Tactile Sensing System for Lung Tumour Localization during Minimally Invasive Surgery

Video-assisted thoracoscopie surgery (VATS) is becoming a prevalent method for lung cancer treatment. However, VATS suffers from the inability to accurately relay haptic information to the surgeon, often making tumour localization difficult. This limitation was addressed by the design of a tactile sensing system (TSS) consisting of a probe with a tactile sensor and interfacing visualization software. In this thesis, TSS performance was tested to determine the feasibility of implementing the system in VATS. This was accomplished through a series of ex vivo experiments in which the tactile sensor was calibrated and the visualization software was modified to provide haptic information visually to the user, and TSS performance was compared using human and robot palpation methods, and conventional VATS instruments. It was concluded that the device offers the possibility of providing to the surgeon the haptic information lost during surgery, thereby mitigating one of the current limitations of VATS

Towards tactile sensing active capsule endoscopy

Examination of the gastrointestinal(GI) tract has traditionally been performed using tethered endoscopy tools with limited reach and more recently with passive untethered capsule endoscopy with limited capability. Inspection of small intestines is only possible using the latter capsule endoscopy with on board camera system. Limited to visual means it cannot detect features beneath the lumen wall if they have not affected the lumen structure or colour. This work presents an improved capsule endoscopy system with locomotion for active exploration of the small intestines and tactile sensing to detect deformation of the capsule outer surface when it follows the intestinal wall. In laboratory conditions this system is capable of identifying sub-lumen features such as submucosal tumours.Through an extensive literary review the current state of GI tract inspection in particular using remote operated miniature robotics, was investigated, concluding no solution currently exists that utilises tactile sensing with a capsule endoscopy. In order to achieve such a platform, further investigation was made in to tactile sensing technologies, methods of locomotion through the gut, and methods to support an increased power requirement for additional electronics and actuation. A set of detailed criteria were compiled for a soft formed sensor and flexible bodied locomotion system. The sensing system is built on the biomimetic tactile sensing device, Tactip, \cite{Chorley2008, Chorley2010, Winstone2012, Winstone2013} which has been redesigned to fit the form of a capsule endoscopy. These modifications have required a $360^{o}$ cylindrical sensing surface with $360^{o}$ panoramic optical system. Multi-material 3D printing has been used to build an almost complete sensor assembly with a combination of hard and soft materials, presenting a soft compliant tactile sensing system that mimics the tactile sensing methods of the human finger. The cylindrical Tactip has been validated using artificial submucosal tumours in laboratory conditions. The first experiment has explored the new form factor and measured the device's ability to detect surface deformation when travelling through a pipe like structure with varying lump obstructions. Sensor data was analysed and used to reconstruct the test environment as a 3D rendered structure. A second tactile sensing experiment has explored the use of classifier algorithms to successfully discriminate between three tumour characteristics; shape, size and material hardness. Locomotion of the capsule endoscopy has explored further bio-inspiration from earthworm's peristaltic locomotion, which share operating environment similarities. A soft bodied peristaltic worm robot has been developed that uses a tuned planetary gearbox mechanism to displace tendons that contract each worm segment. Methods have been identified to optimise the gearbox parameter to a pipe like structure of a given diameter. The locomotion system has been tested within a laboratory constructed pipe environment, showing that using only one actuator, three independent worm segments can be controlled. This configuration achieves comparable locomotion capabilities to that of an identical robot with an actuator dedicated to each individual worm segment. This system can be miniaturised more easily due to reduced parts and number of actuators, and so is more suitable for capsule endoscopy. Finally, these two developments have been integrated to demonstrate successful simultaneous locomotion and sensing to detect an artificial submucosal tumour embedded within the test environment. The addition of both tactile sensing and locomotion have created a need for additional power beyond what is available from current battery technology. Early stage work has reviewed wireless power transfer (WPT) as a potential solution to this problem. Methods for optimisation and miniaturisation to implement WPT on a capsule endoscopy have been identified with a laboratory built system that validates the methods found. Future work would see this combined with a miniaturised development of the robot presented. This thesis has developed a novel method for sub-lumen examination. With further efforts to miniaturise the robot it could provide a comfortable and non-invasive procedure to GI tract inspection reducing the need for surgical procedures and accessibility for earlier stage of examination. Furthermore, these developments have applicability in other domains such as veterinary medicine, industrial pipe inspection and exploration of hazardous environments

Wireless Tissue Palpation for Intraoperative Detection of Lumps in the Soft Tissue

In an open surgery, identification of precise margins for curative tissue resection is performed by manual palpation. This is not the case for minimally invasive and robotic procedures, where tactile feedback is either distorted or not available. In this paper, we introduce the concept of intraoperative wireless tissue palpation. The wireless palpation probe (WPP) is a cylindrical device (15 mm in diameter, 60 mm in length) that can be deployed through a trocar incision and directly controlled by the surgeon to create a volumetric stiffness distribution map of the region of interest. This map can then be used to guide the tissue resection to minimize healthy tissue loss. The wireless operation prevents the need for a dedicated port and reduces the chance of instrument clashing in the operating field. The WPP is able to measure in real time the indentation pressure with a sensitivity of 34 Pa, the indentation depth with an accuracy of 0.68 mm, and the probe position with a maximum error of 11.3 mm in a tridimensional workspace. The WPP was assessed on the benchtop in detecting the local stiffness of two different silicone tissue simulators (elastic modulus ranging from 45 to 220 kPa), showing a maximum relative error below 5%. Then, in vivo trials were aimed to identify an agar-gel lump injected into a porcine liver and to assess the device usability within the frame of a laparoscopic procedure. The stiffness map created intraoperatively by the WPP was compared with a map generated ex vivo by a standard uniaxial material tester, showing less than 8% local stiffness error at the site of the lump

OPTICAL-BASED TACTILE SENSORS FOR MINIMALLY INVASIVE SURGERIES: DESIGN, MODELING, FABRICATION AND VALIDATION

Loss of tactile perception is the most challenging limitation of state-of-the-art technology for minimally invasive surgery. In conventional open surgery, surgeons rely on their tactile sensation to perceive the tissue type, anatomical landmarks, and instrument-tissue interaction in the patient’s body. To compensate for the loss of tactile feedback in minimally invasive surgery, researchers have proposed various tactile sensors based on electrical and optical sensing principles. Optical-based sensors have shown the most compatibility with the functional and physical requirements of minimally invasive surgery applications. However, the proposed tactile sensors in the literature are typically bulky, expensive, cumbersome to integrate with surgical instruments and show nonlinearity in interaction with biological tissues. In this doctoral study, different optical tactile sensing principles were proposed, modeled, validated and various tactile sensors were fabricated, and experimentally studied to address the limitations of the state-of-the-art. The present thesis first provides a critical review of the proposed tactile sensors in the literature with a comparison of their advantages and limitations for surgical applications. Afterward, it compiles the results of the design, modeling, and validation of a hybrid optical-piezoresistive sensor, a distributed Bragg reflecting sensor, and two sensors based on the variable bending radius light intensity modulation principle. The performance of each sensor was verified experimentally for the required criteria of accuracy, resolution, range, repeatability, and hysteresis. Also, a novel image-based intensity estimation technique was proposed and its applicability for being used in surgical applications was verified experimentally. In the end, concluding remarks and recommendations for future studies are provided

Development of a medical imaging-based technology for cancer treatment

The Electrical Impedance Mammography (EIM) device is an imaging system developed at the University of Sussex for the detection of breast lesions in vivo using quadrature detection of impedance. The work describes a novel technique to integrate Ultrasound-guided Focused Ultrasound Surgery (USgFUS) with the existing EIM system. The benefits that such a system could provide include the possibility of non-invasive detection, diagnosis and treatment of breast cancer all within a single device and involving no radiation. Furthermore the timescales involved would allow the process to be considered an outpatient procedure such that a patient can be diagnosed and treated on the same day using the same device. Various geometries of transducer were investigated for physical compatibility as well as the ability to target the entire specified volume, based on the dimensions of the existing system. Simulations were performed using a custom written code based on Huygen’s principle, allowing minimum surface area and power requirements to be determined and feasibility of designs to be evaluated. The use of phase differences in the excitation signals applied to individual elements was also investigated, thus the effect of steering the simulated focus could be observed, an important factor to consider when attempting to incorporate a transducer into a device with restricted dimensions. Resulting simulated pressure fields were used to obtain acoustic intensity fields, which could then be used as inputs in the Pennes Bio-Heat Transfer Equation (BHTE) allowing temperature distributions to be observed. Preliminary studies proved the feasibility of using the suggested transducer design in conjunction with the existing EIM system. Pressure fields and heating patterns were all within acceptable limits, confirming the ability of the device to effectively ablate cancerous tissue. Additionally the capability to steer the resultant focal point was validated, and a thermal dose model was implemented allowing different heating patterns to be quantitatively compared

Interstitial diagnosis and treatment of breast tumours

This thesis exploits the interaction of light with breast tissue for diagnosis and therapy. Optical biopsy is an experimental technique, based on Elastic Scattering Spectroscopy (ESS), being developed for characterising breast tissue. An optical probe interrogates tissue with a white light pulse, with spectral analysis of the reflected light. 264 spectral measurements (50 patients) were obtained from a range of breast tissues and axillary lymph nodes and correlated with conventional histology of biopsies from the same sites. Algorithms for spectral analysis were developed using ANN (Artificial Neural Network), HCA (Hierarchical Cluster Analysis) and MBA (Model Based Analysis). The sensitivity and specificity for cancer detection in breast and lymph nodes were: [diagram]. Interstitial Laser Photocoagulation (ILP) involves image guided, thermal coagulation of lesions within the breast using laser energy delivered via optical fibres positioned percutaneously under local anaesthetic. Two groups were studied: 1) Nineteen patients with benign fibroadenomas underwent ILP and the results compared with 11 treated conservatively. Thirteen ILP patients (14 fibroadenomas) and 6 controls (11 fibroadenomas) have reached their one-year review: [diagram]. These differences are statistically significant (P<0.001). 2)Six patients with primary breast cancers underwent ILP (with pre- and post-ILP contrast enhanced MRI) within 3 weeks of diagnosis and were then treated with Tamoxifen. Four underwent surgery at 3 months, two showing complete tumour ablation. MRI was reasonably accurate at detecting residual tumour. In conclusion: a) optical biopsy is a promising 'real time' diagnostic tool for breast disease. b) ILP could provide a simple and safe alternative to surgery for fibroadenomas. c) ILP with MRI monitoring may be an alternative to surgery in the management of some patients with localised primary breast cance

前立腺癌スクリーニングのためのロボット触診システムの開発

Tohoku University田中真美課

Passive Acoustic Emissions in a V-blender

The pharmaceutical manufacturing process consists of a number of batch steps; each step must be monitored and controlled to ensure quality standards are met. The development of process analytical technologies (PAT) can improve product monitoring with the aim of increasing efficiency, product quality and consistency and creating a better understanding of the manufacturing process. This work investigates the feasibility of using passive acoustic emissions (PAE) to monitor particulates in a V-blender. An accelerometer was attached to the lid of a V-blender to measure vibrations from the tumbling solids. A wavelet filter removed the oscillations in the signals from the motion of the shell, focusing on the emissions from the particle interactions. The particle size, fill level and scale affected the acoustic emissions through changes in the particle momentum. Changes in particle cohesiveness and flowability were also reflected in the measured emissions. Powder properties and behavior are critical to efficient and successful manufacturing of pharmaceutical tablets. As the powders must be transferred between the different manufacturing stages, the flowability of powders is critical. Trials were conducted to investigate the effect of moisture content of a powder on its flowability. Through avalanche behavior, it was found that the flowability and the dynamic density of a powder change with moisture content. PAEs were used to detect changes in solids moisture content as solids tumbled within the V-blender. It was found that particle mass, coefficient of restitution (COR) and flowability impacted the amplitude of the acoustic emissions. To further investigate the effects of particle flowability, PAEs were used to monitor lubricant addition. The amplitudes of the acoustic emissions were sensitive to the lubricant addition due to changes in the flowability. A trend in the emission amplitude allowed for the progression of the lubricant mixing to be followed. Overall, the research supports the feasibility of PAEs as a PAT for mixing in a tumbling blender to increase process knowledge and improve product quality

Fuel production by hydrocracking of non-olefinic plastics and vacuum gasoil blends

306 p.The catalytic hydrocracking of different blends of non-olefinic polymers (polystyrene, polymethylmethacrylate and polyethylene terephthalate) with vacuum gasoil has been studied to produce fuel streams suitable for inclusion in refinery pools. For this purpose, a catalyst synthesized in the laboratory composed of Pt and Pd supported on a zeolite Y has been used. For all the mixtures, the influence of the operating conditions (time, temperature, pressure) and the effect they have on the yields of the fractions of interest (naphtha and light cycle oil), as well as on their composition, have been tested. In addition, special attention has been paid to the physicochemical phenomena that take place during the reactions in order to analyze the catalyst behaviour and the different causes of its deactivation with a view to its implementation in industrial units. The use of advanced analytical techniques has allowed to establish the compositional framework of all samples regardless of their heavy nature, which has allowed to determine the mechanisms of hydrocracking of plastics, as well as the routes of elimination of different families of compounds. Finally, kinetic modelling of these systems has been carried out for the optimization of the operating conditions by performing simulations aiming at the maximum conversion of the plastics and maximum yield of the target fractions, while minimizing the products of less interest