Survey on Current State-of-the-Art in Needle Insertion Robots: Open Challenges for Application in Real Surgery

AbstractMinimally invasive percutaneous treatment robots have become a popular area in medical robotics. Minimally invasive treatments are an important part of modern surgery; however percutaneous treatments are a difficult procedure for surgeons. They must carry out a procedure that has limited visibility, tool maneuverability and where the target and tissue surrounding it move because of the tool. Robot technology can overcome those limitations and increase the success of minimally invasive percutaneous treatment. In this paper we will present a review of the current state-of-the-art in robotic insertion needle for minimally invasive treatments, focusing on the limitations and challenges still open for their use in clinical application

Inverse real-time Finite Element simulation for robotic control of flexible needle insertion in deformable tissues

International audienceThis paper introduces a new method for automatic robotic needle steering in deformable tissues. The main contribution relies on the use of an inverse Finite Element (FE) simulation to control an articulated robot interacting with deformable structures. In this work we consider a flexible needle, embedded in the end effector of a 6 arm Mitsubishi RV1A robot, and its insertion into a silicone phantom. Given a trajectory on the rest configuration of the silicone phantom, our method provides in real-time the displacements of the articulated robot which guarantee the permanence of the needle within the predefined path, taking into account any undergoing deformation on both the needle and the trajectory itself. A forward simulation combines i) a kinematic model of the robot, ii) FE models of the needle and phantom gel iii) an interaction model allowing the simulation of friction and puncture force. A Newton-type method is then used to provide the displacement of the robot to minimize the distance between the needle's tip and the desired trajectory. We validate our approach with a simulation in which a virtual robot can successfully perform the insertion while both the needle and the trajectory undergo significant deformations

Robotically Steered Needles: A Survey of Neurosurgical Applications and Technical Innovations

This paper surveys both the clinical applications and main technical innovations related to steered needles, with an emphasis on neurosurgery. Technical innovations generally center on curvilinear robots that can adopt a complex path that circumvents critical structures and eloquent brain tissue. These advances include several needle-steering approaches, which consist of tip-based, lengthwise, base motion-driven, and tissue-centered steering strategies. This paper also describes foundational mathematical models for steering, where potential fields, nonholonomic bicycle-like models, spring models, and stochastic approaches are cited. In addition, practical path planning systems are also addressed, where we cite uncertainty modeling in path planning, intraoperative soft tissue shift estimation through imaging scans acquired during the procedure, and simulation-based prediction. Neurosurgical scenarios tend to emphasize straight needles so far, and span deep-brain stimulation (DBS), stereoelectroencephalography (SEEG), intracerebral drug delivery (IDD), stereotactic brain biopsy (SBB), stereotactic needle aspiration for hematoma, cysts and abscesses, and brachytherapy as well as thermal ablation of brain tumors and seizure-generating regions. We emphasize therapeutic considerations and complications that have been documented in conjunction with these applications

Mecanismo para realização de ensaios de inserção de agulhas flexíveis para fins de caracterização de seu comportamento em diferentes tipos de tecido

Monografia (graduação)—Universidade de Brasília, Faculdade de Tecnologia, Departamento de Engenharia Mecânica, 2015.O texto apresenta um estudo sobre o uso de agulhas em cirurgias minimamente invasivas, os diferentes tipos de agulha e as vantagens de um mecanismo robótico para sua inserção. Também mostra as diferentes técnicas e mecanismos usados para guiar agulhas flexíveis bem como modelagens de força e deflexão da interação tecido-agulha. Em seguida, foi demonstrada a confecção de um dispositivo manual de inserção de agulhas que permite fazer medições de força e velocidade a fim de determinar como diferentes fatores influenciam o movimento da agulha. Foram feitos ensaios em gelatina balística e fígado suíno com agulhas de dois diâmetros e diferentes ângulos de bisel. Os resultados obtidos são apresentados e analisados. Conclui-se que para um mesmo tecido e mesmo ângulo de bisel a curvatura da agulha ainda varia muito e é necessário o estudo de melhores formas de controlar essa curvatura.This text presents a study about the use of needles in minimally invasive surgery procedures, the different types of needles and the benefits of the use of robotic systems for insertion applications. Also, it shows the different techniques and mechanisms used to steer flexible needles as well as force and deflection modeling of needle-tissue interaction. Furthermore, a manual needle insertion device, allowing force and speed measurements, built to determine how different factors contribute to the needle deflection is described. Experiments in ballistic gel and in swine liver using needles of two different diameters and different bevel tip angles were conducted. The results are presented and analyzed. It is concluded that for the same tissue and bevel tip angles the needle curve varies a great deal and further study is necessary on better ways to control the curve

下腹部を対象とした極細針によるCTガイド下高正確度穿刺プランニング

早大学位記番号:新8149早稲田大

Robot Assisted Real-time Tumor Manipulation for Breast Biopsy

Abstract—Breast biopsy guided by imaging techniques such as ultrasound is widely used to evaluate suspicious masses within the breast. The current procedure allows the physician to determine the location and extent of a tumor in the patient breast before inserting the needle. However, there are several problems with this procedure: the complex interaction dynamics between the needle force and the breast tissue will likely displace the tumor from its original position necessitating multiple insertions, causing surgeons ’ fatigue, patient’s discomfort, and compromising the integrity of the tissue specimen. In this work, we present a new concept for real-time manipulation of a tumor using a robotic controller that monitors the image of the tumor to generate appropriate external force to position the tumor at a desired location. The idea here is to demonstrate that it is possible to manipulate a tumor in real-time by applying controlled external force in an automated way such that the tumor does not deviate from the path of the needle. A laboratory experiment has been presented on a phantom that demonstrates the essence of this concept. The success of this approach has the potential to reduce the number of attempts a surgeon makes to capture the desired tissue specimen, minimize tissue damage, improve speed of biopsy, and reduce patient discomfort