Development of a Reality-Based, Haptics-Enabled Simulator for Tool-Tissue Interactions

The advent of complex surgical procedures has driven the need for finite element based surgical training simulators which provide realistic visual and haptic feedback throughout the surgical task. The foundation of a simulator stems from the use of accurate, reality-based models for the global tissue response as well as the tool-tissue interactions. To that end, ex vivo and in vivo tests were conducted for soft-tissue probing and in vivo tests were conducted for soft-tissue cutting for the purpose of model development. In formulating a surgical training system, there is a desire to replicate the surgical task as accurately as possible for haptic and visual realism. However, for many biological tissues, there is a discrepancy between the mechanical characteristics of ex vivo and in vivo tissue. The efficacy of utilizing an ex vivo model for simulation of in vivo probing tasks on porcine liver was evaluated by comparing the simulated probing task to an identical in vivo probing experiment. The models were then further improved upon to better replicate the in vivo response. During the study of cutting modeling, in vivo cutting experiments were performed on porcine liver to derive the force-displacement response of the tissue to a scalpel blade. Using this information, a fracture mechanics based approach was applied to develop a fully defined cohesive zone model governing the separation properties of the liver directly in front of the scalpel blade. Further, a method of scaling the cohesive zone parameters was presented to minimize the computational expense in an effort to apply the cohesive based cutting approach to real-time simulators. The development of the models for the global tissue response and local tool-tissue interactions for probing and cutting of soft-tissue provided the framework for real-time simulation of basic surgical skills training. Initially, a pre-processing approach was used for the development of reality-based, haptics enabled simulators for probing and cutting of soft tissue. Then a real-time finite element based simulator was developed to simulate the probing task without the need to know the tool path prior to simulation

Realistic tool-tissue interaction models for surgical simulation and planning

Surgical simulators present a safe and potentially effective method for surgical training, and can also be used in pre- and intra-operative surgical planning. Realistic modeling of medical interventions involving tool-tissue interactions has been considered to be a key requirement in the development of high-fidelity simulators and planners. The soft-tissue constitutive laws, organ geometry and boundary conditions imposed by the connective tissues surrounding the organ, and the shape of the surgical tool interacting with the organ are some of the factors that govern the accuracy of medical intervention planning.\ud \ud This thesis is divided into three parts. First, we compare the accuracy of linear and nonlinear constitutive laws for tissue. An important consequence of nonlinear models is the Poynting effect, in which shearing of tissue results in normal force; this effect is not seen in a linear elastic model. The magnitude of the normal force for myocardial tissue is shown to be larger than the human contact force discrimination threshold. Further, in order to investigate and quantify the role of the Poynting effect on material discrimination, we perform a multidimensional scaling study. Second, we consider the effects of organ geometry and boundary constraints in needle path planning. Using medical images and tissue mechanical properties, we develop a model of the prostate and surrounding organs. We show that, for needle procedures such as biopsy or brachytherapy, organ geometry and boundary constraints have more impact on target motion than tissue material parameters. Finally, we investigate the effects surgical tool shape on the accuracy of medical intervention planning. We consider the specific case of robotic needle steering, in which asymmetry of a bevel-tip needle results in the needle naturally bending when it is inserted into soft tissue. We present an analytical and finite element (FE) model for the loads developed at the bevel tip during needle-tissue interaction. The analytical model explains trends observed in the experiments. We incorporated physical parameters (rupture toughness and nonlinear material elasticity) into the FE model that included both contact and cohesive zone models to simulate tissue cleavage. The model shows that the tip forces are sensitive to the rupture toughness. In order to model the mechanics of deflection of the needle, we use an energy-based formulation that incorporates tissue-specific parameters such as rupture toughness, nonlinear material elasticity, and interaction stiffness, and needle geometric and material properties. Simulation results follow similar trends (deflection and radius of curvature) to those observed in macroscopic experimental studies of a robot-driven needle interacting with gels

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

Improved tribology and materials for a new generation of hip prostheses

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Failure mechanism of coated biomaterials under high impact-sliding contact stresses

This study uses a newly developed testing method-- inclined cyclic impact-sliding test to investigate the failure behaviors of different types of biomaterials, (SS316L, Ti6Al4V and CoCr) coated by different coatings (TiN, DLC and PEO), under extremely high dynamic contact stress conditions. This test method can simulate the combined impact and sliding/rolling loading conditions, which is very practical in many aspects of commercial usages. During the tests, fatigue cracking, chipping, peeling and material transferring were observed in damaged area. This research is mainly focused on the failure behaviors of load-bearing materials which cyclic impacting and sliding are always involved. This purpose was accomplished in the three stages: First, impact-sliding test was carried out on TiN coated unhardened M2. It was found that soft substrate can cause early failure of coating due to the considerable plastic deformation in the substrate. In this case, stronger substrate is required to support coating better when tested under high contact stresses. Second, PEO coated Ti-6Al-4V was tested under pure sliding and impact-sliding wear conditions. PEO coating was found not strong enough to afford the high contact pressure under cyclic impact-sliding wear test due to its porous surface structure. However, the wear performance of PEO coating was enhanced due to the sub-stoichiometric oxide. To sum up, for load-bearing biomedical implants involved in high impacting movement, PEO coating may not be a promising surface protection. Third, the dense, smooth PVD/CVD bio-inert coatings were reconsidered. DLC and TiN coatings, combined by different substrates together with different interface materials were tested under the cyclic impact-sliding test using a set of proper loading. The results show that to choose a proper combination of coating, interface and substrate based on their mechanical properties is of great importance under the test condition. Hard substrates provide support to coating better and a ductile and adhesive interface layer can delay the cracked coating from peeled-off

Optimal Inference Methods in Linear Models with Change-points

In this dissertation, we consider an estimation problem of the regression coefficients in both multiple regression model and multivariate multiple regression model with several unknown change-points. More precisely, we consider the cases where the target parameters (vectors or matrices) are suspected to satisfy some restrictions. In particular, we generalize in four ways, some recent statistical methods in the literatures. First, we relax some assumptions about the dependance structure of the noise and the regressors given in recent literature. Namely, in this dissertation, the dependance structure is as weak as that of an L 2 -mixingale arrays of size -1/2. Second, under such weak assumptions, we derive the joint asymptotic normality between the RE and UE. Third, in the context of change-points models, the estimation problem of a vector of the regression coefficients is extended to that of a matrix of the regression coefficients. Fourth, we propose a class of estimators which includes as a special cases shrinkage estimators (SEs) as well as the unrestricted estimator (UE) and the restricted estimator (RE). We also derive a more general condition for the SEs to dominate the UE in mean square error. To this end, we generalize some identities for the evaluation of the bias and risk functions of shrinkage-type estimators (vectors or matrices). As illustrative example, our method is applied to the gross domestic product\u27\u27 data set of 10 countries including USA, Canada, UK, France and Germany. The simulation results corroborate our theoretical findings

Book of Abstracts 15th International Symposium on Computer Methods in Biomechanics and Biomedical Engineering and 3rd Conference on Imaging and Visualization

In this edition, the two events will run together as a single conference, highlighting the strong connection with the Taylor & Francis journals: Computer Methods in Biomechanics and Biomedical Engineering (John Middleton and Christopher Jacobs, Eds.) and Computer Methods in Biomechanics and Biomedical Engineering: Imaging and Visualization (JoãoManuel R.S. Tavares, Ed.). The conference has become a major international meeting on computational biomechanics, imaging andvisualization. In this edition, the main program includes 212 presentations. In addition, sixteen renowned researchers will give plenary keynotes, addressing current challenges in computational biomechanics and biomedical imaging. In Lisbon, for the first time, a session dedicated to award the winner of the Best Paper in CMBBE Journal will take place. We believe that CMBBE2018 will have a strong impact on the development of computational biomechanics and biomedical imaging and visualization, identifying emerging areas of research and promoting the collaboration and networking between participants. This impact is evidenced through the well-known research groups, commercial companies and scientific organizations, who continue to support and sponsor the CMBBE meeting series. In fact, the conference is enriched with five workshops on specific scientific topics and commercial software.info:eu-repo/semantics/draf

Developing a novel methodology to investigate the biomechanics and wear in natural patello-femoral joints

Patello-femoral problems affect nearly a quarter of the population and remain a common cause of knee replacement revision surgery. Minimally invasive treatments such as osteochondral substitutions are early interventions that can be used to prevent or delay the need for these replacements. Lack of pre-clinical testing is a major challenge in getting these promising treatments to clinical trials. The purpose of this research was to develop a platform that can get these products one step closer to clinical trials and hence getting them out in the market as a viable product for treating osteochondral lesions. The aim of this project was to develop and validate a design specification for the pre-clinical testing of natural patello-femoral joint (PFJ). A characterization study was carried out to investigate the suitable animal model required to simulate a human joint that requires osteochondral substitutions. The size of the porcine PFJ was closer to the human PFJ and the material properties of its cartilage were also similar to the human cartilage. Therefore, the porcine PFJ was chosen as the animal model to develop the methodologies for this project. A methodology was developed to investigate wear of the natural porcine PFJ by adapting a single station knee simulator to apply the porcine PFJ gait cycle to the joints. The position of the patella with respect to the femur determined through a contact point study was used to set up the samples in the simulator. A positive (cobalt chrome on natural cartilage) and negative (cartilage on cartilage) control was used to investigate the wear. This study showed the potential of using an Alicona Infinite focus G5 optical profiler to assess the change in cartilage topography in natural joints. The contact area and pressure in the PFJ was measured using Tekscan pressure sensors. This study showed the change in contact mechanics across a gait cycle and the effect of sample geometry on the contact mechanics of a joint. In-vitro simulation can reduce the need for animal testing and progress the preclinical trials for new tissue substitutions. Developing the methodology in a human knee is not practical. However, by establishing an animal model can bring this a step closer. The methods developed in this thesis can contribute towards creating a pre-clinical testing system that can be used to assess early interventions to the PFJ

Force Sensing Surgical Scissor Blades using Fibre Bragg Grating Sensors

This thesis considers the development and analysis of unique sensorised surgical scissor blades for application in minimally invasive robotic surgery (MIRS). The lack of haptic (force and tactile) feedback to the user is currently an unresolved issue with modern MIRS systems. This thesis presents details on smart sensing scissor blades which enable the measurement of instrument-tissue interaction forces for the purpose of force reflection and tissue property identification. A review of current literature established that there exists a need for small compact, biocompatible, sterilisable and robust sensors which meet the demands of current MIRS instruments. Therefore, the sensorised blades exploit the strain sensing capabilities of a single fibre Bragg grating (FBG) sensor bonded to their surface. The nature and magnitude of the strain likely to be experienced by the blades, and consequently the FBG sensor, while cutting soft tissue samples were characterised through the use of an application specific test-bed. Using the sensorised blades to estimate fracture properties is proposed, hence two methods of extracting fracture toughness information from the test samples are assessed and compared. Investigations were carried out on the factors affecting the transfer of strain from the blade material to the core of the FBG sensor for surface mounted or partially embedded arrangements. Results show that adhesive bond length, thickness and stiffness need to be carefully specified when bonding FBG sensors to ensure effective strain transfer. Calibration and dynamic cutting experiments were carried out using the characterisation test-bed. The complex nature of the blade interaction forces were modelled, primarily for the purpose of decoupling the direct, lateral, friction and fracture strains experienced by the bonded FBG sensor during cutting. The modelled and experimental results show that the approach taken in sensorising the blade enables detailed cutting force data to be obtained and consequently leads to a unique method in estimating the kinetic friction coefficient for the blades. The forces measured using the FBG are validated against a commercial load cell used in the test-bed. This research work demonstrates that this unique approach of placing a single optical fibre onto the scissor blades can, in an unobtrusive manner, measure interblade friction forces and material fracture properties occurring at the blade-tissue interface