Clinical Study Treatment of Glioma Using neuroArm Surgical System

The use of robotic technology in the surgical treatment of brain tumour promises increased precision and accuracy in the performance of surgery. Robotic manipulators may allow superior access to narrow surgical corridors compared to freehand or conventional neurosurgery. This paper reports values and ranges of tool-tissue interaction forces during the performance of glioma surgery using an MR compatible, image-guided neurosurgical robot called neuroArm. The system, capable of microsurgery and stereotaxy, was used in the surgical resection of glioma in seven cases. neuroArm is equipped with force sensors at the end-effector allowing quantification of tool-tissue interaction forces and transmits force of dissection to the surgeon sited at a remote workstation that includes a haptic interface. Interaction forces between the tool tips and the brain tissue were measured for each procedure, and the peak forces were quantified. Results showed maximum and minimum peak force values of 2.89 N (anaplastic astrocytoma, WHO grade III) and 0.50 N (anaplastic oligodendroglioma, WHO grade III), respectively, with the mean of peak forces varying from case to case, depending on type of the glioma. Mean values of the peak forces varied in range of 1.27 N (anaplastic astrocytoma, WHO grade III) to 1.89 N (glioblastoma with oligodendroglial component, WHO grade IV). In some cases, ANOVA test failed to reject the null hypothesis of equality in means of the peak forces measured. However, we could not find a relationship between forces exerted to the pathological tissue and its size, type, or location

Review of robotic technology for keyhole transcranial stereotactic neurosurgery

The research of stereotactic apparatus to guide surgical devices began in 1908, yet a major part of today's stereotactic neurosurgeries still rely on stereotactic frames developed almost half a century ago. Robots excel at handling spatial information, and are, thus, obvious candidates in the guidance of instrumentation along precisely planned trajectories. In this review, we introduce the concept of stereotaxy and describe a standard stereotactic neurosurgery. Neurosurgeons' expectations and demands regarding the role of robots as assistive tools are also addressed. We list the most successful robotic systems developed specifically for or capable of executing stereotactic neurosurgery. A critical review is presented for each robotic system, emphasizing the differences between them and detailing positive features and drawbacks. An analysis of the listed robotic system features is also undertaken, in the context of robotic application in stereotactic neurosurgery. Finally, we discuss the current perspective, and future directions of a robotic technology in this field. All robotic systems follow a very similar and structured workflow despite the technical differences that set them apart. No system unequivocally stands out as an absolute best. The trend of technological progress is pointing toward the development of miniaturized cost-effective solutions with more intuitive interfaces.This work has been partially financed by the NETT Project (FP7-PEOPLE-2011-ITN-289146), ACTIVE Project (FP7-ICT-2009-6-270460), and FCT PhD grant (ref. SFRH/BD/86499/2012)

An Intraoperative Force Perception and Signal Decoupling Method on Capsulorhexis Forceps

Force perception on medical instruments is critical for understanding the mechanism between surgical tools and tissues for feeding back quantized force information, which is essential for guidance and supervision in robotic autonomous surgery. Especially for continuous curvilinear capsulorhexis (CCC), it always lacks a force measuring method, providing a sensitive, accurate, and multi-dimensional measurement to track the intraoperative force. Furthermore, the decoupling matrix obtained from the calibration can decorrelate signals with acceptable accuracy, however, this calculating method is not a strong way for thoroughly decoupling under some sensitive measuring situations such as the CCC. In this paper, a three-dimensional force perception method on capsulorhexis forceps by installing Fiber Bragg Grating sensors (FBGs) on prongs and a signal decoupling method combined with FASTICA is first proposed to solve these problems. According to experimental results, the measuring range is up to 1 N (depending on the range of wavelength shifts of sensors) and the resolution on x, y, and z axial force is 0.5, 0.5, and 2 mN separately. To minimize the coupling effects among sensors on measuring multi-axial forces, by unitizing the particular parameter and scaling the corresponding vector in the mixing matrix and recovered signals from FastICA, the signals from sensors can be decorrelated and recovered with the errors on axial forces decreasing up to 50% least. The calibration and calculation can also be simplified with half the parameters involved in the calculation. Experiments on thin sheets and in vitro porcine eyes were performed, and it was found that the tearing forces were stable and the time sequence of tearing forceps was stationary or first-order difference stationary during roughly circular crack propagating.Comment: 12pages, 17 figure

Medical Robotics

The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently “medical roboticists” or not

Augmented reality (AR) for surgical robotic and autonomous systems: State of the art, challenges, and solutions

Despite the substantial progress achieved in the development and integration of augmented reality (AR) in surgical robotic and autonomous systems (RAS), the center of focus in most devices remains on improving end-effector dexterity and precision, as well as improved access to minimally invasive surgeries. This paper aims to provide a systematic review of different types of state-of-the-art surgical robotic platforms while identifying areas for technological improvement. We associate specific control features, such as haptic feedback, sensory stimuli, and human-robot collaboration, with AR technology to perform complex surgical interventions for increased user perception of the augmented world. Current researchers in the field have, for long, faced innumerable issues with low accuracy in tool placement around complex trajectories, pose estimation, and difficulty in depth perception during two-dimensional medical imaging. A number of robots described in this review, such as Novarad and SpineAssist, are analyzed in terms of their hardware features, computer vision systems (such as deep learning algorithms), and the clinical relevance of the literature. We attempt to outline the shortcomings in current optimization algorithms for surgical robots (such as YOLO and LTSM) whilst providing mitigating solutions to internal tool-to-organ collision detection and image reconstruction. The accuracy of results in robot end-effector collisions and reduced occlusion remain promising within the scope of our research, validating the propositions made for the surgical clearance of ever-expanding AR technology in the future

Augmented Reality (AR) for Surgical Robotic and Autonomous Systems: State of the Art, Challenges, and Solutions

Despite the substantial progress achieved in the development and integration of augmented reality (AR) in surgical robotic and autonomous systems (RAS), the center of focus in most devices remains on improving end-effector dexterity and precision, as well as improved access to minimally invasive surgeries. This paper aims to provide a systematic review of different types of state-of-the-art surgical robotic platforms while identifying areas for technological improvement. We associate specific control features, such as haptic feedback, sensory stimuli, and human–robot collaboration, with AR technology to perform complex surgical interventions for increased user perception of the augmented world. Current researchers in the field have, for long, faced innumerable issues with low accuracy in tool placement around complex trajectories, pose estimation, and difficulty in depth perception during two-dimensional medical imaging. A number of robots described in this review, such as Novarad and SpineAssist, are analyzed in terms of their hardware features, computer vision systems (such as deep learning algorithms), and the clinical relevance of the literature. We attempt to outline the shortcomings in current optimization algorithms for surgical robots (such as YOLO and LTSM) whilst providing mitigating solutions to internal tool-to-organ collision detection and image reconstruction. The accuracy of results in robot end-effector collisions and reduced occlusion remain promising within the scope of our research, validating the propositions made for the surgical clearance of ever-expanding AR technology in the future

Computer vision techniques for a robot-assisted emergency neurosurgery system

This thesis presents the development of computer vision techniques for a robot-assisted emergency neurosurgery system that is being developed by the Mechatronics in Medicine group at Loughborough University, UK, and situates them within the context of the overall project. There are two main contributions in this thesis. The first is the development of a registration framework, to establish spatial correspondence between a preoperative plan of a patient (based on computed tomography images) and the patient. The registration is based on the rigid transformation of homologous anatomical soft tissue point landmarks of the head, the medial canthus and tragus, in CT and patient space. As a step towards automating the registration, a computational framework to localise these landmarks in CT space, with performance comparable to manual localisation, has been developed. The second contribution in this thesis is the development of computer vision techniques for a passive intraoperative supervisory system, based on visual cues from the operative site. Specifically, the feasibility of using computer vision to assess the outcome of a surgical intervention was investigated. The ability to mimic and embody part of a surgeon s visual sensory and decision-making capability is aimed at improving the robustness of the robotic system. Low-level image features to distinguish the two possible outcomes, complete and incomplete, were identified. Encouraging results were obtained for the surgical actions under consideration, which have been demonstrated by experiments on cadaveric pig heads. The results obtained are suggestive of the potential use of computer vision to assist surgical robotics in an operating theatre. The computational approaches developed, to provide greater autonomy to the robotic system, have the potential to improve current practice in robotic surgery. It is not inconceivable that the state of the art in surgical robotics can advance to a stage where it is able to emulate the ability and interpretation process of a surgeon.EThOS - Electronic Theses Online ServiceGBUnited Kingdo