Closed-Loop Active Compensation for Needle Deflection and Target Shift During Cooperatively Controlled Robotic Needle Insertion

Data-driven adaptive needle insertion assist for transperineal prostate interventions

Objective.Clinical outcomes of transperineal prostate interventions, such as biopsy, thermal ablations, and brachytherapy, depend on accurate needle placement for effectiveness. However, the accurate placement of a long needle, typically 150-200 mm in length, is challenging due to needle deviation induced by needle-tissue interaction. While several approaches for needle trajectory correction have been studied, many of them do not translate well to practical applications due to the use of specialized needles not yet approved for clinical use, or to relying on needle-tissue models that need to be tailored to individual patients.Approach.In this paper, we present a robot-assisted collaborative needle insertion method that only requires an actuated passive needle guide and a conventional needle. The method is designed to assist a physician inserting a needle manually through a needle guide. If the needle is deviated from the intended path, actuators shifts the needle radially in order to steer the needle trajectory and compensate for needle deviation adaptively. The needle guide is controlled by a new data-driven algorithm which does not requirea prioriinformation about needle or tissue properties. The method was evaluated in experiments with bothin vitroandex vivophantoms.Main results.The experiments inex vivotissue reported a mean final placement error of 0.36 mm with a reduction of 96.25% of placement error when compared to insertions without the use of assistive correction.Significance.Presented results show that the proposed closed-loop formulation can be successfully used to correct needle deflection during collaborative manual insertion with potential to be easily translated into clinical application.

Review of research on path planning and control methods of flexible steerable needle puncture robot

In the field of minimally invasive interventional therapy, the related research on the soft tissue puncture robot and its technology based on the flexible steerable needle as a research hot topic at present, and it has been developed rapidly in the past ten years. In order to better understand the development status of the flexible steerable needle puncture (FSNP) robot and provide reference for its design and improvement in subsequent research, it is necessary to introduce in two aspects of FSNP robot: the puncture path planning and the control methods. First, this article introduced the concept of the FSNP technology, and the necessity of the application of FSNP soft tissue robot in minimally invasive interventional surgery. Second, this article mainly introduced the principle of FSNP, the path planning of FSNP, the navigation and positioning control of the needle tip of the flexible steerable needle, the control method of FSNP system, and the controllable flexible needle. Finally, combined with the above analysis and introduction, it was pointed out that FSNP soft tissue robot and its related technology would be an important development direction in the field of minimally invasive interventional therapy in the future, and the current existing problems were pointed out. Meanwhile, the development trend of FSNP robot control technology was summarized and prospected.

Design and validation of a medical robotic device system to control two collaborative robots for ultrasound-guided needle insertions

The percutaneous biopsy is a critical intervention for diagnosis and staging in cancer therapy. Robotic systems can improve the efficiency and outcome of such procedures while alleviating stress for physicians and patients. However, the high complexity of operation and the limited possibilities for robotic integration in the operating room (OR) decrease user acceptance and the number of deployed robots. Collaborative systems and standardized device communication may provide approaches to overcome named problems. Derived from the IEEE 11073 SDC standard terminology of medical device systems, we designed and validated a medical robotic device system (MERODES) to access and control a collaborative setup of two KUKA robots for ultrasound-guided needle insertions. The system is based on a novel standard for service-oriented device connectivity and utilizes collaborative principles to enhance user experience. Implementing separated workflow applications allows for a flexible system setup and configuration. The system was validated in three separate test scenarios to measure accuracies for 1) co-registration, 2) needle target planning in a water bath and 3) in an abdominal phantom. The co-registration accuracy averaged 0.94 ± 0.42 mm. The positioning errors ranged from 0.86 ± 0.42 to 1.19 ± 0.70 mm in the water bath setup and from 1.69 ± 0.92 to 1.96 ± 0.86 mm in the phantom. The presented results serve as a proof-of-concept and add to the current state of the art to alleviate system deployment and fast configuration for percutaneous robotic interventions.

Study of the surgical needle and biological soft tissue interaction phenomenon during insertion process for medical application: A Survey

The insertion of the surgical needle in soft tissue has involved significant interest in the current time because of its purpose in minimally invasive surgery (MIS) and percutaneous events like biopsies, PCNL, and brachytherapy. This study represents a review of the existing condition of investigation on insertion of a surgical needle in biological living soft tissue material. As observes the issue from numerous phases, like, analysis of the cutting forces modeling (insertion), tissue material deformation, analysis of the needle deflection for the period of the needle insertion, and the robot-controlled insertion procedures. All analysis confirms that the total needle insertion force is the total of dissimilar forces spread sideways the shaft of the insertion needle for example cutting force, stiffness force, and frictional force. Various investigations have analyzed all these kinds of forces during the needle insertion process. The force data in several measures are applied for recognizing the biological tissue materials as the needle is penetrated or for path planning. The deflection of the needle during insertion and tissue material deformation is the main trouble for defined needle placing and efforts have been prepared to model them. Applying existing models numerous insertion methods are established that are discussed in this review.

A robotic puncture system with optical and mechanical feedback under respiratory motion

Puncture robot can improve the accuracy and efficiency of puncture surgery, such as thoracoabdominal and liver puncture. However, as soft tissue is deformed and shifted under respiratory motion and during the puncture process, the needle is pulled, resulting in the needle's bending and deformation, which increases the risks and sufferings of the patient, a robotic puncture system with optical and mechanical feedback is necessary. Therefore, this paper proposes a multi-information sensing 'guide-clamp' end effector for puncture surgery to accurately detect the posture and force on the puncture needle in real time. And gravity bias method with trajectory planning and the compensational controlling model are also proposed to offset the interference of self-weight and achieve zero force following. This system is evaluated by the experiments of robot controlling and human tissue simulation and the results prove the excellent robustness of the system, which meet the clinical requirement.

State of the Art and Future Opportunities in MRI-Guided Robot-Assisted Surgery and Interventions

Magnetic resonance imaging (MRI) can provide high-quality 3-D visualization of target anatomy, surrounding tissue, and instrumentation, but there are significant challenges in harnessing it for effectively guiding interventional procedures. Challenges include the strong static magnetic field, rapidly switching magnetic field gradients, high-power radio frequency pulses, sensitivity to electrical noise, and constrained space to operate within the bore of the scanner. MRI has a number of advantages over other medical imaging modalities, including no ionizing radiation, excellent soft-tissue contrast that allows for visualization of tumors and other features that are not readily visible by other modalities, true 3-D imaging capabilities, including the ability to image arbitrary scan plane geometry or perform volumetric imaging, and capability for multimodality sensing, including diffusion, dynamic contrast, blood flow, blood oxygenation, temperature, and tracking of biomarkers. The use of robotic assistants within the MRI bore, alongside the patient during imaging, enables intraoperative MR imaging (iMRI) to guide a surgical intervention in a closed-loop fashion that can include tracking of tissue deformation and target motion, localization of instrumentation, and monitoring of therapy delivery. With the ever-expanding clinical use of MRI, MRI-compatible robotic systems have been heralded as a new approach to assist interventional procedures to allow physicians to treat patients more accurately and effectively. Deploying robotic systems inside the bore synergizes the visual capability of MRI and the manipulation capability of robotic assistance, resulting in a closed-loop surgery architecture. This article details the challenges and history of robotic systems intended to operate in an MRI environment and outlines promising clinical applications and associated state-of-the-art MRI-compatible robotic systems and technology for making this possible.

Experimental study of the optimum puncture pattern of robot-assisted needle insertion into hyperelastic materials

The robot-assisted insertion surgery plays a crucial role in biopsy and therapy. This study focuses on determining the optimum puncture pattern for robot-assisted insertion, aiming at the matching problem of needle insertion parameters, thereby to reduce the pain for patients and to improve the reachability to the lesion point. First, a 6-degrees of freedom (DOFs) Computed Tomography (CT)-guided surgical robotic system for minimally invasive percutaneous lung is developed and used to perform puncture experiments. The effects of four main insertion factors on the robotic puncture are verified by designing the orthogonal test, where the inserting object is the artificial skin-like specimen with high transparent property and a digital image processing method is used to analyze the needle tip deflection. Next, the various phases of puncture process are divided and analyzed in detail in view of the tissue deformation and puncture force. Then, short discussion on the comparison of puncture force with different effect factors for the same beveled needle is presented. The same pattern can be observed for all of the cases. Finally, based on the experimental data, the formulations of the puncture force and needle deflection which depends on Gauge size, insertion velocity, insertion angle, and insertion depth are developed using the multiple regression method, which can be used to get an optimum puncture pattern under the constrains of minimum peak force and minimum needle tip deflection. The developed models have the effectiveness and applicability on determining the optimum puncture pattern for one puncture event, and which can also provide insights useful for the setting of insertion parameters in clinical practice.

Lung and Abdominal Biopsies in the Age of Precision Medicine

Image-guided percutaneous needle biopsies (PNBs) are one of the most common procedures performed in radiology departments today. Rapid developments in precision medicine, which identifies molecular and genomic biomarkers in cancers, have ushered a new paradigm of oncologic workup and treatment. PNB has conventionally been used to establish a benign or malignant nature of a lesion during initial diagnosis or in suspected metastatic or recurrent disease. However, increasing amounts of tissue are being required to meet the demands of molecular pathologic analysis, which are now being sought at multiple time points during the course of the disease to guide targeted therapy. As primary providers of biopsy, radiologists must be proactive in these developments to improve diagnostic yield and tissue acquisition in PNB. Herein, we discuss the important and expanding role of PNB in the age of precision medicine and review the technical considerations of percutaneous lung and intra-abdominal biopsy. Finally, we examine promising state-of-the-art techniques in PNB that may safely increase tissue acquisition for optimal molecular pathologic analysis.