MR-based navigation for robot-assisted endovascular procedures

There is increasing interests in robotic and computer technologies to accurately perform endovascular intervention. One major limitation of current endovascular intervention—either manual or robot-assisted is the surgical navigation which still relies on 2D fluoroscopy. Recent research efforts are towards MRI-guided interventions to reduce ionizing radiation exposure, and to improve diagnosis, planning, navigation, and execution of endovascular interventions. We propose an MR-based navigation framework for robot-assisted endovascular procedures. The framework allows the acquisition of real-time MR images; segmentation of the vasculature and tracking of vascular instruments; and generation of MR-based guidance, both visual and haptic. The instrument tracking accuracy—a key aspect of the navigation framework—was assessed via 4 dedicated experiments with different acquisition settings, framerate, and time. The experiments showed clinically acceptable tracking accuracy in the range of 1.30–3.80 mm RMSE. We believe that this work represents a valuable first step towards MR-guided robot-assisted intervention

Robot-assistive minimally invasive surgery:trends and future directions

The evolution of medical technologies—such as surgical devices and imaging techniques—has transformed all aspects of surgery. A key area of development is robot-assisted minimally invasive surgery (MIS). This review paper provides an overview of the evolution of robotic MIS, from its infancy to our days, and envisioned future challenges. It provides an outlook of breakthrough surgical robotic platforms, their clinical applications, and their evolution over the years. It discusses how the integration of robotic, imaging, and sensing technologies has contributed to create novel surgical platforms that can provide the surgeons with enhanced dexterity, precision, and surgical navigation while reducing the invasiveness and efficacy of the intervention. Finally, this review provides an outlook on the future of robotic MIS discussing opportunities and challenges that the scientific community will have to address in the coming decade. We hope that this review serves to provide a quick and accessible way to introduce the readers to this exciting and fast-evolving area of research, and to inspire future research in this field

The benefits of haptic feedback in robot assisted surgery and their moderators: a metaanalysis

Robot assisted surgery (RAS) provides medical practitioners with valuable tools, decreasing strain during surgery and leading to better patient outcomes. While the loss of haptic sensation is a commonly cited disadvantage of RAS, new systems aim to address this problem by providing artificial haptic feedback. N = 56 papers that compared robotic surgery systems with and without haptic feedback were analyzed to quantify the performance benefits of restoring the haptic modality. Additionally, this study identifies factors moderating the effect of restoring haptic sensation. Overall results showed haptic feedback was effective in reducing average forces (Hedges' g = 0.83) and peak forces (Hedges' g = 0.69) applied during surgery, as well as reducing the completion time (Hedges' g = 0.83). Haptic feedback has also been found to lead to higher accuracy (Hedges' g = 1.50) and success rates (Hedges' g = 0.80) during surgical tasks. Effect sizes on several measures varied between tasks, the type of provided feedback, and the subjects' levels of surgical expertise, with higher levels of expertise generally associated with smaller effect sizes. No significant differences were found between virtual fixtures and rendering contact forces. Implications for future research are discussed

Haptic feedback and dynamic active constraints for robot-assisted endovascular catheterization

Robotic and computer assistance can bring significant benefits to endovascular procedures in terms of precision and stability, reduced radiation doses, improved comfort and access to difficult and tortuous anatomy . However, the d esign of current commercially available platform s tends to alter the natural bedside manipulation skills of the operator, so that the manually acquired experience and dexterity are not well utilized. Furthermore , most of these systems lack of haptic feedback, preventing their acceptance and limiting the clinical usability. In this paper a new robotic platform for endovascular catheterization, the CathBot, is presented. It is an ergonomic master - slave system with navigation system and integrate d vision - based haptic feedback, designed to maintain the natural bedside skills of the vascular surgeon. Unlike previous work reported in literature, dynamic motion tracking of both the vessel walls the catheter tip is incorporated to create dynamic active constraints . The system was evaluated through a combined quantitative and qualitative user study simulating catheterization tasks on a phantom. Forces exerted on the phantom were measured. The results showed a 70% decrease in mean force and 61% decrease i n maximum force when force feedback is provided. This research provides the first integration of vision - based dynamic active constraints within an ergonomic robotic catheter manipulator. The technological advan ces presented here, demonstrates that vision - b ased haptic feedback can improve the effectiveness, precision, and safety of robot - assisted endovascular procedures