsystem consisted of a thermal phase-change peristaltic micropump with wireless control and a refillable reservoir. The micropump is fabricated around a catheter microtubing (250 μm OD, 125 μm ID) that provided a biocompatible leak-free flow path while avoiding complicated microfluidic interconnects. Direct-write micro-scale printing technology was used to build the mechanical components of the pump around the microtubing directly on the back of a printed circuit board assembly. In vitro characterization results indicated nanoliter resolution control over the desired flow rates of 10–100 nL/min by changing the actuation frequency, with negligible deviations in presence of up to 10× greater than physiological backpressures and ±3°C ambient temperature variation. A biocompatibility study was performed to evaluate material suitability for chronic subcutaneous implantation and clinical translational development. A stand-alone, refillable, in-plane, scalable, and fully implantable microreservoir platform was designed and fabricated to be integrated with the micropump. The microreservoir consists two main components: a cavity for storing the drug and a septum for refilling. The cavity membrane is fabricated with thin Parylene-C layers, using a polyethylene glycol (PEG) sacrificial layer. The septum thickness is minimized by pre-compression down to 1 mm. The results of in vitro characterization indicated negligible restoring force for the optimized cavity membrane and thousands of punctures through the septum without leakage. The micropump and microreservoir were integrated into microsystems which were implanted in mice. The microtubing was implanted into the round window membrane niche for infusion of a known ototoxic compound (sodium salicylate) at 50 nL/min for 20 min. Real-time shifts in distortion product otoacoustic emission thresholds and amplitudes were measured during the infusion. The results match with syringe pump gold standard. For the first time a miniature and yet scalable microsystem for inner ear drug delivery was developed, enabling drug discovery opportunities and translation to human

The Design and Development of an Intelligent Atraumatic Laparoscopic Grasper

A key tool in laparoscopic surgery is the grasper, which is the surgeon’s main means of manipulating tissue within the body. However inappropriate use may lead to tissue damage and poor surgical outcomes. This thesis presents a novel approach to the assessment and prevention of tissue damage caused by laparoscopic graspers. The research focusses on establishing typical grasping characteristics used in surgery and thus developing a model of mechanically induced tissue trauma. A review explored the state-of-the-art in devices for measuring surgical grasping, tissue mechanics, and damage quantification to inform the research. An instrumented grasper was developed to characterise typical surgical tasks, enabling the grasping force and jaw displacement to be measured. This device was then used to quantitatively characterise grasper use in an in-vivo porcine model where the device was used to perform organ retraction and manipulation tasks. From this work, the range of forces and the grasping times used in certain tasks were determined and this information was used to guide the rest of the study. The in-vivo investigation highlighted a need for grasping in a controlled environment where the tissue’s mechanical properties could be studied. A grasper test rig was designed and developed to provide automated controlled grasping of ex-vivo tissue. This allowed the mechanical properties of tissue to be determined and analysed for indications of tissue damage. A series of experimental studies were conducted with this system which showed how the mechanical response of tissue varies depending on the applied grasping force characteristics, and how this is indicative of tissue damage through comparison to histological analysis. These data were then used to develop a model which predicts the likelihood and severity of tissue damage during grasping, based on the input conditions of grasping force and time. The model was integrated into the instrumented grasper system to provide a tool which could enable real-time grading and feedback of grasping during surgery, or be used to inform best practice in training scenarios

Viscoelasticity Imaging of Biological Tissues and Single Cells Using Shear Wave Propagation

Changes in biomechanical properties of biological soft tissues are often associated with physiological dysfunctions. Since biological soft tissues are hydrated, viscoelasticity is likely suitable to represent its solid-like behavior using elasticity and fluid-like behavior using viscosity. Shear wave elastography is a non-invasive imaging technology invented for clinical applications that has shown promise to characterize various tissue viscoelasticity. It is based on measuring and analyzing velocities and attenuations of propagated shear waves. In this review, principles and technical developments of shear wave elastography for viscoelasticity characterization from organ to cellular levels are presented, and different imaging modalities used to track shear wave propagation are described. At a macroscopic scale, techniques for inducing shear waves using an external mechanical vibration, an acoustic radiation pressure or a Lorentz force are reviewed along with imaging approaches proposed to track shear wave propagation, namely ultrasound, magnetic resonance, optical, and photoacoustic means. Then, approaches for theoretical modeling and tracking of shear waves are detailed. Following it, some examples of applications to characterize the viscoelasticity of various organs are given. At a microscopic scale, a novel cellular shear wave elastography method using an external vibration and optical microscopy is illustrated. Finally, current limitations and future directions in shear wave elastography are presented

Image Guided Robots for Urology

This dissertation addresses the development of medical image-guided robots and their applications in urology. Image-guided robots integrate medical image information with robotic precision to assist the planning and execution of the image-guided interventions. Robots guided by two different image modalities, ultrasound and MR image, were developed. Ultrasound image-guided robots manipulate an ultrasound probe and a needle-guide that are calibrated with respect to the robot for image-guided targeting. A method for calibration was developed and verified through the image-guided targeting experiments. Robotic manipulation of the calibrated probe allows acquisition of image slices at precise location, which can be combined to generate a 3D ultrasound image. Software for 3D ultrasound image acquisition, processing, and segmentation was developed as a part of the image-guided robot system. The feasibility of several image-guided intervention procedures using the ultrasound image-guided robot system was tested. The robot was used in a clinical trial of intraoperative transrectal ultrasound (TRUS) guided prostatectomy. The accuracy of TRUS-guided prostate biopsy using the robot was evaluated in a comparative study versus the classic human operation of the probe. Robot controlled palpation and image processing methods were developed for ultrasound elastography imaging of the prostate. An ultrasound to CT image-fusion method using the robot as a common reference was developed for percutaneous access of the kidney. MRI-guided robots were developed for transrectal and transperineal prostate biopsy. Extensive in-vitro tests were performed to ensure MRI compatibility and image-guided accuracy of the robots. The transrectal robot was evaluated in an animal study and the transperineal robot is undergoing a clinical trial. The collection of methods and algorithms presented in this dissertation can contribute to the development of image-guided robots that may provide less invasive and more precise interventions in urology, interventional radiology, and other fields

The Development of a Flexible Sensor for Continuum Soft-Bodied Robots

In this thesis, we investigate, develop, and verify an approach to sense over soft and flexible materials based on the use of a tomographic technique known as Electrical Impedance Tomography