Force Modeling, Identification, and Feedback Control of Robot-Assisted Needle Insertion: A Survey of the Literature

Design of a wasp-inspired biopsy needle capable of self-propulsion and friction-based tissue transport

Percutaneous pancreatic core biopsy is conclusive but challenging due to large-diameter needles, while smaller-diameter needles used in aspiration methods suffer from buckling and clogging. Inspired by the ovipositor of parasitic wasps, which resists buckling through self-propulsion and prevents clogging via friction-based transport, research has led to the integration of these functionalities into multi-segment needle designs or tissue transport system designs. This study aimed to combine these wasp-inspired functionalities into a single biopsy needle by changing the interconnection of the needle segments. The resulting biopsy needle features six parallel needle segments interconnected by a ring passing through slots along the length of the needle segments, enabling a wasp-inspired reciprocating motion. Actuation employs a cam and follower mechanism for controlled translation of the segments. The needle prototype, constructed from nitinol rods and stainless steel rings, measures 3 mm in outer diameter and 1 mm in inner diameter. Testing in gelatin phantoms demonstrated efficient gelatin core transport (up to 69.9% ± 9.1% transport efficiency) and self-propulsion (0.842 ± 0.042 slip ratio). Future iterations should aim to reduce the outer diameter while maintaining tissue yield. The design offers a promising new avenue for wasp-inspired medical tools, potentially enhancing early pancreatic cancer detection, thus reducing healthcare costs and patient complications.

A Generalized Tracking Wall Approach to the Haptic Simulation of Tip Forces During Needle Insertion

Haptic simulation of needle insertion requires both a needle-tissue interaction model and a method to render the outputs of this model into real-time force feedback for the user. In comparison with interaction models, rendering methods in the literature have seen little development and are either oversimplified or too computationally complex. Therefore, this study introduces the Generalized Tracking Wall (GTW) approach, a haptic rendering method inspired by the proxy approach. It aims to accurately simulate the interaction between a needle tip and soft tissues without the complex calculations of tissue deformations. The essence of the proposed method is that it associates an algorithm based on the energetic analysis of cutting with a contact model capable of simulating viscoelasticity and nonlinearity. This association proved to be a potent tool to faithfully replicate the different phases of needle insertion while adhering to underlying physics. Multi-layered-tissue insertions are also considered. The performance and generecity of the GTW are first evaluated through simulations. Then, the GTW is experimentally compared to empirical methods inspired by the literature.

Design and Evaluation of Augmented Reality-Enhanced Robotic System for Epidural Interventions

The epidural injection is a medical intervention to inject therapeutics directly into the vicinity of the spinal cord for pain management. Because of its proximity to the spinal cord, imprecise insertion of the needle may result in irreversible damage to the nerves or spinal cord. This study explores enhancing procedural accuracy by integrating a telerobotic system and augmented reality (AR) assistance. Tele-kinesthesia is achieved using a leader-follower integrated system, and stable force feedback is provided using a novel impedance-matching force rendering approach. In this domain, augmented reality employs a magnetic-tracker-based approach for real-time 3D model projection onto the patient's body, aiming to augment the physician's visual field and improve needle insertion accuracy. Preliminary results indicate that our AR-enhanced robotic system may reduce the cognitive load and improve the accuracy of ENI, highlighting the promise of AR technologies in complex medical procedures. However, further studies with larger sample sizes and more diverse clinical settings must comprehensively validate these findings. This work lays the groundwork for future research into integrating AR into medical robotics, potentially transforming clinical practices by enhancing procedural safety and efficiency.

TransVFS: A spatio-temporal local-global transformer for vision-based force sensing during ultrasound-guided prostate biopsy

Robot-assisted prostate biopsy is a new technology to diagnose prostate cancer, but its safety is influenced by the inability of robots to sense the tool-tissue interaction force accurately during biopsy. Recently, vision based force sensing (VFS) provides a potential solution to this issue by utilizing image sequences to infer the interaction force. However, the existing mainstream VFS methods cannot realize the accurate force sensing due to the adoption of convolutional or recurrent neural network to learn deformation from the optical images and some of these methods are not efficient especially when the recurrent convolutional operations are involved. This paper has presented a Transformer based VFS (TransVFS) method by leveraging ultrasound volume sequences acquired during prostate biopsy. The TransVFS method uses a spatio-temporal local-global Transformer to capture the local image details and the global dependency simultaneously to learn prostate deformations for force estimation. Distinctively, our method explores both the spatial and temporal attention mechanisms for image feature learning, thereby addressing the influence of the low ultrasound image resolution and the unclear prostate boundary on the accurate force estimation. Meanwhile, the two efficient local-global attention modules are introduced to reduce 4D spatio-temporal computation burden by utilizing the factorized spatio-temporal processing strategy, thereby facilitating the fast force estimation. Experiments on prostate phantom and beagle dogs show that our method significantly outperforms existing VFS methods and other spatio-temporal Transformer models. The TransVFS method surpasses the most competitive compared method ResNet3dGRU by providing the mean absolute errors of force estimation, i.e., 70.4 ± 60.0 millinewton (mN) vs 123.7 ± 95.6 mN, on the transabdominal ultrasound dataset of dogs.

Assessment of needle-tissue force models based on ex vivo measurements

Needle insertion is one of the most common procedures in clinical practice. Existing statistics reveal that success rates of needle insertions can be low, leading to potential complications and patient discomfort. Real-time imaging techniques like ultrasound and X-ray can assist in improving precision, but even experienced practitioners may face challenges in visualizing the needle tip. Researchers have proposed models of force interactions during needle insertions into biological tissue to enhance accuracy. This article presents an evaluation of the forces acting on intravenous needles during insertion into skin. The aim was to explore mathematical models, compare them with data from tests on animal specimens, and select the most suitable model for future research. The experimental setup involved conducting needle insertion tests on animal-originated cadavers, using the Brucker Universal Mechanical Tester device, which measured the force response during vertical movement of the needle. The research was divided into 2 stages. In Stage I, force measurements were recorded for both the insertion and extraction phases of the hypodermic needles. The measurements were conducted for several different needle sizes, speed and insertion angles. In Stage II, five different models were examined to determine how well they matched the experimental data. Based on the analysis of fit quality coefficients, the Gordon's exponential model was identified as the best fit to the measured data. The influence of needle size, insertion angle, and insertion speed on the measured force values was confirmed. Different insertion speeds revealed the viscoelastic properties of the tested samples. The presence of the skin layer affected the puncture force and force values for subsequent layers.

Study of Tissue Damage Induced by Insertion of Composite-Coated Needle

Medical interventions have significantly progressed in developing minimally invasive techniques like percutaneous procedures. These procedures include biopsy and internal radiation therapy, where a needle or needle-like medical device is inserted through the skin to access a target inside the body. Ensuring accurate needle insertion and minimizing tissue-damage or cracks are critical in these procedures. This research aims to examine the coated needle effect on the force required to insert the needle (i.e., insertion force) and on tissue-damage during needle insertion into the bovine kidney. Reducing the needle insertion force, which is influenced by needle surface friction, generally results in a reduction in tissue-damage. Surgical needles were coated with a composite material, combining Polytetrafluoroethylene, Polydopamine, and Activated Carbon. Force measurement during needle insertion and a histological study to determine tissue-damage were conducted to evaluate the effectiveness of the coating. The insertion force was reduced by 49 % in the case of the coated needles. Furthermore, a histological analysis comparing tissue-damage resulting from coated and uncoated needles revealed an average 39 % reduction in tissue-damage with the use of coated needles. The results of this study demonstrate the potential of coated needles to enhance needle insertion and safety during percutaneous procedures.

Design of a locust leg-like compliant constant-force mechanism supporting large-scale damage-free manipulation

Precision manipulation is plays an increasingly crucial role in bioengineering fields such as cell injection. Due to the specificity of the operational process, which is highly susceptible and damageable by the actuated force, millimeter-level nondestructive operations are gaining more and more attention. With this, a symmetrical compliant constant-force mechanism (CCFM) is developed to provide stable and large motion stroke for damage-free precision manipulation in this paper. The mechanism design is inspired by the legs of the locust, which flexes and folds when the locust jumps. In terms of structure design, double biomimetic diamond beams are used to generate positive and negative stiffness. A crossbeam is added to the internal diamond mechanism, which flexes during movement to provide negative stiffness, while the external diamond mechanism without additional constraint provides positive stiffness. The theoretical model of this CCFM is established to analyze its force-displacement relationship, which is verified by performing finite element analysis simulations and experimental studies. Meanwhile, a parametric study is conducted to investigate the influence of the dominant design variable of the CCFM. Finally, the test results show that the CCFM can generate motion range up to 5 mm with a constant output force ∼15.2 N. The developed CCFM has potential applications in the field of manipulation techniques of cell engineering and robotics in the future.

Simultaneous Online Registration-Independent Stiffness Identification and Tip Localization of Surgical Instruments in Robot-assisted Eye Surgery

Notable challenges during retinal surgery lend themselves to robotic assistance which has proven beneficial in providing a safe steady-hand manipulation. Efficient assistance from the robots heavily relies on accurate sensing of surgery states (e.g. instrument tip localization and tool-to-tissue interaction forces). Many of the existing tool tip localization methods require preoperative frame registrations or instrument calibrations. In this study using an iterative approach and by combining vision and force-based methods, we develop calibration- and registration-independent (RI) algorithms to provide online estimates of instrument stiffness (least squares and adaptive). The estimations are then combined with a state-space model based on the forward kinematics (FWK) of the Steady-Hand Eye Robot (SHER) and Fiber Brag Grating (FBG) sensor measurements. This is accomplished using a Kalman Filtering (KF) approach to improve the deflected instrument tip position estimations during robot-assisted eye surgery. The conducted experiments demonstrate that when the online RI stiffness estimations are used, the instrument tip localization results surpass those obtained from pre-operative offline calibrations for stiffness.

Lung nodule pre-diagnosis and insertion path planning for chest CT images

Medical image processing has proven to be effective and feasible for assisting oncologists in diagnosing lung, thyroid, and other cancers, especially at early stage. However, there is no reliable method for the recognition, screening, classification, and detection of nodules, and even deep learning-based methods have limitations. In this study, we mainly explored the automatic pre-diagnosis of lung nodules with the aim of accurately identifying nodules in chest CT images, regardless of the benign and malignant nodules, and the insertion path planning of suspected malignant nodules, used for further diagnosis by robotic-based biopsy puncture. The overall process included lung parenchyma segmentation, classification and pre-diagnosis, 3-D reconstruction and path planning, and experimental verification. First, accurate lung parenchyma segmentation in chest CT images was achieved using digital image processing technologies, such as adaptive gray threshold, connected area labeling, and mathematical morphological boundary repair. Multi-feature weight assignment was then adopted to establish a multi-level classification criterion to complete the classification and pre-diagnosis of pulmonary nodules. Next, 3-D reconstruction of lung regions was performed using voxelization, and on its basis, a feasible local optimal insertion path with an insertion point could be found by avoiding sternums and/or key tissues in terms of the needle-inserting path. Finally, CT images of 900 patients from Lung Image Database Consortium and Image Database Resource Initiative were chosen to verify the validity of pulmonary nodule diagnosis. Our previously designed surgical robotic system and a custom thoracic model were used to validate the effectiveness of the insertion path. This work can not only assist doctors in completing the pre-diagnosis of pulmonary nodules but also provide a reference for clinical biopsy puncture of suspected malignant nodules considered by doctors.

Optical force estimation for interactions between tool and soft tissues

Robotic assistance in minimally invasive surgery offers numerous advantages for both patient and surgeon. However, the lack of force feedback in robotic surgery is a major limitation, and accurately estimating tool-tissue interaction forces remains a challenge. Image-based force estimation offers a promising solution without the need to integrate sensors into surgical tools. In this indirect approach, interaction forces are derived from the observed deformation, with learning-based methods improving accuracy and real-time capability. However, the relationship between deformation and force is determined by the stiffness of the tissue. Consequently, both deformation and local tissue properties must be observed for an approach applicable to heterogeneous tissue. In this work, we use optical coherence tomography, which can combine the detection of tissue deformation with shear wave elastography in a single modality. We present a multi-input deep learning network for processing of local elasticity estimates and volumetric image data. Our results demonstrate that accounting for elastic properties is critical for accurate image-based force estimation across different tissue types and properties. Joint processing of local elasticity information yields the best performance throughout our phantom study. Furthermore, we test our approach on soft tissue samples that were not present during training and show that generalization to other tissue properties is possible.

Experimental study of mosquito-inspired needle to minimize insertion force and tissue deformation

The aim of this work is to propose a mosquito-inspired (bioinspired) design of a surgical needle that can decrease the insertion force and the tissue deformation, which are the main causes of target inaccuracy during percutaneous procedures. The bioinspired needle was developed by mimicking the geometrical shapes of mosquito proboscis. Needle prototypes were manufactured and tested to determine optimized needle shapes and geometries. Needle insertion tests on a tissue-mimicking polyvinylchloride (PVC) gel were then performed to emulate the mosquito-proboscis stinging dynamics by applying vibration and insertion velocity during the insertion. An insertion test setup equipped with a sensing system was constructed to measure the insertion force and to assess the deformation of the tissue. It was discovered that using the proposed bioinspired design, the needle insertion force was decreased by 60% and the tissue deformation was reduced by 48%. This finding is significant for improving needle-based medical procedures.

A Transparent Teleoperated Robotic Surgical System with Predictive Haptic Feedback and Force Modelling

In recent years, robotic minimally invasive surgery has transformed many types of surgical procedures and improved their outcomes. Implementing effective haptic feedback into a teleoperated robotic surgical system presents a significant challenge due to the trade-off between transparency and stability caused by system communication time delays. In this paper, these time delays are mitigated by implementing an environment estimation and force prediction methodology into an experimental robotic minimally invasive surgical system. At the slave, an exponentially weighted recursive least squares (EWRLS) algorithm estimates the respective parameters of the Kelvin-Voigt (KV) and Hunt-Crossley (HC) force models. The master then provides force feedback by interacting with a virtual environment via the estimated parameters. Palpation experiments were conducted with the slave in contact with polyurethane foam during human-in-the-loop teleoperation. The experimental results indicated that the prediction RMSE of error between predicted master force feedback and measured slave force was reduced to 0.076 N for the Hunt-Crossley virtual environment, compared to 0.356 N for the Kelvin-Voigt virtual environment and 0.560 N for the direct force feedback methodology. The results also demonstrated that the HC force model is well suited to provide accurate haptic feedback, particularly when there is a delay between the master and slave kinematics. Furthermore, a haptic feedback approach that incorporates environment estimation and force prediction improve transparency during teleoperation. In conclusion, the proposed bilateral master-slave robotic system has the potential to provide transparent and stable haptic feedback to the surgeon in surgical robotics procedures.

FPGA Applied to Latency Reduction for the Tactile Internet

Tactile internet applications allow robotic devices to be remotely controlled over a communication medium with an unnoticeable time delay. In bilateral communication, the acceptable round trip latency is usually 1 ms up to 10 ms, depending on the application requirements. The communication network is estimated to generate 70% of the total latency, and master and slave devices produce the remaining 30%. Thus, this paper proposes a strategy to reduce 30% of the total latency produced by such devices. The strategy is to use FPGAs to minimize the execution time of device-associated algorithms. With this in mind, this work presents a new hardware reference model for modules that implement nonlinear positioning and force calculations and a tactile system formed by two robotic manipulators. In addition to presenting the implementation details, simulations and experimental tests are performed in order to validate the hardware proposed model. Results associated with the FPGA sampling rate, throughput, latency, and post-synthesis occupancy area are analyzed.

Reinforcing the effect of microsurgery practice during robotic suturing skill acquisition

BACKGROUND

This study aimed to examine the effectiveness of microsurgery practice during an interval in robotic surgical training.

METHODS

Two participant groups with 30 trainees each practiced Thread the Rings 1 on a dV-Trainer. There were four 2-h training sessions, with a 72-h interval between each session. Group A received no additional training during the study period. During every interval, Group B practiced a similar 2-h ring penetration exercise using a microscope three times (once every 24 h).

RESULTS

The 72-h delay between two sessions for Group A caused the forgetting effect. For Group B, additional microscope-based training aided memory retention. After the training session, Group B presented a significantly higher score than Group A in Thread the Ring 1 learning curves.

CONCLUSIONS

Adding microsurgical skill training into the basic robotic-surgery training curriculum could be helpful because additional trainings with a binocular microscope could improve robotic surgical skill levels.

Design of a seed implantation robot with counterbalance and soft tissue stabilization mechanism for prostate cancer brachytherapy

This article focuses on the topic of the structural design of surgical radioactive surgery robot for prostate cancer. To improve the weight-to-payload ratio of surgery robot end-effector, the energy consumption and stability of robot joint drive and reducing the displacement and deformation of needle insertion in soft tissue. This article discusses the new static torque balancing method and multi-needle insertion soft tissue stabilization mechanisms that may be used in previously articulated seed implantation robots. Compared with the existing balancing system schemes, we adopt the idea of mutual conversion of gravitational potential energy and elastic potential energy and establish a static balancing model. With preloaded displacement parameter of the spring α, the variable gravity torque balance of robot arm can be achieved. Torque and equivalent gravity balancing distribution with the spring balance system and the quantitative evaluation experiment were performed, and experiment results provide evidence that these spring balance devices can basically compensate the gravity torque of the robot arm. In addition, we used nonlinear spring–damper model to establish multi-needles insertion soft tissue force model. Then, a variable multi-needle insertion soft tissue stabilization device is designed with six working modes. The innovative design of this device is the use of the first four needles that are introduced simultaneously on either side of the midline. Initially completed displacement simulation of different numbers of needle insertion prostate tissue, experiment results indicate that multi-needle puncture mechanism could reduce prostate displacement in the y- or z-direction. By this method, the prostate may be fixed, thus this mechanism maybe reduces rotation of the prostate and enabling subsequent needles to be inserted accurately.

Study on an Integral Algorithm of Load Identification Based on Displacement Response

Load identification is a very important and challenging indirect load measurement method because load identification is an inverse problem solution with ill-conditioned characteristics. A new method of load identification is proposed here, in which a virtual function was introduced to establish integral structure equations of motion, and partial integration was applied to reduce the response types in the equations. The effects of loading duration, the type of basis function, and the number of basis function expansion items on the calculation efficiency and the accuracy of load identification were comprehensively taken into account. Numerical simulation and experimental results showed that our algorithm could not only effectively identify periodic and random loads, but there was also a trade-off between the calculation efficiency and identification accuracy. Additionally, our algorithm can improve the ill-conditionedness of the solution of load identification equations, has better robustness to noise, and has high computational efficiency.

Study on cutting force of reaming porcine bone and substitute bone

Accurate mechanical feedback systems are critical to the successful implementation of virtual and robotic surgical assistant systems. Experimental measurements of reaming force could further our understanding of the cancellous bone reaming process during hip arthroplasty to help develop surgical simulators with realistic force effects and improve the protection mechanism of robot-assisted surgical systems. In this study, reaming experiments with natural bone (porcine femur) and a bone substitute (polyurethane blocks) were performed on a CNC lathe. This paper proposes using the maximum reaming force of the steady reaming stage to represent the force characteristic. The reaming force is biased to one side in the overlap direction and the maximum reaming force will vary when the reamer is not coincident with the long axis of the bone. The diameter of the reamer has the greatest influence on reaming force, which clearly increases with increasing reamer diameter. During operation, a medium rotation speed and high feed speed can reduce the reaming force. After cutting, the morphology of the cut surface is not flat, but arc-shaped, which will have a significant impact on implantation of the femoral prosthesis. In in vitro cutting experiments, polyurethane blocks can be used as a substitute for cancellous bone.

Recent advances in critical nodes of embryo engineering technology

The normal development and maturation of oocytes and sperm, the formation of fertilized ova, the implantation of early embryos, and the growth and development of foetuses are the biological basis of mammalian reproduction. Therefore, research on oocytes has always occupied a very important position in the life sciences and reproductive medicine fields. Various embryo engineering technologies for oocytes, early embryo formation and subsequent developmental stages and different target sites, such as gene editing, intracytoplasmic sperm injection (ICSI), preimplantation genetic diagnosis (PGD), and somatic cell nuclear transfer (SCNT) technologies, have all been established and widely used in industrialization. However, as research continues to deepen and target species become more advanced, embryo engineering technology has also been developing in a more complex and sophisticated direction. At the same time, the success rate also shows a declining trend, resulting in an extension of the research and development cycle and rising costs. By studying the existing embryo engineering technology process, we discovered three critical nodes that have the greatest impact on the development of oocytes and early embryos, namely, oocyte micromanipulation, oocyte electrical activation/reconstructed embryo electrofusion, and the in vitro culture of early embryos. This article mainly demonstrates the efforts made by researchers in the relevant technologies of these three critical nodes from an engineering perspective, analyses the shortcomings of the current technology, and proposes a plan and prospects for the development of embryo engineering technology in the future.

Implementation and Evaluation of a Semi-Autonomous Hydraulic Dual Manipulator for Cutting Pipework in Radiologically Active Environments

We describe the implementation of a bespoke two arm hydraulically actuated robotic platform which is used to semi-autonomously cut approximately 50 mm diameter pipes of three different materials: cardboard, ABS plastic and aluminium. The system is designed to be utilised within radiologically active environments where human access is limited due to dose limits and thus remote operation is greatly beneficial. The remotely located operator selects the object from an image via a bespoke algorithm featuring a COTS 3D vision system, along with the desired positions for gripping with one manipulator, and cutting with the other. A pseudo-Jacobian inverse kinematic technique and a programmable automation controller are used to achieve the appropriate joint positions within the dual arm robotic platform. In this article, we present the latest developments to the system and the lessons learnt from the new cutting experiments with a reciprocating saw. A comparison to tele-operated control and manual cutting is also made, with this technique shown to be slower than manual cutting, but faster than pure tele-operational control, where the requirements for highly trained users and operator fatigue are further deleterious factors.

Needle insertion-induced quasiperiodic cone cracks in hydrogel

Needle insertion, a standard process for various minimally invasive surgeries, results in tissue damage which sometimes leads to catastrophic outcomes. Opaqueness and inhomogeneity of the tissues make it difficult to observe the underlying damage mechanisms. In this paper, we use transparent and homogeneous polyacrylamide hydrogel as a tissue mimic to investigate the damages caused during needle insertion. The insertion force shows multiple events, characterised by a gradual increase in the force followed by a sharp fall. Synchronised recording of the needle displacement into the gel shows that each event corresponds to propagation of stable cone crack. Though sporadic uncontrolled cracking has been discussed earlier, this is the first report of nearly periodic, stable and well-controlled 3-D cone cracks inside the hydrogel during deep penetration. We show that the stress field around the needle tip is responsible for the symmetry and periodicity of the cone cracks. These results provide a better understanding of the fracture processes in soft and brittle materials and open a promising perspective in needle designs and the control of tissue damages during surgical operations.

Image-guided robots for low dose rate prostate brachytherapy: Perspectives on safety in design and use

BACKGROUND

Image-guided brachytherapy (BT) robots can be used to assist urologists during seed implantation, thereby improving therapeutic effects. However, safety issues must be considered in the design of such robots, including their structure, mechanical movements, function, materials and actuators. Previous reviews focused on image-guided prostate BT robot technology (e.g., imaging and robot navigation technology and robot system introduction); however, this review is the first time that safety issues have been investigated as part of a study on low-dose-rate (LDR) prostate BT robots.

METHODS

Multiple electronic databases were searched for LDR prostate BT robot articles published during the last 24 years (1996-2020), with a particular focus on two aspects of robots: safety in design and use.

RESULTS

We retrieved a total of 26 LDR prostate BT robots. BT robots were divided into ultrasound, computed tomography, magnetic resonance imaging and fusion-guided systems. The conditions associated with each system were then analysed to develop a set of requirements for the safety of prostate BT robots. Recommendations are also provided for future BT robot development.

CONCLUSIONS

The transrectal approach for prostate seed implantation is safer than the traditional transperineal approach. Research into the control of a steerable needle by the urologists and robot, the needle deflection model, and robotic automated needle changing and seed injection equipment should be pursued in a future study.

Design and Applicability of a Mechanical Impedance Sensor for Vein Penetration Detection

Intravenous needle insertion is typically conducted manually, with needles guided into vessels by feel while looking for a brief flash of blood. This process is imprecise and leads to mispositioned needles, multiple reinsertion attempts, increased procedure time and higher costs for the hospital. We present a method for indicating that the needle has reached the vein by measuring the change in mechanical impedance of the needle as it passes through different tissue layers. Testing in a phantom indicated that this has the potential to identify transitions through tissue boundaries.

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.

Laparoscopic Robotic Surgery: Current Perspective and Future Directions

Just as laparoscopic surgery provided a giant leap in safety and recovery for patients over open surgery methods, robotic-assisted surgery (RAS) is doing the same to laparoscopic surgery. The first laparoscopic-RAS systems to be commercialized were the Intuitive Surgical, Inc. (Sunnyvale, CA, USA) da Vinci and the Computer Motion Zeus. These systems were similar in many aspects, which led to a patent dispute between the two companies. Before the dispute was settled in court, Intuitive Surgical bought Computer Motion, and thus owned critical patents for laparoscopic-RAS. Recently, the patents held by Intuitive Surgical have begun to expire, leading to many new laparoscopic-RAS systems being developed and entering the market. In this study, we review the newly commercialized and prototype laparoscopic-RAS systems. We compare the features of the imaging and display technology, surgeons console and patient cart of the reviewed RAS systems. We also briefly discuss the future directions of laparoscopic-RAS surgery. With new laparoscopic-RAS systems now commercially available we should see RAS being adopted more widely in surgical interventions and costs of procedures using RAS to decrease in the near future.

Developing a novel force forecasting technique for early prediction of critical events in robotics

Safety critical events in robotic applications can often be characterized by forces between the robot end-effector and the environment. One application in which safe interaction between the robot and environment is critical is in the area of medical robots. In this paper, we propose a novel Compact Form Dynamic Linearization Model-Free Prediction (CFDL-MFP) technique to predict future values of any time-series sensor data, such as interaction forces. Existing time series forecasting methods have high computational times which motivates the development of a novel technique. Using Autoregressive Integrated Moving Average (ARIMA) forecasting as benchmark, the performance of the proposed model was evaluated in terms of accuracy, computation efficiency, and stability on various force profiles. The proposed algorithm was 11% more accurate than ARIMA and maximum computation time of CFDL-MFP was 4ms, compared to ARIMA (7390ms). Furthermore, we evaluate the model in the special case of predicting needle buckling events, before they occur, by using only axial force and needle-tip position data. The model was evaluated experimentally for robustness with steerable needle insertions into different tissues including gelatin and biological tissue. For a needle insertion velocity of 2.5mm/s, the proposed algorithm was able to predict needle buckling 2.03s sooner than human detections. In biological tissue, no false positive or false negative buckling detections occurred and the rates were low in artificial tissue. The proposed forecasting model can be used to ensure safe robot interactions with delicate environments by predicting adverse force-based events before they occur.

Influence of a Biocompatible Hydrophilic Needle Surface Coating on a Puncture Biopsy Process for Biomedical Applications

A puncture biopsy is a widely used, minimally invasive surgery process. During the needle insertion process, the needle body is always in direct contact with a biological soft tissue. Tissue adhesion and different degrees of tissue damage occur frequently. Optimization of the needle surface, and especially the lubrication of the needle surface, can deal with these problems efficiently. Therefore, in this paper, a biocompatible hydrophilic coating was applied onto the surface of a needle to improve the surface quality of the needle surface. Further, a simplified finite element model of insertion was established, and extracorporeal insertion experiments were used to verify the accuracy of the model. Then, by analyzing a simulation model of a coated needle and a conventional needle, the influence of the application of the coated needle on the insertion process was obtained. It can be seen from the results that the coating application relieved the force on the needle and the soft tissue during the insertion process and could significantly reduce friction during the insertion process. At the same time, the deformation of biological soft tissue was reduced, and the adhesion situation between the needle and tissue improved, which optimized the puncture needle.

Experimental evaluation of a self-propelling bio-inspired needle in single- and multi-layered phantoms

In percutaneous interventions, reaching targets located deep inside the body with minimal tissue damage and patient pain requires the use of long and thin needles. However, when pushed through a solid substrate, a structure with a high aspect ratio is prone to buckle. We developed a series of multi-element needles with a diameter smaller than 1 mm and a length larger than 200 mm, and we experimentally evaluated the performance of a bio-inspired insertion mechanism that prevents needle buckling of such slender structures. The needles consisted of Nitinol wires and advance into a substrate by pushing the wires forward one after the other, followed by pulling all the wires simultaneously backward. The resulting net push force is low, allowing the needles to self-propel through the substrate. We investigated the effect of the needle design parameters (number of wires and their diameter) and substrate characteristics (stiffness and number of layers) on the needle motion. Three needle prototypes (consisting of six 0.25-mm wires, six 0.125-mm wires, and three 0.25-mm wires, respectively) were inserted into single- and multi-layered tissue-mimicking phantoms. The prototypes were able to move forward in all phantoms without buckling. The amount of needle slip with respect to the phantom was used to assess the performance of the prototypes. The six-wire 0.25-mm prototype exhibited the least slip among the three prototypes. Summarizing, we showed that a bio-inspired motion mechanism prevents buckling in very thin (diameter <1 mm), long (length >200 mm) needles, allowing deep insertion into tissue-mimicking phantoms.

Proposal of the Tactile Glove Device

This project aims to develop a tactile glove device and a virtual environment inserted in the context of tactile internet. The tactile glove allows a human operator to interact remotely with objects from a 3D environment through tactile feedback or tactile sensation. In other words, the human operator is able to feel the contour and texture from virtual objects. Applications such as remote diagnostics, games, remote analysis of materials, and others in which objects could be virtualized can be significantly improved using this kind of device. These gloves have been an essential device in all research on the internet next generation called "Tactile Internet", in which this project is inserted. Unlike the works presented in the literature, the novelty of this work is related to architecture, and tactile devices developed. They are within the 10 ms round trip latency limits required in a tactile internet environment. Details of hardware and software designs of a tactile glove, as well as the virtual environment, are described. Results and comparative analysis about round trip latency time in the tactile internet environment is developed.

Real-Time Needle Force Modeling for VR-Based Renal Biopsy Training with Respiratory Motion Using Direct Clinical Data

Realistic tool-tissue interactive modeling has been recognized as an essential requirement in the training of virtual surgery. A virtual basic surgical training framework integrated with real-time force rendering has been recognized as one of the most immersive implementations in medical education. Yet, compared to the original intraoperative data, there has always been an argument that these data are represented by lower fidelity in virtual surgical training. In this paper, a dynamic biomechanics experimental framework is designed to achieve a highly immersive haptic sensation during the biopsy therapy with human respiratory motion; it is the first time to introduce the idea of periodic extension idea into the dynamic percutaneous force modeling. Clinical evaluation is conducted and performed in the Yunnan First People's Hospital, which not only demonstrated a higher fitting degree (AVG: 99.36%) with the intraoperation data than previous algorithms (AVG: 87.83%, 72.07%, and 66.70%) but also shows a universal fitting range with multilayer tissue. 27 urologists comprising 18 novices and 9 professors were invited to the VR-based training evaluation based on the proposed haptic rendering solution. Subjective and objective results demonstrated higher performance than the existing benchmark training simulator. Combining these in a systematic approach, tuned with specific fidelity requirements, haptically enabled medical simulation systems would be able to provide a more immersive and effective training environment.

Effect of Cell Inner Pressure on Deposition Volume in Microinjection

Microinjection is a widely used technique for introducing exogenous materials into cells. Many applications of microinjection, such as gene editing and drug testing, rely on the accurate control of the deposition volume. However, the deposition volume in microinjection is presently calibrated in an open medium without considering the cell inner pressure effect, which we experimentally show in this paper that it can induce an error as large as 30% between the actual deposition volume and the set volume. In this work, the relationship between the cell inner pressure and the deposition volume was analytically modeled and experimentally validated. On the basis of the developed model, the cell inner pressure of a given cell type can be well estimated from the injection pressure and the resulting deposition volume. The quantitated cell inner pressure is then used to reduce the error between the set volume and the actual deposition volume. Experiments conducted on human bladder cancer cells (T24 and RT4) showed that T24 cells have a higher inner pressure than RT4 cells (405 ± 45 Pa vs 341 ± 34 Pa), and after compensating for the cell inner pressure, the error between the intended set volume and the actual deposition volume into a cell became less than 3%.