Needle and Biopsy Robots: a Review

Purpose of the review Robotics is a rapidly advancing field, and its introduction in healthcare can have a multitude of benefits for clinical practice. Especially, applications depending on the radiologist\u2019s accuracy and precision, such as percutaneous interventions, may profit. This paper provides an overview of recent robot-assisted percutaneous solutions. Recent findings Percutaneous interventions are relatively simple and the quality of the procedure increases a lot by introducing robotics due to the improved accuracy and precision. The success of the procedure is heavily dependent on the ability to merge pre- and intraoperative images, as an accurate estimation of the current target location allows to exploit the robot\u2019s capabilities. Summary Despite much research, the application of robotics in some branches of healthcare is not commonplace yet. Recent advances in percutaneous robotic solutions and imaging are highlighted, as they will pave the way to more widespread implementation of robotics in clinical practic

Surgical Applications of Compliant Mechanisms:A Review

Current surgical devices are mostly rigid and are made of stiff materials, even though their predominant use is on soft and wet tissues. With the emergence of compliant mechanisms (CMs), surgical tools can be designed to be flexible and made using soft materials. CMs offer many advantages such as monolithic fabrication, high precision, no wear, no friction, and no need for lubrication. It is therefore beneficial to consolidate the developments in this field and point to challenges ahead. With this objective, in this article, we review the application of CMs to surgical interventions. The scope of the review covers five aspects that are important in the development of surgical devices: (i) conceptual design and synthesis, (ii) analysis, (iii) materials, (iv) maim facturing, and (v) actuation. Furthermore, the surgical applications of CMs are assessed by classification into five major groups, namely, (i) grasping and cutting, (ii) reachability and steerability, (iii) transmission, (iv) sensing, and (v) implants and deployable devices. The scope and prospects of surgical devices using CMs are also discussed

From Concept to Market: Surgical Robot Development

Surgical robotics and supporting technologies have really become a prime example of modern applied information technology infiltrating our everyday lives. The development of these systems spans across four decades, and only the last few years brought the market value and saw the rising customer base imagined already by the early developers. This chapter guides through the historical development of the most important systems, and provide references and lessons learnt for current engineers facing similar challenges. A special emphasis is put on system validation, assessment and clearance, as the most commonly cited barrier hindering the wider deployment of a system

A Novel Bio-Inspired Insertion Method for Application to Next Generation Percutaneous Surgical Tools

The use of minimally invasive techniques can dramatically improve patient outcome from neurosurgery, with less risk, faster recovery, and better cost effectiveness when compared to conventional surgical intervention. To achieve this, innovative surgical techniques and new surgical instruments have been developed. Nevertheless, the simplest and most common interventional technique for brain surgery is needle insertion for either diagnostic or therapeutic purposes. The work presented in this thesis shows a new approach to needle insertion into soft tissue, focussing on soft tissue-needle interaction by exploiting microtextured topography and the unique mechanism of a reciprocating motion inspired by the ovipositor of certain parasitic wasps. This thesis starts by developing a brain-like phantom which I was shown to have mechanical properties similar to those of neurological tissue during needle insertion. Secondly, a proof-of-concept of the bio-inspired insertion method was undertaken. Based on this finding, the novel method of a multi-part probe able to penetrate a soft substrate by reciprocal motion of each segment is derived. The advantages of the new insertion method were investigated and compared with a conventional needle insertion in terms of needle-tissue interaction. The soft tissue deformation and damage were also measured by exploiting the method of particle image velocimetry. Finally, the thesis proposes the possible clinical application of a biologically-inspired surface topography for deep brain electrode implantation. As an adjunct to this work, the reciprocal insertion method described here fuelled the research into a novel flexible soft tissue probe for percutaneous intervention, which is able to steer along curvilinear trajectories within a compliant medium. Aspects of this multi-disciplinary research effort on steerable robotic surgery are presented, followed by a discussion of the implications of these findings within the context of future work

Assessment of the AH-64D Longbow Apache’s Handling Qualities for Instrument Meteorological Conditions/Instrument Flight Rules Flight

An assessment of the handling of the AH-64D for flight in IMC and under IFR was conducted. Testing was performed in the configurations listed in table 1 and under the conditions presented in tables 3 and 4. All test objectives were met. IMC mission maneuvers with all systems working resulted in satisfactory handling qualities with no excessive compensation required from the pilot (altitude and attitude holds ON). However, as the aircraft systems were progressively degraded the workload for the evaluating pilot increased significantly. The high workload coupled with the absence of a vertical speed indicator (VSI) and torque indication during an AC failure and the observed errors in the standby altimeter and airspeed indicators would most likely prevent flying a successful unusual attitude recovery, an airport surveillance radar (ASR) approach, or a precision approach radar (PAR) approach. The inadequacy of the standby instruments is a deficiency. The aircraft’s longitudinal gust response with FMC OFF required extensive pilot compensation to maintain altitude and airspeed within adequate parameters, further increasing the overall pilot workload, and is a deficiency. Additionally, the aircraft’s battery life does not meet the 30- min requirement for IMC/IFR flight that would be required in the unlikely event of an aircraft AC power failure and results in a deficiency. Engineering maneuvers conducted to quantify the handling qualities of the AH-64D with FMC OFF confirmed the high pilot workload and extensive compensation required. These maneuvers revealed an oscillatory divergent long-term mode, an oscillatory divergent lateral-directional oscillation (LDO), negative spiral stability when banked to the right, and significant coupling between pitch and roll. While conducting these maneuvers, excessive instrumentation lag was observed in the standby altimeter during climbs and descents. This resulted in errors of up to 300 ft between boom data and the standby altimeter. The excessive observed instrument lag and inaccuracy of the standby altimeter is a shortcoming. Other findings included the absence of any information on IMC/IFR procedures in the operator’s manual was also found to be a shortcoming. Consequently a clearance for aircraft operation in IMC is not recommended. Plots of representative engineering data collected in the heavy weapons (configuration 3) and two-tank configurations (configuration 5) are in Appendix D

Challenges of continuum robots in clinical context: a review

With the maturity of surgical robotic systems based on traditional rigid-link principles, the rate of progress slowed as limits of size and controllable degrees of freedom were reached. Continuum robots came with the potential to deliver a step change in the next generation of medical devices, by providing better access, safer interactions and making new procedures possible. Over the last few years, several continuum robotic systems have been launched commercially and have been increasingly adopted in hospitals. Despite the clear progress achieved, continuum robots still suffer from design complexity hindering their dexterity and scalability. Recent advances in actuation methods have looked to address this issue, offering alternatives to commonly employed approaches. Additionally, continuum structures introduce significant complexity in modelling, sensing, control and fabrication; topics which are of particular focus in the robotics community. It is, therefore, the aim of the presented work to highlight the pertinent areas of active research and to discuss the challenges to be addressed before the potential of continuum robots as medical devices may be fully realised

DEVELOPMENT OF A KINETIC MODEL FOR STEERABLE CATHETERS FOR MINIMALLY INVASIVE SURGERY

The steerable catheters have demonstrated many advantages to overcome the limitations of the conventional catheters in the minimally invasive surgery. The motion and force transmission from the proximal end to distal tip of the catheter have significant effects to the efficiency and safety of surgery. While the force information between the catheter and the body (e.g., vessel) can be obtained by mounting sensors on the distal tip of the catheter, this would be more intrusive and less reliable than the one without the sensors, which is described in this disseration. In addition, the small diameters of the catheters may also restrict the idea of mounting sensors on the distal tip. The other approach to obtain the force information is to infer it from the information outside the body. This will demand an accurate mathematical model that describes the force and motion relation called kinetic model, and unfortunately, such a kinetic model is not available in the literature. In this dissertation, a kinetic model for steerable catheters is presented wich captures the following characteristics of the steerable catheter, namely (1) the geometrical non-linear behavior of the catheter in motion, (2) the deformable pathway, (3) the friction between the catheter and the pathyway, and (4) the contact between the catheter and pathway. A non-linear finite element system (SPACAR) was employed to capture these characteristics. A test-bed was built and an experiment was carried out to verify the developed kinetic model. The following conclusions can be drawn from this dissertation: (1) the developed kinetic model is accurte in comparison with those in literature; (2) the Dahl friction model, the LuGre friction model and the simplified LuGre friction model are able to capture the friction behavior between the catheter and the pathway but the Coulomb friction model fails (as it cannot capture the hysteresis property which has a significant influence on the behavior of the catheter); (3) the developed kinetic model has the potential of being used to optimize the design and operation of steerable catheters with several salient findings that (3a) the maximal contact force between the catheter and the pathway occurs on the tip of the distal part or the connecting part between the distal part and catheter body of the catheter and (3b) the rigidity and length of the distal part are crucial structural parameters that affect the motion and force transmission significantly. There are several contributions made by this dissertation. In the field of the steerable catheter, biomechanics and bio-instrumentation, the contributions are summarized in the following: (1) the approach to develop the kinetic model of the steerable catheter in a complex work environment is useful to model other similar compliant medical devices, such as endoscope; (2) the kinetic model of the steerable catheter can provide the force information to improve the efficiency and safety of MIS (minimally invastive surgery) and to realize the “doctor-assisted” catheter-based MIS procedure; (3) the kinetic model can provide accurate data for developing other simplified models for the steerable catheters in their corresponding work environments for realizing the robotic-based fully automated MIS procedure. (4) The kinetic model of the steerable catheter and the test-bed with the corresponding instruments and methods for the kinetic and kinematic measurements are a useful design validation in the steerable catheter technology as well as for the training of physicians to perform the catheter-based interventional procedure by adding more complex anatomic phantoms. In the field of continuum manipulator and continuum robots, the approach to develop the kinetic model is useful to model other manipulators and robots, such as snake-like robots

Medical robots with potential applications in participatory and opportunistic remote sensing: A review

Among numerous applications of medical robotics, this paper concentrates on the design, optimal use and maintenance of the related technologies in the context of healthcare, rehabilitation and assistive robotics, and provides a comprehensive review of the latest advancements in the foregoing field of science and technology, while extensively dealing with the possible applications of participatory and opportunistic mobile sensing in the aforementioned domains. The main motivation for the latter choice is the variety of such applications in the settings having partial contributions to functionalities such as artery, radiosurgery, neurosurgery and vascular intervention. From a broad perspective, the aforementioned applications can be realized via various strategies and devices benefiting from detachable drives, intelligent robots, human-centric sensing and computing, miniature and micro-robots. Throughout the paper tens of subjects, including sensor-fusion, kinematic, dynamic and 3D tissue models are discussed based on the existing literature on the state-of-the-art technologies. In addition, from a managerial perspective, topics such as safety monitoring, security, privacy and evolutionary optimization of the operational efficiency are reviewed