Development of a fiber-based shape sensor for navigating flexible medical tools

Robot-assisted minimally invasive surgical procedure (RAMIS) is a subfield of minimally invasive surgeries with enhanced manual dexterity, manipulability, and intraoperative image guidance. In typical robotic surgeries, it is common to use rigid instruments with functional articulating tips. However, in some operations where no adequate and direct access to target anatomies is available, continuum robots can be more practical, as they provide curvilinear and flexible access. However, their inherent deformable design makes it difficult to accurately estimate their 3D shape during the operation in real-time. Despite extensive model-based research that relies on kinematics and mechanics, accurate shape sensing of continuum robots remains challenging. The state-of-the-art tracking technologies, including optical trackers, EM tracking systems, and intraoperative imaging modalities, are also unsuitable for this task, as they all have shortcomings. Optical fiber shape sensing solutions offer various advantages compared to other tracking modalities and can provide high-resolution shape measurements in real-time. However, commercially available fiber shape sensors are expensive and have limited accuracy. In this thesis, we propose two cost-effective fiber shape sensing solutions based on multiple single-mode fibers with FBG (fiber Bragg grating) arrays and eccentric FBGs. First, we present the fabrication and calibration process of two shape sensing prototypes based on multiple single-mode fibers with semi-rigid and super-elastic substrates. Then, we investigate the sensing mechanism of edge-FBGs, which are eccentric Bragg gratings inscribed off-axis in the fiber's core. Finally, we present a deep learning algorithm to model edge-FBG sensors that can directly predict the sensor's shape from its signal and does not require any calibration or shape reconstruction steps. In general, depending on the target application, each of the presented fiber shape sensing solutions can be used as a suitable tracking device. The developed fiber sensor with the semi-rigid substrate has a working channel in the middle and can accurately measure small deflections with an average tip error of 2.7 mm. The super-elastic sensor is suitable for measuring medium to large deflections, where a centimeter range tip error is still acceptable. The tip error in such super-elastic sensors is higher compared to semi-rigid sensors (9.9-16.2 mm in medium and large deflections, respectively), as there is a trade-off between accuracy and flexibility in substrate-based fiber sensors. Edge-FBG sensor, as the best performing sensing mechanism among the investigated fiber shape sensors, can achieve a tip accuracy of around 2 mm in complex shapes, where the fiber is heavily deflected. The developed edge-FBG shape sensing solution can compete with the state-of-the-art distributed fiber shape sensors that cost 30 times more

Progress in Probe-Based Sensing Techniques for In Vivo Diagnosis

Advancements in robotic surgery help to improve the endoluminal diagnosis and treatment with minimally invasive or non-invasive intervention in a precise and safe manner. Miniaturized probe-based sensors can be used to obtain information about endoluminal anatomy, and they can be integrated with medical robots to augment the convenience of robotic operations. The tremendous benefit of having this physiological information during the intervention has led to the development of a variety of in vivo sensing technologies over the past decades. In this paper, we review the probe-based sensing techniques for the in vivo physical and biochemical sensing in China in recent years, especially on in vivo force sensing, temperature sensing, optical coherence tomography/photoacoustic/ultrasound imaging, chemical sensing, and biomarker sensing

Optically Sensorized Tendons for Articulate Robotic Needles

This study proposes an optically sensorized tendon composed of a 195 µm diameter, high strength, polarization maintaining (PM) fiber Bragg gratings (FBG) optical fiber which resolves the cross-sensitivity issue of conventional FBGs. The bare fiber tendon is locally reinforced with a 250 µm diameter Kevlar bundle enhancing the level of force transmission and enabling high curvature tendon routing. The performance of the sensorized tendons is explored in terms of strength (higher than 13N for the bare PM-FBG fiber tendon, up to 40N for the Kevlar-reinforced tendon under tensile loading), strain sensitivity (0.127 percent strain per newton for the bare PM-FBG fiber tendon, 0.04 percent strain per newton for the Kevlar-reinforced tendon), temperature stability, and friction-independent sensing behavior. Subsequently, the tendon is instrumented within an 18 Ga articulate NiTi cannula and evaluated under static and dynamic loading conditions, and within phantoms of varying stiffness for tissue-stiffness estimation. The results from this series of experiments serve to validate the effectiveness of the proposed tendon as a bi-modal sensing and actuation component for robot-assisted minimally invasive surgical instruments

Fiber bragg gratings for medical applications and future challenges: A review

In the last decades, fiber Bragg gratings (FBGs) have become increasingly attractive to medical applications due to their unique properties such as small size, biocompatibility, immunity to electromagnetic interferences, high sensitivity and multiplexing capability. FBGs have been employed in the development of surgical tools, assistive devices, wearables, and biosensors, showing great potentialities for medical uses. This paper reviews the FBG-based measuring systems, their principle of work, and their applications in medicine and healthcare. Particular attention is given to sensing solutions for biomechanics, minimally invasive surgery, physiological monitoring, and medical biosensing. Strengths, weaknesses, open challenges, and future trends are also discussed to highlight how FBGs can meet the demands of next-generation medical devices and healthcare system

Curvature, twist and pose measurements using fiber Bragg gratings in multi-core fiber:A comparative study between helical and straight core fibers

This paper presents a technique to acquire measurements of curvature, twist and pose for two multi-core fibers; one with straight cores and the other with helical cores. Both the fibers have multiple fiber Bragg grating (FBG) sensors inscribed in the cores and the fibers are placed in known configurations in order to compare their measurement accuracy. For the curvature measurements both the fibers are placed in constant curvature slots; for the twist measurements, a set of twists are applied to each fiber and for the pose measurements the fibers are placed in molds of different shape. The mean curvature errors are 0.22 and 0.13 m(-1), in the helical and straight core fiber respectively. For the twist measurement the mean errors are 26.57 degrees 1m and 146.50 degrees 1m in the helical and straight core fiber, respectively. Lastly, the pose measurement consists of position and orientation where the orientation is represented in the axis-angle form. The mean position errors are 0.49 and 0.27 mm, the mean axis orientation errors are 0.12 degrees and 0.26 degrees degrees and the mean angle orientation errors are 1.10 degrees and 1.18 degrees, for the helical and straight core fiber, respectively. The results show that the twist measurement error is significantly low with the helical core fiber, thus helical core fiber is better suited than straight core fiber for applications where twist measurements are required. (C) 2020 Elsevier B.V. All rights reserved

Fiber Bragg Gratings for Medical Applications and Future Challenges: A Review

[EN] In the last decades, fiber Bragg gratings (FBGs) have become increasingly attractive to medical applications due to their unique properties such as small size, biocompatibility, immunity to electromagnetic interferences, high sensitivity and multiplexing capability. FBGs have been employed in the development of surgical tools, assistive devices, wearables, and biosensors, showing great potentialities for medical uses. This paper reviews the FBG-based measuring systems, their principle of work, and their applications in medicine and healthcare. Particular attention is given to sensing solutions for biomechanics, minimally invasive surgery, physiological monitoring, and medical biosensing. Strengths, weaknesses, open challenges, and future trends are also discussed to highlight how FBGs can meet the demands of next-generation medical devices and healthcare system.This work was supported in part by INAIL (the Italian National Institute for Insurance against Accident at Work), through the BRIC (Bando ricerche in collaborazione) 2018 SENSE-RISC (Sviluppo di abiti intelligENti Sensorizzati per prevenzione e mitigazione di Rischi per la SiCurezza dei lavoratori) Project under Grant ID10/2018, in part by the UCBM (Universita Campus Bio-Medico di Roma) under the University Strategic HOPE (HOspital to the PatiEnt) Project, in part by the EU Framework Program H2020-FETPROACT-2018-01 NeuHeart Project under Grant GA 824071, by FCT/MEC (Fundacao para a Ciencia e Tecnologia) under the Projects UIDB/50008/2020 - UIDP/50008/2020, and by REACT (Development of optical fiber solutions for Rehabilitation and e-Health applications) FCT-IT-LA scientific action.Lo Presti, D.; Massaroni, C.; Leitao, CSJ.; Domingues, MDF.; Sypabekova, M.; Barrera, D.; Floris, I.... (2020). Fiber Bragg Gratings for Medical Applications and Future Challenges: A Review. IEEE Access. 8:156863-156888. https://doi.org/10.1109/ACCESS.2020.3019138S156863156888

Recent developments in fibre optic shape sensing

This paper presents a comprehensive critical review of technologies used in the development of fibre optic shape sensors (FOSSs). Their operation is based on multi-dimensional bend measurements using a series of fibre optic sensors. Optical fibre sensors have experienced tremendous growth from simple bend sensors in 1980s to full three-dimensional FOSSs using multicore fibres in recent years. Following a short review of conventional contact-based shape sensor technologies, the evolution trend and sensing principles of FOSSs are presented. This paper identifies the major optical fibre technologies used for shape sensing and provides an account of the challenges and emerging applications of FOSSs in various industries such as medical robotics, industrial robotics, aerospace and mining industry

Recent advances in biomedical photonic sensors: a focus on optical-fibre-based sensing

In this invited review, we provide an overview of the recent advances in biomedical pho tonic sensors within the last five years. This review is focused on works using optical-fibre technology, employing diverse optical fibres, sensing techniques, and configurations applied in several medical fields. We identified technical innovations and advancements with increased implementations of optical-fibre sensors, multiparameter sensors, and control systems in real applications. Examples of outstanding optical-fibre sensor performances for physical and biochemical parameters are covered, including diverse sensing strategies and fibre-optical probes for integration into medical instruments such as catheters, needles, or endoscopes.This work was supported by Ministerio de Ciencia e Innovación and Agencia Estatal de Investigación (PID2019-107270RB-C21/AEI/10.13039/501100011033), and TeDFeS Project (RTC-2017- 6321-1) co-funded by European FEDER funds. M.O. and J.F.A. received funding from Ministerio de Ciencia, Innovación y Universidades of Spain under Juan de la Cierva-Formación and Juan de la Cierva-Incorporación grants, respectively. P.R-V. received funding from Ministerio de Educación, Cultura y Deporte of Spain under PhD grant FPU2018/02797

Design of Novel Sensors and Instruments for Minimally Invasive Lung Tumour Localization via Palpation

Minimally Invasive Thoracoscopic Surgery (MITS) has become the treatment of choice for lung cancer. However, MITS prevents the surgeons from using manual palpation, thereby often making it challenging to reliably locate the tumours for resection. This thesis presents the design, analysis and validation of novel tactile sensors, a novel miniature force sensor, a robotic instrument, and a wireless hand-held instrument to address this limitation. The low-cost, disposable tactile sensors have been shown to easily detect a 5 mm tumour located 10 mm deep in soft tissue. The force sensor can measure six degrees of freedom forces and torques with temperature compensation using a single optical fiber. The robotic instrument is compatible with the da Vinci surgical robot and allows the use of tactile sensing, force sensing and ultrasound to localize the tumours. The wireless hand-held instrument allows the use of tactile sensing in procedures where a robot is not available

Modeling, Sensorization and Control of Concentric-Tube Robots

Since the concept of the Concentric-Tube Robot (CTR) was proposed in 2006, CTRs have been a popular research topic in the field of surgical robotics. The unique mechanical design of this robot allows it to navigate through narrow channels in the human anatomy and operate in highly constrained environments. It is therefore likely to become the next generation of surgical robots to overcome the challenges that cannot be addressed by current technologies. In CSTAR, we have had ongoing work over the past several years aimed at developing novel techniques and technologies for CTRs. This thesis describes the contributions made in this context, focusing primarily on topics such as modeling, sensorization, and control of CTRs. Prior to this work, one of the main challenges in CTRs was to develop a kinematic model that achieves a balance between the numerical accuracy and computational efficiency for surgical applications. In this thesis, a fast kinematic model of CTRs is proposed, which can be solved at a comparatively fast rate (0.2 ms) with minimal loss of accuracy (0.1 mm) for a 3-tube CTR. A Jacobian matrix is derived based on this model, leading to the development of a real-time trajectory tracking controller for CTRs. For tissue-robot interactions, a force-rejection controller is proposed for position control of CTRs under time-varying force disturbances. In contrast to rigid-link robots, instability of position control could be caused by non-unique solutions to the forward kinematics of CTRs. This phenomenon is modeled and analyzed, resulting in design criteria that can ensure kinematic stability of a CTR in its entire workspace. Force sensing is another major difficulty for CTRs. To address this issue, commercial force/torque sensors (Nano43, ATI Industrial Automation, United States) are integrated into one of our CTR prototypes. These force/torque sensors are replaced by Fiber-Bragg Grating (FBG) sensors that are helically-wrapped and embedded in CTRs. A strain-force calculation algorithm is proposed, to convert the reflected wavelength of FBGs into force measurements with 0.1 N force resolution at 100 Hz sampling rate. In addition, this thesis reports on our innovations in prototyping drive units for CTRs. Three designs of CTR prototypes are proposed, the latest one being significantly more compact and cost efficient in comparison with most designs in the literature. All of these contributions have brought this technology a few steps closer to being used in operating rooms. Some of the techniques and technologies mentioned above are not merely limited to CTRs, but are also suitable for problems arising in other types of surgical robots, for example, for sensorizing da Vinci surgical instruments for force sensing (see Appendix A)