Stiffness Control of Surgical Continuum Manipulators

This paper introduces the first stiffness controller for continuum robots. The control law is based on an accurate approximation of a continuum robot’s coupled kinematic and static force model. To implement a desired tip stiffness, the controller drives the actuators to positions corresponding to a deflected robot configuration that produces the required tip force for the measured tip position. This approach provides several important advantages. First, it enables the use of robot deflection sensing as a means to both sense and control tip forces. Second, it enables stiffness control to be implemented by modification of existing continuum robot position controllers. The proposed controller is demonstrated experimentally in the context of a concentric tube robot. Results show that the stiffness controller achieves the desired stiffness in steady state, provides good dynamic performance, and exhibits stability during contact transitions

Beating-heart mitral valve chordal replacement

Replacing open-heart surgical procedures with beating-heart interventions substantially decreases the trauma and risk of a procedure. One of the most challenging procedures to perform on the beating heart is valve repair. To address this need, this paper proposes a tool for replacing mitral valve chordae to correct regurgitation. The chordae is secured to the papillary muscle and leaflet using NiTi tissue anchors that also incorporate an internal adjustment mechanism to enable initial adjustment as well as subsequent readjustment of chordae length. Efficacy of the proposed tool for chordae replacement and reduction of regurgitation was demonstrated in an ex-vivo heart simulator

Tubular structure enhancement for surgical instrument detection in 3D ultrasound

Three-dimensional ultrasound has been an effective imaging modality for diagnostics and is now an emerging modality for image-guided minimally-invasive interventions since it enables visualization of both instruments and tissue. Challenges to ultrasound-guided interventions arise, however, due to the low signal-to-noise ratio and the imaging artifacts created by the interventional instruments. Metallic instruments, in particular, are strong scatters and so produce a variety of artifacts. For many interventions, the manual or robotic instrument is comprised of a long curved tubular structure with specialized tooling at its tip. Toward the goal of developing a surgical navigation system, this paper proposes an image processing algorithm for enhancing the tubular structure of imaged instruments while also reducing imaging artifacts. Experiments are presented to evaluate the effectiveness of the approach in the context of robotic instruments whose shape comprises a smooth curve along their length

Passive Markers for Tracking Surgical Instruments in Real-Time 3-D Ultrasound Imaging

A family of passive echogenic markers is presented by which the position and orientation of a surgical instrument can be determined in a 3-D ultrasound volume, using simple image processing. Markers are attached near the distal end of the instrument so that they appear in the ultrasound volume along with the instrument tip. They are detected and measured within the ultrasound image, thus requiring no external tracking device. This approach facilitates imaging instruments and tissue simultaneously in ultrasound-guided interventions. Marker-based estimates of instrument pose can be used in augmented reality displays or for image-based servoing. Design principles for marker shapes are presented that ensure imaging system and measurement uniqueness constraints are met. An error analysis is included that can be used to guide marker design and which also establishes a lower bound on measurement uncertainty. Finally, examples of marker measurement and tracking algorithms are presented along with experimental validation of the concepts

Real-time position control of concentric tube robots

A novel approach to constructing robots is based on concentrically combining pre-curved elastic tubes. By rotating and extending the tubes with respect to each other, their curvatures interact elastically to position and orient the robot's tip, as well as to control the robot's shape along its length. Since these robots form slender curves, they are well suited for minimally invasive medical procedures. A substantial challenge to their practical use is the real-time solution of their kinematics that are described by differential equations with split boundary equations. This paper proposes a numerically efficient approach to real-time position control. It is shown that the forward kinematics are smooth functions that can be pre-computed and accurately approximated using Fourier series. The inverse kinematics can be solved in real time using root finding applied to the functional approximation. Experimental demonstration of real-time position control using this approach is also described

Algorithms for design of continuum robots using the concentric tubes approach: A neurosurgical example

We propose a novel systematic approach to optimizing the design of concentric tube robots for neurosurgical procedures. These procedures require that the robot approach specified target sites while navigating and operating within an anatomically constrained work space. The availability of preoperative imaging makes our approach particularly suited for neurosurgery, and we illustrate the method with the example of endoscopic choroid plexus ablation. A novel parameterization of the robot characteristics is used in conjunction with a global pattern search optimization method. The formulation returns the design of the least-complex robot capable of reaching single or multiple target points in a confined space with constrained optimization metrics. A particular advantage of this approach is that it identifies the need for either fixed-curvature versus variable-curvature sections. We demonstrate the performance of the method in four clinically relevant examples

Enabling automated magnetic resonance imaging-based targeting assessment during dipole field navigation

The magnetic navigation of drugs in the vascular network promises to increase the efficacy and reduce the secondary toxicity of cancer treatments by targeting tumors directly. Recently, dipole field navigation (DFN) was proposed as the first method achieving both high field and high navigation gradient strengths for whole-body interventions in deep tissues. This is achieved by introducing large ferromagnetic cores around the patient inside a magnetic resonance imaging (MRI) scanner. However, doing so distorts the static field inside the scanner, which prevents imaging during the intervention. This limitation constrains DFN to open-loop navigation, thus exposing the risk of a harmful toxicity in case of a navigation failure. Here, we are interested in periodically assessing drug targeting efficiency using MRI even in the presence of a core. We demonstrate, using a clinical scanner, that it is in fact possible to acquire, in specific regions around a core, images of sufficient quality to perform this task. We show that the core can be moved inside the scanner to a position minimizing the distortion effect in the region of interest for imaging. Moving the core can be done automatically using the gradient coils of the scanner, which then also enables the core to be repositioned to perform navigation to additional targets. The feasibility and potential of the approach are validated in an in vitro experiment demonstrating navigation and assessment at two targets

Robotics and imaging in congenital heart surgery

The initial success seen in adult cardiac surgery with the application of available robotic systems has not been realized as broadly in pediatric cardiac surgery. The main obstacles include extended set-up time and complexity of the procedures, as well as the large size of the instruments with respect to the size of the child. Moreover, while the main advantage of robotic systems is the ability to minimize incision size, for intracardiac repairs, cardiopulmonary bypass is still required. Catheter-based interventions, on the other hand, have expanded rapidly in both application as well as the complexity of procedures and lesions being treated. However, despite the development of sophisticated devices, robotic systems to aid catheter procedures have not been commonly applied in children. In this article, we describe new catheter-like robotic delivery platforms, which facilitate safe navigation and enable complex repairs, such as tissue approximation and fixation, and tissue removal, inside the beating heart. Additional features including the tracking of rapidly moving tissue targets and novel imaging approaches are described, along with a discussion of future prospects for steerable robotic systems

Real-time adaptive kinematic model estimation of concentric tube robots

Kinematic models of concentric tube robots have matured from considering only tube bending to considering tube twisting as well as external loading. While these models have been demonstrated to approximate actual behavior, modeling error can be significant for medical applications that often call for positioning accuracy of 1–2mm. As an alternative to moving to more complex models, this paper proposes using sensing to adaptively update model parameters during robot operation. Advantages of this method are that the model is constantly tuning itself to provide high accuracy in the region of the workspace where it is currently operating. It also adapts automatically to changes in robot shape and compliance associated with the insertion and removal of tools through its lumen. As an initial exploration of this approach, a recursive on-line estimator is proposed and evaluated experimentally

A general method for manipulating DNA sequences from any organism with optical tweezers

Mechanical manipulation of single DNA molecules can provide novel information about DNA properties and protein–DNA interactions. Here we describe and characterize a useful method for manipulating desired DNA sequences from any organism with optical tweezers. Molecules are produced from either genomic or cloned DNA by PCR using labeled primers and are tethered between two optically trapped microspheres. We demonstrate that human, insect, plant, bacterial and viral sequences ranging from ∼10 to 40 kilobasepairs can be manipulated. Force-extension measurements show that these constructs exhibit uniform elastic properties in accord with the expected contour lengths for the targeted sequences. Detailed protocols for preparing and manipulating these molecules are presented, and tethering efficiency is characterized as a function of DNA concentration, ionic strength and pH. Attachment strength is characterized by measuring the unbinding time as a function of applied force. An alternative stronger attachment method using an amino–carboxyl linkage, which allows for reliable DNA overstretching, is also described