Minimization of needle deflection in robot-assisted percutaneous therapy

Sensorless motion planning for medical needle insertion in deformable tissues

Minimally invasive medical procedures such as biopsies, anesthesia drug injections, and brachytherapy cancer treatments require inserting a needle to a specific target inside soft tissues. This is difficult because needle insertion displaces and deforms the surrounding soft tissues causing the target to move during the procedure. To facilitate physician training and preoperative planning for these procedures, we develop a needle insertion motion planning system based on an interactive simulation of needle insertion in deformable tissues and numerical optimization to reduce placement error. We describe a 2-D physically based, dynamic simulation of needle insertion that uses a finite-element model of deformable soft tissues and models needle cutting and frictional forces along the needle shaft. The simulation offers guarantees on simulation stability for mesh modifications and achieves interactive, real-time performance on a standard PC. Using texture mapping, the simulation provides visualization comparable to ultrasound images that the physician would see during the procedure. We use the simulation as a component of a sensorless planning algorithm that uses numerical optimization to compute needle insertion offsets that compensate for tissue deformations. We apply the method to radioactive seed implantation during permanent seed prostate brachytherapy to minimize seed placement error.

Urologic robots and future directions

PURPOSE OF REVIEW

Robot-assisted laparoscopic surgery in urology has gained immense popularity with the daVinci system, but a lot of research teams are working on new robots. The purpose of this study is to review current urologic robots and present future development directions.

RECENT FINDINGS

Future systems are expected to advance in two directions: improvements of remote manipulation robots and developments of image-guided robots.

SUMMARY

The final goal of robots is to allow safer and more homogeneous outcomes with less variability of surgeon performance, as well as new tools to perform tasks on the basis of medical transcutaneous imaging, in a less invasive way, at lower costs. It is expected that improvements for a remote system could be augmented in reality, with haptic feedback, size reduction, and development of new tools for natural orifice translumenal endoscopic surgery. The paradigm of image-guided robots is close to clinical availability and the most advanced robots are presented with end-user technical assessments. It is also notable that the potential of robots lies much further ahead than the accomplishments of the daVinci system. The integration of imaging with robotics holds a substantial promise, because this can accomplish tasks otherwise impossible. Image-guided robots have the potential to offer a paradigm shift.

Compensating for Torsion Windup in Steerable Needles

Long, flexible, bevel-tip needles curve during insertion into tissue, and rotations of the needle base reorient the tip to steer subsequent insertions. Friction between the tissue and the needle shaft, however, can cause a severe discrepancy between the needle base and tip angles. In this paper, I demonstrate an algorithm to properly align the entire length of the needle using torque measured at the base. My algorithm uses several intermediate base rotations to align the orientation of points along the shaft with the desired angle, with minimal remaining torque exerted by the base. I performed an experimental validation with four angle sensors attached to the needle throughout the tissue. My compensation algorithm decreased the lag throughout the needle by up to 88%.