Use of 3D printed connectors to redesign full face snorkeling masks in the COVID-19 era: a preliminary technical case-study

The COVID-19 pandemic resulted in severe shortages of personal protection equipment and non-invasive ventilation devices. As traditional supply chains could not meet up with the demand, makeshift solutions were developed and locally manufactured by rapid prototyping networks. Among the different global initiatives, retrofitting of full-face snorkeling masks for Non-Invasive-Ventilation (NIV) applications seems the most challenging. This article provides a systematic overview of rapid prototyped - 3D printed - designs that enable attachment of medical equipment to snorkeling masks, highlighting potential and challenges in additive manufacturing. The different NIV connector designs are compared on low-cost 3D fabrication time and costs, which allows a rapid assessment of developed connectors for health care workers in urgent need of retrofitting snorkeling masks for NIV purposes. Challenges and safety issues of the rapid prototyping approach for healthcare applications during the pandemic are discussed as well. When critical parameters such as the final product cost, geographical availability of the feedstock and the 3D printers and the medical efficiency of the rapid prototyped products are well considered before deploying decentralized 3D printing as manufacturing method, this rapid prototyping strategy contributed to reduce personal protective equipment and NIV shortages during the first wave of the COVID-19 pandemic. It is also concluded that it is crucial to carefully optimize material and printer parameter settings to realize best fitting and airtight connector-mask connections, which is heavily depending on the chosen feedstock and type of printer

3-D Visualization and Inter-Session Comparison for Robotic Assisted Bladder Cancer Screening

Over 570,000 new cases of bladder cancer are diagnosed worldwide every year. It is essential to detect new tumors as early as possible to reduce the mortality rate. In addition, the muscle invasiveness of lesions should be quantified to determine the optimal treatment plan.Within the "Next-gen in-vivo cancer diagnostics" research project we propose a new cystoscopy instrument consisting of an optical coherence tomography (OCT) sensor, a camera and a light source, mounted on the tip of a concentric tube robot (CTR). The camera images could then be used to create 3-D reconstructions of the bladder wall and to quantifiy changes in its texture between successive cystoscopy sessions. In addition, the camera could guide the OCT sensor to investigate the bladder wall structure at the locations of possible tumors in order to investigate the malignancy and muscle invasiveness.This research specifically reports on creating 3-D reconstructions of bladder phantoms and co-registration of successive sessions, in order to automatically detect and indicate changes in texture which might be related to the onset and growth of tumors.The results show that cystoscopy images of the bladder could be reconstructed in 3-D and subsequently projected to a 2-D atlas. Registrations of successive sessions were effectively co-registered with help of the TPS algorithm and the system was able to automatically detect all six images of tumors which were added between the two sessions

Image-guided Breast Biopsy of MRI-visible Lesions with a Hand-mounted Motorised Needle Steering Tool

A biopsy is the only diagnostic procedure for accurate histological confirmation of breast cancer. When sonographic placement is not feasible, a Magnetic Resonance Imaging(MRI)-guided biopsy is often preferred. The lack of real-time imaging information and the deformations of the breast make it challenging to bring the needle precisely towards the tumour detected in pre-interventional Magnetic Resonance (MR) images. The current manual MRI-guided biopsy workflow is inaccurate and would benefit from a technique that allows real-time tracking and localisation of the tumour lesion during needle insertion. This paper proposes a robotic setup and software architecture to assist the radiologist in targeting MR-detected suspicious tumours. The approach benefits from image fusion of preoperative images with intraoperative optical tracking of markers attached to the patient's skin. A hand-mounted biopsy device has been constructed with an actuated needle base to drive the tip toward the desired direction. The steering commands may be provided both by user input and by computer guidance. The workflow is validated through phantom experiments. On average, the suspicious breast lesion is targeted with a radius down to 2.3 mm. The results suggest that robotic systems taking into account breast deformations have the potentials to tackle this clinical challenge.Comment: Submitted to 2021 International Symposium on Medical Robotics (ISMR

Increasing the precision of the biopsy with robots: two case studies

Robotics is a rapidly advancing field and its introduction in healthcare can have a multitude of benefits for clinical practice. Especially applications depending on the radiologist’s accuracy and precision, such as percutaneous interventions, may profit. Percutaneous interventions are relatively simple and the quality of the procedure increases a lot by introducing robotics due to the improved accuracy and precision. This paper provides the description of two robotic systems for percutaneous interventions: breast biopsy and prostate biopsy. The systems presented here are complete prototypes in an advanced state ready to be tested in clinical practice.https://youtu.be/KZxfRtg0afg https://www.youtube.com/watch?v=AB3Qa6LyHP

Needle and Biopsy Robots: a Review

Purpose of the review Robotics is a rapidly advancing field, and its introduction in healthcare can have a multitude of benefits for clinical practice. Especially, applications depending on the radiologist\u2019s accuracy and precision, such as percutaneous interventions, may profit. This paper provides an overview of recent robot-assisted percutaneous solutions. Recent findings Percutaneous interventions are relatively simple and the quality of the procedure increases a lot by introducing robotics due to the improved accuracy and precision. The success of the procedure is heavily dependent on the ability to merge pre- and intraoperative images, as an accurate estimation of the current target location allows to exploit the robot\u2019s capabilities. Summary Despite much research, the application of robotics in some branches of healthcare is not commonplace yet. Recent advances in percutaneous robotic solutions and imaging are highlighted, as they will pave the way to more widespread implementation of robotics in clinical practic

MRI and Stereo Vision Surface Reconstruction and Fusion

Breast cancer, the most commonly diagnosed cancer in women worldwide, is mostly detected through a biopsy where tissue is extracted and chemically examined or pathologist assessed. Medical imaging plays a valuable role in targeting malignant tissue accurately and guiding the radiologist during needle insertion in a biopsy. This paper proposes a computer software that can process and combine 3D reconstructed surfaces from different imaging modalities, particularly Magnetic Resonance Imaging (MRI) and camera, showing a visualization of important features and investigates its feasibility. The development of this software aims to combine the detectability of MRI with the physical space of the camera. It demonstrates that the registration accuracy of the proposed system is acceptable and has potential for clinical application

Sunram 7: An MR Safe Robotic System for Breast Biopsy

In breast cancer patients, some nodules are only visible on MRI, thus, requiring MRI-guidance to perform the biopsy. MRI interventions are cumbersome due to the magnetic field and the constrained working space. An MR safe robotic system actuated by pneumatic stepper motors may enable these procedures, improving both accuracy and image-guided navigation. A compact multipurpose pneumatic stepper motor has been designed with outer dimensions $(45 \times 40\times 15)\mathbf{mm}^{\mathbf{3}}$. This is configurable as a linear, rotational or curved stepper motor with a customizable step size and radius of curvature. Five copies of these motors actuate the Sunram 7 biopsy robot, of which the moving part (without protruding racks and tubes) measures $(130 \times 65\times 55)\mathbf{mm}^{\mathbf{3}}$. After manually choosing the target location and angle of approach, the needle is robotically inserted into the breast and the integrated pneumatic biopsy gun is fired to sample tissue from the lesion. The maximum torque of the presented motor is 0.61 N m at 6 bar which can be achieved using 13-teeth polycarbonate gears. Using 17-teeth gears for higher accuracy and a more convenient working pressure of 2 bar the maximum torque is 0.28 N m. The accuracy in free air of the Sunram 7 robot is 1.69mm and 1.72mm in X and Z-direction respectively, with a resulting 2-D error of 2.54 mm. The workspace volume is 4.1 L. When targeting 10 mm-sized lesions in phantoms under MRI guidance, Sunram 7 achieved a success rate of 68%. The minimum interval between two successive biopsies was 5:47 minutes. The presented multipurpose stepper motor has distinct advantages over previous designs in terms of robustness, customizability, printability and ease of integration in MR safe robotics. The Sunram 7 is able to perform accurate MRI-guided biopsies in a large workspace volume while reducing the intervention time when compared to the gold standard (i.e., MRI-guided free-hand biopsy)