3D Dynamic Motion Planning for Robot-Assisted Cannula Flexible Needle Insertion into Soft Tissue

In robot-assisted needle-based medical procedures, insertion motion planning is a crucial aspect. 3D dynamic motion planning for a cannula flexible needle is challenging with regard to the nonholonomic motion of the needle tip, the presence of anatomic obstacles or sensitive organs in the needle path, as well as uncertainties due to the dynamic environment caused by the movements and deformations of the organs. The kinematics of the cannula flexible needle is calculated in this paper. Based on a rapid and robust static motion planning algorithm, referred to as greedy heuristic and reachability-guided rapidly-exploring random trees, a 3D dynamic motion planner is developed by using replanning. Aiming at the large detour problem, the convergence problem and the accuracy problem that replanning encounters, three novel strategies are proposed and integrated into the conventional replanning algorithm. Comparisons are made between algorithms with and without the strategies to verify their validity. Simulations showed that the proposed algorithm can overcome the above-noted problems to realize real-time replanning in a 3D dynamic environment, which is appropriate for intraoperative planning. © 2016 Author

SMART IMAGE-GUIDED NEEDLE INSERTION FOR TISSUE BIOPSY

M.S

Robotics-Assisted Needle Steering for Percutaneous Interventions: Modeling and Experiments

Needle insertion and guidance plays an important role in medical procedures such as brachytherapy and biopsy. Flexible needles have the potential to facilitate precise targeting and avoid collisions during medical interventions while reducing trauma to the patient and post-puncture issues. Nevertheless, error introduced during guidance degrades the effectiveness of the planned therapy or diagnosis. Although steering using flexible bevel-tip needles provides great mobility and dexterity, a major barrier is the complexity of needle-tissue interaction that does not lend itself to intuitive control. To overcome this problem, a robotic system can be employed to perform trajectory planning and tracking by manipulation of the needle base. This research project focuses on a control-theoretic approach and draws on the rich literature from control and systems theory to model needle-tissue interaction and needle flexion and then design a robotics-based strategy for needle insertion/steering. The resulting solutions will directly benefit a wide range of needle-based interventions. The outcome of this computer-assisted approach will not only enable us to perform efficient preoperative trajectory planning, but will also provide more insight into needle-tissue interaction that will be helpful in developing advanced intraoperative algorithms for needle steering. Experimental validation of the proposed methodologies was carried out on a state of-the-art 5-DOF robotic system designed and constructed in-house primarily for prostate brachytherapy. The system is equipped with a Nano43 6-DOF force/torque sensor (ATI Industrial Automation) to measure forces and torques acting on the needle shaft. In our setup, an Aurora electromagnetic tracker (Northern Digital Inc.) is the sensing device used for measuring needle deflection. A multi-threaded application for control, sensor readings, data logging and communication over the ethernet was developed using Microsoft Visual C 2005, MATLAB 2007 and the QuaRC Toolbox (Quanser Inc.). Various artificial phantoms were developed so as to create a realistic medium in terms of elasticity and insertion force ranges; however, they simulated a uniform environment without exhibiting complexities of organic tissues. Experiments were also conducted on beef liver and fresh chicken breast, beef, and ham, to investigate the behavior of a variety biological tissues

Planning for steerable needles in neurosurgery

The increasing adoption of robotic-assisted surgery has opened up the possibility to control innovative dexterous tools to improve patient outcomes in a minimally invasive way. Steerable needles belong to this category, and their potential has been recognised in various surgical fields, including neurosurgery. However, planning for steerable catheters' insertions might appear counterintuitive even for expert clinicians. Strategies and tools to aid the surgeon in selecting a feasible trajectory to follow and methods to assist them intra-operatively during the insertion process are currently of great interest as they could accelerate steerable needles' translation from research to practical use. However, existing computer-assisted planning (CAP) algorithms are often limited in their ability to meet both operational and kinematic constraints in the context of precise neurosurgery, due to its demanding surgical conditions and highly complex environment. The research contributions in this thesis relate to understanding the existing gap in planning curved insertions for steerable needles and implementing intelligent CAP techniques to use in the context of neurosurgery. Among this thesis contributions showcase (i) the development of a pre-operative CAP for precise neurosurgery applications able to generate optimised paths at a safe distance from brain sensitive structures while meeting steerable needles kinematic constraints; (ii) the development of an intra-operative CAP able to adjust the current insertion path with high stability while compensating for online tissue deformation; (iii) the integration of both methods into a commercial user front-end interface (NeuroInspire, Renishaw plc.) tested during a series of user-controlled needle steering animal trials, demonstrating successful targeting performances. (iv) investigating the use of steerable needles in the context of laser interstitial thermal therapy (LiTT) for maesial temporal lobe epilepsy patients and proposing the first LiTT CAP for steerable needles within this context. The thesis concludes with a discussion of these contributions and suggestions for future work.Open Acces

A mechanics-based model for simulation and control of flexible needle insertion in soft tissue

AbstractIn needle-based medical procedures, beveled-tip exible needles are steered inside soft tissue with the aim of reaching pre-dened target locations. The efciency of needle-based interventions depends on accurate control of the needle tip. This paper presents a comprehensive mechanics-based model for simulation of planar needle insertion in soft tissue. The proposed model for needle deection is based on beam theory, works in real-time, and accepts the insertion velocity as an input that can later be used as a control command for needle steering. The model takes into account the effects of tissue deformation, needle-tissue friction, tissue cutting force, and needle bevel angle on needle deection. Using a robot that inserts a exible needle into a phantom tissue, various experiments are conducted to separately identify different subsets of the model parameters. The validity of the proposed model is veried by comparing the simulation results to the empirical data. The results demonstrate the accuracy of the proposed model in predicting the needle tip deection for different insertion velocities. I

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

3D path planning for flexible needle steering in neurosurgery

Background: We propose a 3D path planning method to steer flexible needles along curved paths in the context of Deep Brain Stimulation (DBS) procedures. Methods: Our approach is based on a rapidly‐exploring random tree strategy and it takes into account constraints coming from anatomical obstacles and physical constraints dictated by flexible needle kinematics. The strategy is evaluated in simulation on a realistic 3D CAD model of the brain. Results: The subthalamic nucleus (STN) and the fornix can be reached along several curved paths from various entry points. As compared to the usual straight line path, these curved paths avoid tissue damage to important neural structures while allowing for a much greater selection of entry points. Conclusions: This path planning method offers alternative curved paths to reach DBS targets with flexible needles. The method potentially leads to safer paths and additional entry points capable of reaching the desired stimulation targets

Robot Autonomy for Surgery

Autonomous surgery involves having surgical tasks performed by a robot operating under its own will, with partial or no human involvement. There are several important advantages of automation in surgery, which include increasing precision of care due to sub-millimeter robot control, real-time utilization of biosignals for interventional care, improvements to surgical efficiency and execution, and computer-aided guidance under various medical imaging and sensing modalities. While these methods may displace some tasks of surgical teams and individual surgeons, they also present new capabilities in interventions that are too difficult or go beyond the skills of a human. In this chapter, we provide an overview of robot autonomy in commercial use and in research, and present some of the challenges faced in developing autonomous surgical robots

Closed-Loop Planning and Control of Steerable Medical Needles

Steerable needles have the potential to increase the effectiveness of needle-based clinical procedures such as biopsy, drug delivery, and radioactive seed implantation for cancer treatment. These needles can trace curved paths when inserted into tissue, thereby increasing maneuverability and targeting accuracy while reaching previously inaccessible targets that are behind sensitive or impenetrable anatomical regions. Guiding these flexible needles along an intended path requires continuously inserting and twisting the needle at its base, which is not intuitive for a human operator. In addition, the needle often deviates from its intended trajectory due to factors such as tissue deformation, needle-tissue interaction, noisy actuation and sensing, modeling errors, and involuntary patient motions. These challenges can be addressed with the assistance of robotic systems that automatically compensate for these perturbations by performing motion planning and feedback control of the needle in a closed-loop fashion under sensory feedback. We present two approaches for efficient closed-loop guidance of steerable needles to targets within clinically acceptable accuracy while safely avoiding sensitive or impenetrable anatomical structures. The first approach uses a fast motion planning algorithm that unifies planning and control by continuously replanning, enabling correction for perturbations as they occur. We evaluate our method using a needle steering system in phantom and ex vivo animal tissues. The second approach integrates motion planning and feedback control of steerable needles in highly deformable environments. We demonstrate that this approach significantly improves the probability of success compared to prior approaches that either consider uncertainty or deformations but not both simultaneously. We also propose a data-driven method to estimate parameters of stochastic models of steerable needle motion. These models can be used to create realistic medical simulators for clinicians wanting to train for steerable needle procedures and to improve the effectiveness of existing planning and control methods. This dissertation advances the state of the art in planning and control of steerable needles and is an important step towards realizing needle steering in clinical practice. The methods developed in this dissertation also generalize to important applications beyond medical needle steering, such as manipulating deformable objects and control of mobile robots.Doctor of Philosoph