Comanipulation Série Dextre pour la chirurgie Mini Invasive

A minimally invasive surgery, which typically involves endoscopic camera and laparoscopic instruments, may seem to be the ideal surgical procedure for its apparent benefits. However, in comparison to open surgeries, the spatial and mechanical tool limitations posed on surgeons are so high that often MIS is foregone for complex cases and even when it is possible, the procedure requires a high dexterity, caliber and experience from the surgeon. This research was motivated by the need for dexterous surgical instruments that offer an intuitive control and an ergonomic interface, with the final objective of developing a suitable robotic hand-held surgical device for laparoscopic interventions. The research was based on comparative evaluation of different interfaces, control modes and kinematics, using a virtual reality simulator, developed specially for this purpose. The results show that: 1. The optimal interface has a WYSIWYD (what you see is what you do) control mode and is finger-operated. 2. The optimal distal motorized mobilities of the end-effector produce two independent DOF for exion and rotation of the end-effector which are sufficient for complex MIS gestures. 3. Adding a free articulation to the instrument's handle allows the surgeon to have an ergonomic posture. 4. An active trocar makes the rotation of the shaft with a free joint possible. This research also resulted in the development of a proof-of-concept prototype. The prototype was tested successfully, in vitro and in vivo on a porcine model.Une chirurgie minimalement invasive (CMI), qui implique généralement une caméra endoscopique et des instruments de laparoscopie, peut sembler être la procédure chirurgicale idéale pour ses avantages apparents. Toutefois, en comparaison à la chirurgie ouverte, les limites spatiales et outils mécaniques posés sur les chirurgiens sont si élevés que, souvent, la CMI est abandonné pour des cas complexes et même quand elle est possible, la procédure nécessite une grande dextérité, calibre et expérience du chirurgien. Cette recherche a été motivée par la nécessité d'habiles instruments chirurgicaux qui offrent un contrôle intuitif et une interface ergonomique, avec l'objectif final de développer un instrument robotisé adapté aux interventions par laparoscopie. La recherche a été basée sur l'évaluation comparative des différentes interfaces, modes de contrôle et cinématiques, en utilisant un simulateur de réalité virtuelle, développée spécialement à cet effet. Les résultats montrent que: 1. l'interface optimale a un mode de contrôle WYSIWYD (ce que vous voyez est ce que vous faites) et est exploité par les doigt. 2. les mobilités distales motorisées de l'effecteur doivent produire deux degrés de liberté (DDL) indépendants pour la flexion et la rotation de l'effecteur. Ce qui est suffisant pour des gestes SIG complexes. 3. ajouter une libre articulation à la poignée de l'instrument permet au chirurgien d'avoir une posture ergonomique. 4. un trocart actif permettrait la rotation de l'arbre de l'instrument avec un joint libre. Cette recherche a également permis le développement d'un prototype de validation de concept. Le prototype a été testé avec succès, in vitro et in vivo sur un modèle porcin

Dexterous Serial Comanipulation for Minimally Invasive Surgery

Une chirurgie minimalement invasive (CMI), qui implique généralement une caméra endoscopique et des instruments de laparoscopie, peut sembler être la procédure chirurgicale idéale pour ses avantages apparents. Toutefois, en comparaison à la chirurgie ouverte, les limites spatiales et outils mécaniques posés sur les chirurgiens sont si élevés que, souvent, la CMI est abandonné pour des cas complexes et même quand elle est possible, la procédure nécessite une grande dextérité, calibre et expérience du chirurgien. Cette recherche a été motivée par la nécessité d'habiles instruments chirurgicaux qui offrent un contrôle intuitif et une interface ergonomique, avec l'objectif final de développer un instrument robotisé adapté aux interventions par laparoscopie. La recherche a été basée sur l'évaluation comparative des différentes interfaces, modes de contrôle et cinématiques, en utilisant un simulateur de réalité virtuelle, développée spécialement à cet effet. Les résultats montrent que: 1. l'interface optimale a un mode de contrôle WYSIWYD (ce que vous voyez est ce que vous faites) et est exploité par les doigt. 2. les mobilités distales motorisées de l'effecteur doivent produire deux degrés de liberté (DDL) indépendants pour la flexion et la rotation de l'effecteur. Ce qui est suffisant pour des gestes SIG complexes. 3. ajouter une libre articulation à la poignée de l instrument permet au chirurgien d'avoir une posture ergonomique. 4. un trocart actif permettrait la rotation de l'arbre de l instrument avec un joint libre. Cette recherche a également permis le développement d'un prototype de validation de concept. Le prototype a été testé avec succès, in vitro et in vivo sur un modèle porcin.A minimally invasive surgery, which typically involves endoscopic camera and laparoscopic instruments, may seem to be the ideal surgical procedure for its apparent benefits. However, in comparison to open surgeries, the spatial and mechanical tool limitations posed on surgeons are so high that often MIS is foregone for complex cases and even when it is possible, the procedure requires a high dexterity, caliber and experience from the surgeon. This research was motivated by the need for dexterous surgical instruments that offer an intuitive control and an ergonomic interface, with the final objective of developing a suitable robotic hand-held surgical device for laparoscopic interventions. The research was based on comparative evaluation of different interfaces, control modes and kinematics, using a virtual reality simulator, developed specially for this purpose. The results show that: 1. The optimal interface has a WYSIWYD (what you see is what you do) control mode and is finger-operated. 2. The optimal distal motorized mobilities of the end-effector produce two independent DOF for exion and rotation of the end-effector which are sufficient for complex MIS gestures. 3. Adding a free articulation to the instrument's handle allows the surgeon to have an ergonomic posture. 4. An active trocar makes the rotation of the shaft with a free joint possible. This research also resulted in the development of a proof-of-concept prototype. The prototype was tested successfully, in vitro and in vivo on a porcine model.PARIS-BIUSJ-Biologie recherche (751052107) / SudocSudocFranceF

Covariance tracking: architecture optimizations for embedded systems

International audienceCovariance matching techniques have recently grown in interest due to their good performances for object retrieval, detection, and tracking. By mixing color and texture information in a compact representation, it can be applied to various kinds of objects (textured or not, rigid or not). Unfortunately, the original version requires heavy computations and is difficult to execute in real time on embedded systems. This article presents a review on different versions of the algorithm and its various applications; our aim is to describe the most crucial challenges and particularities that appeared when implementing and optimizing the covariance matching algorithm on a variety of desktop processors and on low-power processors suitable for embedded systems. An application of texture classification is used to compare different versions of the region descriptor. Then a comprehensive study is made to reach a higher level of performance on multi-core CPU architectures by comparing different ways to structure the information, using single instruction, multiple data (SIMD) instructions and advanced loop transformations. The execution time is reduced significantly on two dual-core CPU architectures for embedded computing: ARM Cortex-A9 and Cortex-A15 and Intel Penryn-M U9300 and Haswell-M 4650U. According to our experiments on covariance tracking, it is possible to reach a speedup greater than ×2 on both ARM and Intel architectures, when compared to the original algorithm, leading to real-time execution

Toward the Development of a Hand-Held Surgical Robot for Laparoscopy

Minimally invasive surgery (MIS), which typically involves endoscopic camera and laparoscopic instruments may seem to be the ideal surgical procedure for its apparent benefits. However, in comparison to open surgeries, the spatial and mechanical tool limitations posed on surgeons are so high that often MIS is foregone for complex cases and even when it is possible, the procedure requires a high dexterity, caliber, and experience from the surgeon. Particularly, suturing procedure through MIS is known to be extremely challenging. We are working toward the development of a robotic hand-held surgical device for laparoscopic interventions that enhances the surgeons' dexterity. The instrument produces two independent DOFs, which is sufficient for enabling MIS suturing procedure in vivo. The end-effector's orientation is controlled by an intuitive and ergonomic controller and its position is controlled directly by the surgeon. Different control modes, handles, and end-effector kinematics are primarily evaluated using a virtual reality simulator before choosing the best combination. A proof-of-concept prototype of the device has been developed

Robotic Hand-Held Surgical Device: Evaluation of End-Effector's Kinematics and Development of Proof-of-Concept Prototypes

We are working towards the development of a robotic hand-held surgical device for laparoscopic interventions that enhances the surgeons' dexterity. In this paper, the kinematics of the end effector is studied. Different choices of kinematics are compared during an evaluation campaign using a virtual reality simulator to find the optimal one: the Yaw-Roll (YR) kinematics. A proof of concept prototype is made based on the results

An articulated handle to improve the ergonomic performance of robotic dextrous instruments for laparoscopic surgery

Hand-held robotic instruments with dextrous end-effectors offer increased accessibility and gesture precision in minimally invasive laparoscopic surgery. They combine advantages of both intuitive but large, complex, and expensive telesurgery systems, and much cheaper but less user-friendly steerable mechanical instruments. However, the ergonomics of such instruments still needs to be improved in order to decrease surgeon discomfort. Based on the results of former experimental studies, a handle connected to the instrument shaft through a lockable ball joint was designed. An experimental assessment of ergonomic and gesture performance was performed on a custom-made virtual reality simulator. Results show that this solution improves ergonomics, demanding less wrist flexion and deviation and elbow elevation, while providing gesture performance similar to a robotic dextrous instrument with standard pistol-like handle configuration

Real-time covariance tracking architecture optimizations for embedded systems

International audienceCovariance matching techniques have recently grown in interest due to their good performances for object retrieval, detection and tracking. By mixing color and texture information in a compact representation, it can be applied to various kinds of objects (textured or not, rigid motion or not).Unfortunately, the original version requires heavy computations, and is difficult to execute in real-time. This article presents a review on different versions of the algorithm and the variousapplications. Then, a comprehensive study is made to reach highest acceleration rates, by comparing different ways to structure the information, using specialized instructions and parallel programming. The execution time is reduced significantly on different multi-core CPU architectures for embedded computing: Panda Board ARM Cortex 9 and an Intel Ultra Low voltage U9300. According to our experiments on Covariance Tracking (CT), it is possible to reach a speed-up of 3.75 on ARM Cortex and 5 on Intel, when compared to the original algorithm

Mechatronic design of a hand-held instrument with active trocar for taparoscopy

Instruments used in many types of minimally invasive procedures, in particular laparoscopy, are rigid or only limitedly flexible and some tasks like suturing are difficult to perform with them. A novel hand-held, lightweight and ergonomic mechatronic instrument is presented in this paper. The instrument has a 3-DOF roll-pitch-roll end-effector controlled using an easy to use handle that provides the surgeon with a 6-DOF movement, including a distal circular movement which resembles the circular movement of stitching. The design of the instrument is based on a global study involving control, dexterity and ergonomic aspects, with the aim of developing an instrument that enhances the dexterity of the surgeon while having an intuitive and ergonomic interface. A proof of concept prototype was built and tested in vitro and in vivo

Improving the inventory levels of a blood supply chain through system dynamic simulation

The blood supply chain is a complex system with a multi-echelon structure. Hence, the integration of various interconnected elements, which should be synchronized appropriately, is a necessity to meet the patients' requirements. The performance of the blood supply chain is a function of different variables that are dependent of each other. Therefore, the main aim of the chain is the optimization of the overall supply chain by considering the dynamic behavior of the system. The purpose of this study is to develop a system dynamic simulation model for a complex blood supply chain in order to improve the average level of inventories. The developed model is based on three echelons with a centrality on a regional blood center. The performance of the supply chain network in the current condition is investigated and based on the objectives, 17 scenarios were experimented for improving the average level of inventories to avoid outdates while there are not any backlogged orders. In addition, the best values of the investigated parameters (safety stock, supplier preparing lead time, in transit time and separation time) were determined

Ergonomic and Gesture Performance of Robotized Instruments for Laparoscopic Surgery

IEEE/RSJ International Conference on Intelligent Robots and Systems, San Francisco, CA, SEP 25-30, 2011International audienceShape and mechanical structure of instruments play a large part in the lack of ergonomics during laparoscopic surgery. Providing intra-abdominal mobility and rethinking handles design are two solutions to increase comfort and precision of gestures. Based on previous work that determined the optimal intra-abdominal kinematics, this study analyses the influence of handle design on both gesture and ergonomic performance. A virtual reality laparoscopic simulator was developed to perform an experimental comparison between two novel robotized instruments and standard ones. A group of 10 surgeons and 6 researchers in robotics carried out two representative surgical tasks with each instrument. Based on instrument and arm segments tracking, a gesture performance index and an ergonomic performance index were computed. The study demonstrates that distal mobilities combined with improved handle design and integration increase ergonomic level during laparoscopy and facilitate complex gestures