Robust realtime instrument tracking in ultrasound images for visual servoing

Abstract-Minimally invasive surgery in combination with ultrasound (US) imaging imposes high demands on the surgeon's hand-eye-coordination capabilities. A possible solution to reduce these requirements is minimally invasive robotic surgery in which the instrument is guided by visual servoing towards the goal defined by the surgeon in the US image. This approach requires robust tracking of the instrument in the US image sequences which is known to be difficult due to poor image quality. This paper presents computer vision algorithms and results of visual servoing experiments. Adaptive thresholding according to Otsu's method allows to cope with large intensity variations of the instrument echo. Subsequently applied morphological operations suppress noise and echo artefacts. A fast labelling algorithm based on run length coding allows for realtime labelling of the regions. A heuristic exploiting region size and region velocity helps to overcome ambiguities. The overall computation time is less than 10 ms per frame on a standard PC. The tracking algorithm requires no information about texture and shape which are known to be very unreliable in US image sequences. Experimental results for different instrument materials (polyvinyl chloride, polyurethane, nylon, and plexiglas) are given, illustrating the performance of the proposed approach: when chosing the appropriate material the reconstructed trajectories are smooth and only few outliers occur. As a consequence, the visual servoing loop showed to be robust and stable

Zonisamide in the management of epilepsy in the elderly

Zonisamide (ZNS), a second-generation antiepileptic drug, indicated as add-on treatment of focal epilepsy, has been recently approved as monotherapy for the treatment of partial seizures in adults affected by newly diagnosed epilepsy in Europe. Evidence on the efficacy and tolerability of antiepileptic drugs in the elderly is still lacking as these patients are frequently excluded from clinical trials. Here, a comprehensive overview of available data regarding the use of ZNS in the treatment of epilepsy in elderly people is provided. In a pooled analysis conducted in patients aged 6565 years, no new/unexpected safety findings have emerged. Few data from uncontrolled investigations suggest that ZNS may be effective and well tolerated when administered as monotherapy or adjunctive antiepileptic treatment in the elderly. However, evidence from these observational studies is less than satisfactory, and randomized controlled trials focused on these patients are still needed

Factors Associated to the Onset of Mental Illness Among Hospitalized Migrants to Italy: A Chart Review

Migration is a complex phenomenon and mental illness among immigrants remains a major matter of concern in Italy and worldwide. 243 medical and pharmacy records of patients admitted to University of Foggia hospital between 2004 and 2018 were retrospectively screened and included in the study. Socio-demographic data and clinical characteristics of inpatients were compared in those with and without first-episode of mental illness (FEMI). Subjects (140 men, 103 women; aged 34.4 ± 10.2 years) represented 6.66 ± 3.73% of all hospitalizations in 15 years. Nearly half of them (48.5%) had emigrated from other European countries. 30.8% were diagnosed with a DSM-IV TR unspecified psychosis. 103 patients (42.3%) were in first-lifetime episodes of mental illness. Factors significantly associated with FEMI were: younger age, sex (men), immigrating from Africa, poor language proficiency, lower amount of prescribed psychotropics. Mental health among immigrants is of major concern in Italy. Our findings report on factors possibly associated to the onset of mental illness among immigrant psychiatric inpatients

Automatic Guidance of a Surgical Instrument with US Based Visual Servoing

International audience— Surgeons can hardly perform manually complex tasks under ultrasound (US) imaging. Visual servoing appears as a possible solution to assist the surgeon in such an operation. The idea of the proposed system is to allow the surgeon to select a desired position on a US image and then program a robot to automatically move the instrument towards the location indicated by the surgeon. This approach requires robust tracking of the instrument in the US image, modeling of the overall system and implementation of a visual servoing loop. This paper presents geometrical and kinematic models of the system, as well as the control loop design, which is validated through both numerical simulations, and results of in vitro experiments

A Force Controlled Laparoscopic Surgical Robot without Distal Force Sensing

International audienceAs robot applications in humane nvironments increase, we see many interesting application in medicine. Thesei nclude robotic technologies used in robot-doctor interfaces for minimally invasive surgery and novel roboticdevices that can navigatei nsideh umanbodies.This chapter presents 3 interestingarticles representing the various facets of medical robotics.Papers in other chapters, however,alsodescribemedicalapplications of robotics. The first article by Zemetiand co-workers presents the designand analysis of a Minimally InvasiveSurgery robot.The trocar is designed withforcemeasurement capability, where the force sensor is placed outside the patient – " to reducecost and sterilizibility requirements ". This paper presents the results of the feasibility experiments. In the next article,D ario and colleagues take medical robotics a step further into the futureby reportingo n the concept and the preliminary modelingo fl egged micro robot locomoting in a tubular, slippery and compliant environment.The intendedapplication is for the microrobots ton avigatei nside the gastrointestinal tract for diagnosis and therapy.The microcapsules ared esigned tobei ngestible and then tomake its way to the gastrointestinal tract.The new contributionbeing studied herei s the micro robot's capability of effectivel ocomotion while inside the humanbody. The thirdarticle by Casals, et al .p resents amultimodalapproach toh uman-machine interface,a pplied t om edical robotics.This carries a similar idea to the first article in Chapter XIIIb y Iba et al , under the heading of Haptics and Augmented Reality.The ideais top rovide a rangeo fm ediaof communication between the surgeonand the robots, thus creating aquasi-hands-free control of the equipments.This would allow the surgeon tobetter control the equipments in the operating room without losing too muchf ocus on the taskat hand. The mode of interactionbeing studiedi s gesture recognition, witho ther modes available such as: tactile, speech,pedals,etc. Abstract. Minimally invasive surgery (MIS) challenges the surgeon's skills due to his separation from the operation area which can be reached with long instruments only. Therefore, the surgeon loses access to the manipulation forces inside the patient. This reduces his dexterity when performing the operation. A new compact and lightweight robot for MIS is presented which allows for the measurement of manipulation forces. The main advantage of this concept is that no miniaturized force sensor has to be integrated into surgical instruments and inserted into the patient. Rather, a standard sensor is attached to a modified trocar outside the patient, which allows for the measurement of manipulation forces. This approach reduces costs and sterilizability demands. Results of first force control experiments are presented to show the feasibility of the concepts

A SIMULATION SURVEY ON THE EFFECTS OF PROGRESSING FAULTS WITHIN THE SCAS OF A FLIGHT CONTROL ACTUATOR FOR HELICOPTERS

Stability Control Augmentation Systems (SCAS) are widely adopted to enhance the flight stability of rotary-wing aircraft operating in difficult aerodynamic conditions, such as low altitude missions, stationary flight nearby vertical walls or in presence of heavy gusts. Such systems are based upon small electro-hydraulic servosystems controlled in position through a dedicated servovalve. The SCAS operates with limited authority over the main control linkage translating the pilot input in the movement of the main flight control actuator. Being critical for the operability of the helicopter, the definition of a Prognostics and Health Management (PHM) framework for the SCAS systems would provide significant advantages, such as better risk mitigation, improved availability, and a reduction in the occurrences of unpredicted failures which still represent one of the most known downsides of helicopters. This paper provides the results of a preliminary analysis on the effects of the inception and progression of several degradation types within a simulated SCAS system. Signals usually available within such devices are hence combined with measurements provided by additional sensors to check the feasibility of a PHM system with and without dedicated sensors. The resulting features selection process shows that although the dedicated measurements are required to design a complete PHM system, it appears nonetheless possible to obtain valuable information on the health status of the SCAS system without resorting to additional sensors