Optimizing Tube Precurvature to Enhance Elastic Stability of Concentric Tube Robots

A Telescopic Tendon-Driven Needle Robot for Minimally Invasive Neurosurgery

This paper presents the design, characterization, and testing of a steerable needle robot for minimally invasive neurosurgery. The robot consists of a rigid outer tube and two telescopic tendon-driven steerable tubes. Through the rotation, translation, and bending of individual tubes, this telescopic tendon-driven needle robot can perform dexterous motion and follow the path of the tip. We presented the design of the needle robot and its actuation system, modeling of the robotic kinematics, characterization of the robot motion, results of the open-loop kinematic control, and demonstration of the follow-the-leader motion. The position error of the robot tip is 0.92 mm, and follow-the-leader motion error is 1.1 mm. Due to its small footprint and unique motion ability, the robot has the potential to be manipulated inside human brain and used for minimally invasive neurosurgery.

Continuum Robots for Medical Interventions

Continuum robots are not constructed with discrete joints but, instead, change shape and position their tip by flexing along their entire length. Their narrow curvilinear shape makes them well suited to passing through body lumens, natural orifices, or small surgical incisions to perform minimally invasive procedures. Modeling and controlling these robots are, however, substantially more complex than traditional robots comprised of rigid links connected by discrete joints. Furthermore, there are many approaches to achieving robot flexure. Each presents its own design and modeling challenges, and to date, each has been pursued largely independently of the others. This article attempts to provide a unified summary of the state of the art of continuum robot architectures with respect to design for specific clinical applications. It also describes a unifying framework for modeling and controlling these systems while additionally explaining the elements unique to each architecture. The major research accomplishments are described for each topic and directions for the future progress needed to achieve widespread clinical use are identified.

Magnetic concentric tube robots: introduction and analysis

In this paper, we propose a new type of continuum robot, referred to as a magnetic concentric tube robot (M-CTR), for performing minimally invasive surgery in narrow and difficult-to-access areas. The robot combines concentric tubes and magnetic actuation to benefit from the ‘follow the leader’ behaviour, the dexterity and stability of existing robots, while targeting millimetre-sized external diameters. These three kinematic properties are assessed through numerical and experimental studies performed on a prototype of a M-CTR. They are performed with general forward and inverse kineto-static models of the robot, continuation and bifurcation analysis, and a specific experimental setup. The prototype presents unique capabilities in terms of deployment and active stability management, while its dexterity in terms of tip orientability is also among the best reported for other robots at its scale.

Targeting Epilepsy Through the Foremen Ovale: How Many Helical Needles are Needed?

Laser ablation of the hippocampus offers medically refractory epilepsy patients an alternative to invasive surgeries. Emerging commercial solutions deliver the ablator through a burr hole in the back of the head. We recently introduced a new access path through the foremen ovale, using a helical needle, which minimizes the amount of healthy brain tissue the needle must pass through on its way to the hippocampus, and also enables the needle to follow the medial axis of the hippocampus more closely. In this paper, we investigate whether helical needles should be designed and fabricated on a patient-specific basis as we had previously proposed, or whether a small collection of pre-defined needle shapes can apply across many patients. We propose a new optimization strategy to determine this needle set using patient data, and investigate the accuracy with which these needles can reach the the medial axis of the hippocampus. We find that three basic tube shapes (mirrored as necessary for left vs. right hippocampi) are all that is required, across 20 patient datasets (obtained from 10 patient CT scans), to reduce worst-case maximum error below 2 mm.

Eccentric Tube Robots as Multiarmed Steerable Sheaths

This paper presents a novel continuum robot sheath for use in single-port minimally invasive procedures such as neuroendoscopy in which the sheath is designed to deliver multiple robotic arms. Actuation of the sheath is achieved by using precurved superelastic tubes lining the working channels used for arm delivery. These tubes perform a similar role to push/pull tendons, but can accomplish shape change of the sheath via rotation. A kinematic model using Cosserat rod theory is derived which is based on modeling the system as a set of eccentrically aligned precurved tubes constrained along their length by an elastic backbone. The specific case of a two-arm sheath is considered in detail. Simulation and experiments are used to investigate the validate the concept and model.

Continuum Robot With Follow-the-Leader Motion for Endoscopic Third Ventriculostomy and Tumor Biopsy

BACKGROUND

In a combined endoscopic third ventriculostomy (ETV) and endoscopic tumor biopsy (ETB) procedure, an optimal tool trajectory is mandatory to minimize trauma to surrounding cerebral tissue.

OBJECTIVE

This paper presents wire-driven multi-section robot with push-pull wire. The robot is tested to attain follow-the-leader (FTL) motion to place surgical instruments through narrow passages while minimizing the trauma to tissues.

METHODS

A wire-driven continuum robot with six sub-sections was developed and its kinematic model was proposed to achieve FTL motion. An accuracy test to assess the robot's ability to attain FTL motion along a set of elementary curved trajectory was performed. We also used hydrocephalus ventricular model created from human subject data to generate five ETV/ETB trajectories and conducted a study assessing the accuracy of the FTL motion along these clinically desirable trajectories.

RESULTS

In the test with elementary curved paths, the maximal deviation of the robot was increased from 0.47 mm at 30 ° turn to 1.78 mm at 180 ° in a simple C-shaped curve. S-shaped FTL motion had lesser deviation ranging from 0.16 to 0.18 mm. In the phantom study, the greatest tip deviation was 1.45 mm, and the greatest path deviation was 1.23 mm.

CONCLUSION

We present the application of a continuum robot with FTL motion to perform a combined ETV/ETB procedure. The validation study using human subject data indicated that the accuracy of FTL motion is relatively high. The study indicated that FTL motion may be useful tool for combined ETV and ETB.

Modeling Tube Clearance and Bounding the Effect of Friction in Concentric Tube Robot Kinematics

The shape of a concentric tube robot depends not only on the relative rotations and translations of its constituent tubes, but also on the history of relative tube displacements. Existing mechanics-based models neglect all history-dependent phenomena with the result that when calibrated on experimental data collected over a robot's workspace, the maximum tip position error can exceed 8 mm for a 200-mm-long robot. In this paper, we develop a model that computes the bounding kinematic solutions in which Coulomb friction is acting either to maximize or minimize the relative twisting between each pair of contacting tubes. The path histories associated with these limiting cases correspond to first performing all tube translations and then performing relative tube rotations of sufficient angle so that the maximum Coulomb friction force is obtained along the interface of each contacting tube pair. The robot tip configurations produced by these path histories are shown experimentally to bound position error with respect to the estimated frictionless model compared to path histories comprised of translation or mixed translation and rotation. Intertube friction forces and torques are computed as proportional to the intertube contact forces. To compute these contact forces, the standard zero-clearance assumption that constrains the concentrically combined tubes to possess the same centerline is relaxed. The effects of clearance and friction are explored through numerical and physical experiments and it is shown that friction can explain much of the prediction error observed in existing models. This model is not intended for real-time control, but rather for path planning-to provide error bounds and to inform how the ordering of tube rotations and translations can be used to reduce the effect of friction.

Toward the Design of Personalized Continuum Surgical Robots

Robot-assisted minimally invasive surgical systems enable procedures with reduced pain, recovery time, and scarring compared to traditional surgery. While these improvements benefit a large number of patients, safe access to diseased sites is not always possible for specialized patient groups, including pediatric patients, due to their anatomical differences. We propose a patient-specific design paradigm that leverages the surgeon's expertise to design and fabricate robots based on preoperative medical images. The components of the patient-specific robot design process are a virtual reality design interface enabling the surgeon to design patient-specific tools, 3-D printing of these tools with a biodegradable polyester, and an actuation and control system for deployment. The designed robot is a concentric tube robot, a type of continuum robot constructed from precurved, elastic, nesting tubes. We demonstrate the overall patient-specific design workflow, from preoperative images to physical implementation, for an example clinical scenario: nonlinear renal access to a pediatric kidney. We also measure the system's behavior as it is deployed through real and artificial tissue. System integration and successful benchtop experiments in ex vivo liver and in a phantom patient model demonstrate the feasibility of using a patient-specific design workflow to plan, fabricate, and deploy personalized, flexible continuum robots.

Designing Stable Concentric Tube Robots Using Piecewise Straight Tubes

Concentric tube robots experience elastic instability when the potential energy stored in torsional twisting of the tubes is suddenly released. To date, ensuring stability for all possible rotational configurations has involved constraining the precurvatures and/or precurved lengths of the tubes comprising the robot, which results in limitations on robot curvature and workspace. This paper presents a design approach that eliminates the constraints on tube precurvature and length for stable rotation. The idea is to compose designs in which, at every point along the length of a robot, a single tube is precurved and the others are straight. The resulting designs do not experience any precurvature-induced torsional tube twisting and so are stable regardless of precurvature and length. This design concept can be usefully employed at the tip of a robot to provide a large stable range of tip orientation angles. A stability analysis is provided for designs composed of an arbitrary number of tubes and design rules are provided for tube pairs that can produce tip angles varying from zero to a desired maximum value. The method is validated experimentally for a tube pair comprised of three sections.