A continuum robotic platform for endoscopic non-contact laser surgery: design, control, and preclinical evaluation

The application of laser technologies in surgical interventions has been accepted in the clinical domain due to their atraumatic properties. In addition to manual application of fibre-guided lasers with tissue contact, non-contact transoral laser microsurgery (TLM) of laryngeal tumours has been prevailed in ENT surgery. However, TLM requires many years of surgical training for tumour resection in order to preserve the function of adjacent organs and thus preserve the patient’s quality of life. The positioning of the microscopic laser applicator outside the patient can also impede a direct line-of-sight to the target area due to anatomical variability and limit the working space. Further clinical challenges include positioning the laser focus on the tissue surface, imaging, planning and performing laser ablation, and motion of the target area during surgery. This dissertation aims to address the limitations of TLM through robotic approaches and intraoperative assistance. Although a trend towards minimally invasive surgery is apparent, no highly integrated platform for endoscopic delivery of focused laser radiation is available to date. Likewise, there are no known devices that incorporate scene information from endoscopic imaging into ablation planning and execution. For focusing of the laser beam close to the target tissue, this work first presents miniaturised focusing optics that can be integrated into endoscopic systems. Experimental trials characterise the optical properties and the ablation performance. A robotic platform is realised for manipulation of the focusing optics. This is based on a variable-length continuum manipulator. The latter enables movements of the endoscopic end effector in five degrees of freedom with a mechatronic actuation unit. The kinematic modelling and control of the robot are integrated into a modular framework that is evaluated experimentally. The manipulation of focused laser radiation also requires precise adjustment of the focal position on the tissue. For this purpose, visual, haptic and visual-haptic assistance functions are presented. These support the operator during teleoperation to set an optimal working distance. Advantages of visual-haptic assistance are demonstrated in a user study. The system performance and usability of the overall robotic system are assessed in an additional user study. Analogous to a clinical scenario, the subjects follow predefined target patterns with a laser spot. The mean positioning accuracy of the spot is 0.5 mm. Finally, methods of image-guided robot control are introduced to automate laser ablation. Experiments confirm a positive effect of proposed automation concepts on non-contact laser surgery.Die Anwendung von Lasertechnologien in chirurgischen Interventionen hat sich aufgrund der atraumatischen Eigenschaften in der Klinik etabliert. Neben manueller Applikation von fasergeführten Lasern mit Gewebekontakt hat sich die kontaktfreie transorale Lasermikrochirurgie (TLM) von Tumoren des Larynx in der HNO-Chirurgie durchgesetzt. Die TLM erfordert zur Tumorresektion jedoch ein langjähriges chirurgisches Training, um die Funktion der angrenzenden Organe zu sichern und damit die Lebensqualität der Patienten zu erhalten. Die Positionierung des mikroskopis chen Laserapplikators außerhalb des Patienten kann zudem die direkte Sicht auf das Zielgebiet durch anatomische Variabilität erschweren und den Arbeitsraum einschränken. Weitere klinische Herausforderungen betreffen die Positionierung des Laserfokus auf der Gewebeoberfläche, die Bildgebung, die Planung und Ausführung der Laserablation sowie intraoperative Bewegungen des Zielgebietes. Die vorliegende Dissertation zielt darauf ab, die Limitierungen der TLM durch robotische Ansätze und intraoperative Assistenz zu adressieren. Obwohl ein Trend zur minimal invasiven Chirurgie besteht, sind bislang keine hochintegrierten Plattformen für die endoskopische Applikation fokussierter Laserstrahlung verfügbar. Ebenfalls sind keine Systeme bekannt, die Szeneninformationen aus der endoskopischen Bildgebung in die Ablationsplanung und -ausführung einbeziehen. Für eine situsnahe Fokussierung des Laserstrahls wird in dieser Arbeit zunächst eine miniaturisierte Fokussieroptik zur Integration in endoskopische Systeme vorgestellt. Experimentelle Versuche charakterisieren die optischen Eigenschaften und das Ablationsverhalten. Zur Manipulation der Fokussieroptik wird eine robotische Plattform realisiert. Diese basiert auf einem längenveränderlichen Kontinuumsmanipulator. Letzterer ermöglicht in Kombination mit einer mechatronischen Aktuierungseinheit Bewegungen des Endoskopkopfes in fünf Freiheitsgraden. Die kinematische Modellierung und Regelung des Systems werden in ein modulares Framework eingebunden und evaluiert. Die Manipulation fokussierter Laserstrahlung erfordert zudem eine präzise Anpassung der Fokuslage auf das Gewebe. Dafür werden visuelle, haptische und visuell haptische Assistenzfunktionen eingeführt. Diese unterstützen den Anwender bei Teleoperation zur Einstellung eines optimalen Arbeitsabstandes. In einer Anwenderstudie werden Vorteile der visuell-haptischen Assistenz nachgewiesen. Die Systemperformanz und Gebrauchstauglichkeit des robotischen Gesamtsystems werden in einer weiteren Anwenderstudie untersucht. Analog zu einem klinischen Einsatz verfolgen die Probanden mit einem Laserspot vorgegebene Sollpfade. Die mittlere Positioniergenauigkeit des Spots beträgt dabei 0,5 mm. Zur Automatisierung der Ablation werden abschließend Methoden der bildgestützten Regelung vorgestellt. Experimente bestätigen einen positiven Effekt der Automationskonzepte für die kontaktfreie Laserchirurgie

On the Statics, Dynamics, and Stability of Continuum Robots: Model Formulations and Efficient Computational Schemes

This dissertation presents advances in continuum-robotic mathematical-modeling techniques. Specifically, problems of statics, dynamics, and stability are studied for robots with slender elastic links. The general procedure within each topic is to develop a continuous theory describing robot behavior, develop a discretization strategy to enable simulation and control, and to validate simulation predictions against experimental results.Chapter 1 introduces the basic concept of continuum robotics and reviews progress in the field. It also introduces the mathematical modeling used to describe continuum robots and explains some notation used throughout the dissertation.The derivation of Cosserat rod statics, the coupling of rods to form a parallel continuum robot (PCR), and solution of the kinematics problem are reviewed in Chapter 2. With this foundation, soft real-time teleoperation of a PCR is demonstrated and a miniature prototype robot with a grasper is controlled.Chapter 3 reviews the derivation of Cosserat rod dynamics and presents a discretization strategy having several desirable features, such as generality, accuracy, and potential for good computational efficiency. The discretized rod model is validated experimentally using high speed camera footage of a cantilevered rod. The discretization strategy is then applied to simulate continuum robot dynamics for several classes of robot, including PCRs, tendon-driven robots, fluidic actuators, and concentric tube robots.In Chapter 4, the stability of a PCR is analyzed using optimal control theory. Conditions of stability are gradually developed starting from a single planar rod and finally arriving at a stability test for parallel continuum robots. The approach is experimentally validated using a camera tracking system.Chapter 5 provides closing discussion and proposes potential future work

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

ReHand - a portable assistive rehabilitation hand exoskeleton

This dissertation presents a synthesis of a novel underactuated exoskeleton (namely ReHand2) thought and designed for a task-oriented rehabilitation and/or for empower the human hand. The first part of this dissertation shows the current context about the robotic rehabilitation with a focus on hand pathologies, which influence the hand capability. The chapter is concluded with the presentation of ReHand2. The second chapter describes the human hand biomechanics. Starting from the definition of human hand anatomy, passing through anthropometric data, to taxonomy on hand grasps and finger constraints, both from static and dynamic point of view. In addition, some information about the hand capability are given. The third chapter analyze the current state of the art in hand exoskeleton for rehabilitation and empower tasks. In particular, the chapter presents exoskeleton technologies, from mechanisms to sensors, passing though transmission and actuators. Finally, the current state of the art in terms of prototype and commercial products is presented. The fourth chapter introduces the concepts of underactuation with the basic explanation and the classical notation used typically in the prosthetic field. In addition, the chapter describe also the most used differential elements in the prosthetic, follow by a statical analysis. Moreover typical transmission tree at inter-finger level as well as the intra- finger underactuation are explained . The fifth chapter presents the prototype called ReHand summarizing the device description and explanation of the working principle. It describes also the kinetostatic analysis for both, inter- and the intra-finger modules. in the last section preliminary results obtained with the exoskeleton are shown and discussed, attention is pointed out on prototype’s problems that have carry out at the second version of the device. The sixth chapter describes the evolution of ReHand, describing the kinematics and dynamics behaviors. In particular, for the mathematical description is introduced the notation used in order to analyze and optimize the geometry of the entire device. The introduced model is also implemented in Matlab Simulink environment. Finally, the chapter presents the new features. The seventh chapter describes the test bench and the methodologies used to evaluate the device statical, and dynamical performances. The chapter presents and discuss the experimental results and compare them with simulated one. Finally in the last chapter the conclusion about the ReHand project are proposed as well as the future development. In particular, the idea to test de device in relevant environments. In addition some preliminary considerations about the thumb and the wrist are introduced, exploiting the possibility to modify the entire layout of the device, for instance changing the actuator location

Modeling and Control for a Class of Tendon-Driven Continuum Mechanisms

This thesis contributes to the emerging field of soft material robots and treats modeling, state estimation and control for a special class of continuum mechanisms. The overall outcome of is a novel treatment of a continuum in robotics research. At first a description of the overall system as a tendon-driven multi-body system modeled by a nonlinear rigid-body dynamics is proposed. In combination with the introduced real-time pose and velocity estimation, nonlinear model-based control in real-time is possible. Furthermore, the structural properties of the model allow employing modern control methods for underactuated mechanical systems which are adapted to provide set point control for the upper platform. The developed methods in modeling, state estimation and control presented in this work are experimentally validated on a humanoid robot. Due to their promising results, this thesis lays the foundation for the use of tendon-driven continuum mechanisms as generic joint modules for modular robotic systems which may mark the beginning of a new generation of light-weight robots

Design, Development and Force Control of a Tendon-driven Steerable Catheter with a Learning-based Approach

In this research, a learning-based force control schema for tendon-driven steerable catheters with the application in robot-assisted tissue ablation procedures was proposed and validated. To this end, initially a displacement-based model for estimating the contact force between the catheter and tissue was developed. Afterward, a tendon-driven catheter was designed and developed. Next, a software-hardware-integrated robotic system for controlling and monitoring the pose of the catheter was designed and developed. Also, a force control schema was developed based on the developed contact force model as a priori knowledge. Furthermore, the position control of the tip of the catheter was performed using a learning-based inverse kinematic approach. By combining the position control and the contact model, the force control schema was developed and validated. Validation studies were performed on phantom tissue as well as excised porcine tissue. Results of the validation studies showed that the proposed displacement-based model was 91.5% accurate in contact force prediction. Also, the system was capable of following a set of desired trajectories with an average root-mean-square error of less than 5%. Further validation studies revealed that the system could fairly generate desired static and dynamic force profiles on the phantom tissue. In summary, the proposed force control system did not necessitate the utilization of force sensors and could fairly contribute in automatizing the ablation task for robotic tissue ablation procedures

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

Proceedings of the ECCOMAS Thematic Conference on Multibody Dynamics 2015

This volume contains the full papers accepted for presentation at the ECCOMAS Thematic Conference on Multibody Dynamics 2015 held in the Barcelona School of Industrial Engineering, Universitat Politècnica de Catalunya, on June 29 - July 2, 2015. The ECCOMAS Thematic Conference on Multibody Dynamics is an international meeting held once every two years in a European country. Continuing the very successful series of past conferences that have been organized in Lisbon (2003), Madrid (2005), Milan (2007), Warsaw (2009), Brussels (2011) and Zagreb (2013); this edition will once again serve as a meeting point for the international researchers, scientists and experts from academia, research laboratories and industry working in the area of multibody dynamics. Applications are related to many fields of contemporary engineering, such as vehicle and railway systems, aeronautical and space vehicles, robotic manipulators, mechatronic and autonomous systems, smart structures, biomechanical systems and nanotechnologies. The topics of the conference include, but are not restricted to: ● Formulations and Numerical Methods ● Efficient Methods and Real-Time Applications ● Flexible Multibody Dynamics ● Contact Dynamics and Constraints ● Multiphysics and Coupled Problems ● Control and Optimization ● Software Development and Computer Technology ● Aerospace and Maritime Applications ● Biomechanics ● Railroad Vehicle Dynamics ● Road Vehicle Dynamics ● Robotics ● Benchmark ProblemsPostprint (published version

Redundant Unilaterally Actuated Kinematic Chains: Modeling and Analysis

Unilaterally Actuated Robots (UAR)s are a class of robots defined by an actuation that is constrained to a single sign. Cable robots, grasping, fixturing and tensegrity systems are certain applications of UARs. In recent years, there has been increasing interest in robotic and other mechanical systems actuated or constrained by cables. In such systems, an individual constraint is applied to a body of the mechanism in the form of a pure force which can change its magnitude but cannot reverse its direction. This uni-directional actuation complicates the design of cable-driven robots and can result in limited performance. Cable Driven Parallel Robot (CDPR)s are a class of parallel mechanisms where the actuating legs are replaced by cables. CDPRs benefit from the higher payload to weight ratio and increased rigidity. There is growing interest in the cable actuation of multibody systems. There are potential applications for such mechanisms where low moving inertia is required. Cable-driven serial kinematic chain (CDSKC) are mechanisms where the rigid links form a serial kinematic chain and the cables are arranged in a parallel configuration. CDSKC benefits from the dexterity of the serial mechanisms and the actuation advantages of cable-driven manipulators. Firstly, the kinematic modeling of CDSKC is presented, with a focus on different types of cable routings. A geometric approach based on convex cones is utilized to develop novel cable actuation schemes. The cable routing scheme and architecture have a significant effect on the performance of the robot resulting in a limited workspace and high cable forces required to perform a desired task. A novel cable routing scheme is proposed to reduce the number of actuating cables. The internal routing scheme is where, in addition to being externally routed, the cable can be re-routed internally within the link. This type of routing can be considered as the most generalized form of the multi-segment pass-through routing scheme where a cable segment can be attached within the same link. Secondly, the analysis for CDSKCs require extensions from single link CDPRs to consider different routings. The conditions to satisfy wrench-closure and the workspace analysis of different multi-link unilateral manipulators are investigated. Due to redundant and constrained actuation, it is possible for a motion to be either infeasible or the desired motion can be produced by an infinite number of different actuation profiles. The motion generation of the CDSKCs with a minimal number of actuating cables is studied. The static stiffness evaluation of CDSKCs with different routing topologies and isotropic stiffness conditions were investigated. The dexterity and wrench-based metrics were evaluated throughout the mechanism's workspace. Through this thesis, the fundamental tools required in studying cable-driven serial kinematic chains have been presented. The results of this work highlight the potential of using CDSKCs in bio-inspired systems and tensegrity robots