Histological evaluation of tissue damage caused by rotational needle insertion

In-Silico Analysis of Optimal Configurations for Rotational Bioinspired Bone Marrow Biopsy Needle Designs: An ANN Approach

Medical needle innovations have utilized rotating motion to enhance tissue-cutting capabilities, reducing cutting force and improving clinical outcomes. This study analyzes the effects of six essential factors on insertion and extraction forces during bone marrow biopsy (BMB) procedures. The study uses Taguchi's L32 orthogonal array and numerically simulates the BMB process using the Lagrangian surface-based method on a three-dimensional (3D) heterogeneous Finite Element (FE) model of the human iliac crest. The study evaluates cutting forces in needle insertion and extraction using uni-directional (360° rotation) and bidirectional (180° clock and anti-clock rotation) bioinspired BMB needles. This work aims to create an AI tool that assists researchers and clinicians in selecting the most suitable and safe design parameters for a bio-inspired barbed biopsy needle. An efficient Graphical User Interface (GUI) has been developed for easy use and seamless interaction with the AI tool. With a remarkable accuracy rate exceeding 98%, the tool's predictions hold significant value in facilitating the development of environmentally conscious biopsy needles. The tool demonstrates significantly higher efficiency compared to Abaqus, rendering it a valuable asset for researchers and clinicians engaged in bio-inspired biopsy needle development.

A Survey of Needle Steering Approaches in Minimally Invasive Surgery

In virtue of a curved insertion path inside tissues, needle steering techniques have revealed the potential with the assistance of medical robots and images. The superiority of this technique has been preliminarily verified with several maneuvers: target realignment, obstacle circumvention, and multi-target access. However, the momentum of needle steering approaches in the past decade leads to an open question-"How to choose an applicable needle steering approach for a specific clinical application?" This survey discusses this question in terms of design choices and clinical considerations, respectively. In view of design choices, this survey proposes a hierarchical taxonomy of current needle steering approaches. Needle steering approaches of different manipulations and designs are classified to systematically review the design choices and their influences on clinical treatments. In view of clinical consideration, this survey discusses the steerability and acceptability of the current needle steering approaches. On this basis, the pros and cons of the current needle steering approaches are weighed and their suitable applications are summarized. At last, this survey concluded with an outlook of the needle steering techniques, including the potential clinical applications and future developments in mechanical design.

Robotic Cytology using Extra-Fine Needles : -Proposal of Puncture Control Strategy for Increasing Collection Amount

Fine needle aspiration cytology requires accurate needle insertion into a tumor and sufficient amount collection of samples, which highly depends on the skill of the physician. The advantage of the diagnosis is to minimize the tissue damage with the fine needle, while, when the amount of the sample sucked from the lesion is not enough for the definite diagnosis, the procedure has to be repeated until satisfying them. Although numerous research reported a robot-assisted insertion method to improve the accuracy of needle placement with fine needles, there was less research to address the efficient tissue collection. Ideally, the amount of the samples can be satisfied for the diagnosis even if an extra-fine needle (e.g. 25-gauge) is used. This paper proposes a novel needle insertion method for increasing the amount of the tissue sample with the extra-fine needle. The proposed insertion method comprises the round-trip insertion motion and trajectory rerouting with the nature of the bevel-tipped needle. The phantom study's result showed the equivalency of the aspiration amount between a physician's manual procedure with a 22-gauge needle and the proposed method with a 25-gauge needle (4.5 ± 1.0 mg vs 5.1 ± 0.7 mg). The results suggested that the proposed robotic aspiration method can increase the sampling amount with the extra-fine needle in the fine needle aspiration cytology.

Steerable needles for radio-frequency ablation in cirrhotic livers

Accurate needle placement in deep-seated liver tumours can be difficult. In this work, we disclose two new manually controlled steerable needles for 17G radio-frequency ablation probe placement. The needles contain stylets with embedded compliant joints for active tip articulations, and concentric tubes for (curved-path) guidance. Needle steering was evaluated sequentially by intended users and in intended-use tissue types. Six interventional radiologists evaluated the needle in repeated ultrasound-guided steering tasks in liver-mimicking phantoms. Targets were located at a 100 mm depth and 20 mm lateral offset from the initial insertion line. The resulting mean absolute tip placement error was 1.0 ± 1.0 mm. Subsequently, steering-induced tissue damage was evaluated in fresh cirrhotic human liver explants. The surface area of puncture holes was estimated in scanned histology slides, using a connected-components analysis. The mean surface area was 0.26 ± 0.16 mm² after steering with a median radius of curvature of 0.7 × 10³ mm, versus 0.35 ± 0.15 mm² after straight-path insertions with the steerable needle and 0.15 ± 0.09 mm² after straight-path RFA probe insertions. The steering mechanisms proposed enable clinically relevant path corrections for 17G needles. Radiologists were quickly adept in curved-path RFA probe placement and the evaluation of histological tissue damage demonstrated a potentially safe use during liver interventions.

Fine needle insertion method for minimising deflection in lower abdomen: In vivo evaluation

BACKGROUND

Fine needle insertion in the lower abdomen is difficult because of complex deflections and few image feedbacks. We aim to develop an approach for generating a straight insertion path by minimizing the needle deflection robustly based on a preoperative computer tomography (CT) image.

METHOD

This study presents two approaches: an insertion control strategy that performs both vibration and rotation-assisted needle insertions and a preoperative insertion path planning for determining an optimal insertion path based on insertion angles at each tissue boundary. Those proposed approaches were evaluated through an in vivo experiment with a Landrace mini-pig. We compered the following: (1) the deflection with and without the insertion control strategy in different 10 insertion paths and (2) the score calculated by the path planning and the actual deflection in the 10 insertion paths.

RESULTS

The result shows that the deflection can be reduced significantly by applying the insertion control strategy in the optimal insertion path calculated by the path planning.

CONCLUSION

The proposed method can decrease fine needle deflections in the lower abdomen, which has the potential for accurate and safety procedures without real-time CT imaging.

Simultaneously Reducing Cutting Force and Tissue Damage in Needle Insertion With Rotation

Rotational needle insertion is commonly used in needle biopsy to improve cutting performance. The application of rotational motion for needle insertion has been shown to efficiently reduce the cutting force. However, studies have found that needle rotation can increase tissue damage due to the tissue winding effect. The bidirectional rotation of a needle during insertion can be a solution to avoid tissue winding while maintaining a low cutting force. In this study, needle insertion with bidirectional rotation was investigated by conducting mechanical and optical experiments. First, needle insertion tests were performed on gelatin-based tissue phantom samples to understand the effect of bidirectional needle rotation on the cutting force. Subsequently, the effective strain, which is an indicator of tissue damage, was observed at the cross-sections of samples in the axial and radial directions of the needle by using the digital image correlation (DIC) technology. The primary findings of this study are as follows: (1) higher needle insertion speeds result in higher cutting forces and effective strains that occur at the axial cross-section, (2) increase in the needle rotation reduces the cutting force and effective strain at the axial cross-section but increases the effective strain at the radial cross-section, (3) application of bidirectional rotation decreases the mean effective strain at the radial cross-section by 10%-25% while maintaining a low cutting force. In clinical applications, bidirectional rotation can be a useful strategy to simultaneously reduce the cutting force and tissue damage, which leads to better cutting performance and lower risks of bleeding and hematoma.

Quantitative Evaluation of Bleeding during Blood Vessel Puncture Caused by Fine Needle in Lower Abdomen

Inserting a fine needle presents a trade-off problem between safety and accuracy. As one of the serious complications due to tissue damages during needle insertion, severe bleeding often occurs owing to blood vessel puncture. However, there are few researches to evaluate the safety quantitatively regarding bleeding during the fine needle insertion. Therefore, the purpose of this study was the quantitative evaluation of the amount of bleeding due the artery and vein puncture depending on the needle size. We developed a blood circulation system for measuring the amount of bleeding due to blood vessel puncture. Using the system, the amount of bleeding due to different needle sizes was evaluated. The results suggested that the amount of bleeding per unit time increased depending on the needle radius. According to ordinal safety standards, the 22-gauge needle is appropriate for insertion into the lower abdomen.

Preoperative Needle Insertion Path Planning for Minimizing Deflection in Multilayered Tissues

Fine needle deflection is a problem encountered during insertion into a soft tissue. Although an axial rotational insertion is an effective approach for minimizing this problem, needle deflection still depends on the insertion angle with respect to the tissue boundary. Since the human body consists of multi-layered tissues of various shapes and mechanical properties, preoperative planning of an optimal path is a key factor for achieving a successful insertion. In this paper, we propose an optimization-based preoperative path planning model that minimizes needle deflection during multi-layered tissue insertion. This model can determine the optimal path based on the sum of insertion angles with respect to each tissue boundary that the needle passes through. To increase the accuracy of the model, we incorporated the effect of distances from tissue boundaries and the probability that the deflection is acceptable by incorporating weighting factors into the model. To validate the model, we performed experiments involving four scenarios of two- and three-layered tissues. The results showed that the proposed model is capable of determining the optimal insertion path in all scenarios.