An original design of remote robot-assisted intubation system.
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ABSTRACT:
SUBMITTER: Wang X
PROVIDER: S-EPMC6128927 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The design of medical devices is a complex and crucial process to ensure patient safety. It has been shown that improperly designed devices lead to errors and associated accidents and costs. A key element for a successful design is incorporating the views of the primary and secondary stakeholders early in the development process. They provide insights into current practice and point out specific issues with the current processes and equipment in use. This work presents how information from a user-study conducted in the early stages of the RAFS (Robot Assisted Fracture Surgery) project informed the subsequent development and testing of the system. The user needs were captured using qualitative methods and converted to operational, functional, and non-functional requirements based on the methods derived from product design and development. This work presents how the requirements inform a new workflow for intra-articular joint fracture reduction using a robotic system. It is also shown how the various elements of the system are developed to explicitly address one or more of the requirements identified, and how intermediate verification tests are conducted to ensure conformity. Finally, a validation test in the form of a cadaveric trial confirms the ability of the designed system to satisfy the aims set by the original research question and the needs of the users.
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Project description:Conventional rehabilitation systems typically execute a fixed set of programs that most motor-impaired stroke patients undergo. In these systems, the brain, which is embodied in the body, is often left out. Including the brains of stroke patients in the control loop of a rehabilitation system can be worthwhile as the system can be tailored to each participant and, thus, be more effective. Here, we propose a novel brain-computer interface (BCI)-based robot-assisted stroke rehabilitation system (RASRS), which takes inputs from the patient's intrinsic feedback mechanism to adapt the assistance level of the RASRS. The proposed system will utilize the patients' consciousness about their performance decoded through their error-related negativity signals. As a proof-of-concept, we experimented on 12 healthy people in which we recorded their electroencephalogram (EEG) signals while performing a standard rehabilitation exercise. We set the performance requirements beforehand and observed participants' neural responses when they failed/met the set requirements and found a statistically significant (p < 0.05) difference in their neural responses in the two conditions. The feasibility of the proposed BCI-based RASRS was demonstrated through a use-case description with a timing diagram and meeting the crucial requirements for developing the proposed rehabilitation system. The use of a patient's intrinsic feedback mechanism will have significant implications for the development of human-in-the-loop stroke rehabilitation systems.
| S-EPMC9085417 | biostudies-literature
Project description:PURPOSE:The biopsy procedure is an important phase in breast cancer diagnosis. Accurate breast imaging and precise needle placement are crucial in lesion targeting. This paper presents an end-effector (EE) for robotic 3D ultrasound (US) breast acquisitions and US-guided breast biopsies. The EE mechanically guides the needle to a specified target within the US plane. The needle is controlled in all degrees of freedom (DOFs) except for the direction of insertion, which is controlled by the radiologist. It determines the correct needle depth and stops the needle accordingly. METHOD:In the envisioned procedure, a robotic arm performs localization of the breast, 3D US volume acquisition and reconstruction, target identification and needle guidance. Therefore, the EE is equipped with a stereo camera setup, a picobeamer, US probe holder, a three-DOF needle guide and a needle stop. The design was realized by prototyping techniques. Experiments were performed to determine needle placement accuracy in-air. The EE was placed on a seven-DOF robotic manipulator to determine the biopsy accuracy on a cuboid phantom. RESULTS:Needle placement accuracy was 0.3?±?1.5 mm in and 0.1?±?0.36 mm out of the US plane. Needle depth was regulated with an accuracy of 100 µm (maximum error 0.89 mm). The maximum holding force of the stop was approximately 6 N. The system reached a Euclidean distance error of 3.21 mm between the needle tip and the target and a normal distance of 3.03 mm between the needle trajectory and the target. CONCLUSION:An all in one solution was presented which, attached to a robotic arm, assists the radiologist in breast cancer imaging and biopsy. It has a high needle placement accuracy, yet the radiologist is in control like in the conventional procedure.
| S-EPMC7142059 | biostudies-literature
Project description:PurposeIn the surgical treatment for lower-leg intra-articular fractures, the fragments have to be positioned and aligned to reconstruct the fractured bone as precisely as possible, to allow the joint to function correctly again. Standard procedures use 2D radiographs to estimate the desired reduction position of bone fragments. However, optimal correction in a 3D space requires 3D imaging. This paper introduces a new navigation system that uses pre-operative planning based on 3D CT data and intra-operative 3D guidance to virtually reduce lower-limb intra-articular fractures. Physical reduction in the fractures is then performed by our robotic system based on the virtual reduction.Methods3D models of bone fragments are segmented from CT scan. Fragments are pre-operatively visualized on the screen and virtually manipulated by the surgeon through a dedicated GUI to achieve the virtual reduction in the fracture. Intra-operatively, the actual position of the bone fragments is provided by an optical tracker enabling real-time 3D guidance. The motion commands for the robot connected to the bone fragment are generated, and the fracture physically reduced based on the surgeon's virtual reduction. To test the system, four femur models were fractured to obtain four different distal femur fracture types. Each one of them was subsequently reduced 20 times by a surgeon using our system.ResultsThe navigation system allowed an orthopaedic surgeon to virtually reduce the fracture with a maximum residual positioning error of [Formula: see text] (translational) and [Formula: see text] (rotational). Correspondent physical reductions resulted in an accuracy of 1.03 ± 0.2 mm and [Formula: see text], when the robot reduced the fracture.ConclusionsExperimental outcome demonstrates the accuracy and effectiveness of the proposed navigation system, presenting a fracture reduction accuracy of about 1 mm and [Formula: see text], and meeting the clinical requirements for distal femur fracture reduction procedures.
| S-EPMC5034012 | biostudies-literature
Project description:Background and objectiveThe master and slave transluminal endoscopic robot and other flexible endoscopy platforms are designed primarily for the remote control of forceps, with manipulation of the endoscope itself still dependent on conventional techniques. We have developed an endoscopic therapeutic robot system (ETRS) that provides complete remote control of all forceps and endoscope operations.MethodWe carried out endoscopic submucosal dissection (ESD) in porcine stomachs using the ETRS. All procedures were completed with the endoscopist seated at the console the entire time.ResultsTotal en bloc resection was achieved in all 7 cases with no complications. The mean total procedure time was 36.14 ± 14.98 min, the mean size of the resected specimen was 3.39 ± 0.66 cm × 3.03 ± 0.63 cm, and the mean dissection time was 14.91 ± 8.61 min.ConclusionWe successfully used the ETRS to perform completely remote-controlled ESD in porcine stomachs.
| S-EPMC6875422 | biostudies-literature
Project description:Robot-assisted cell manipulation is gaining attention for its ability in providing high throughput and high precision cell manipulation for the biological industry. This paper presents a visual servo microrobotic system for cell microinjection. We investigated the automatic cell autofocus method that reduced the complexity of the system. Then, we produced an adaptive visual processing algorithm to detect the location of the cell and micropipette toward the uneven illumination problem. Fourteen microinjection experiments were conducted with zebrafish embryos. A 100% success rate was achieved either in autofocus or embryo detection, which verified the robustness of the proposed automatic cell manipulation system.
| S-EPMC6190104 | biostudies-literature
Project description:BackgroundConventional endotracheal intubation requires laryngoscopy for a direct view of the glottis. However, laryngoscopy is associated with many potential complications. The aim of the present study was to compare the efficacy and safety of pyriform sinus localization-assisted blind orotracheal intubation with those of conventional laryngoscopic orotracheal intubation.Material and methodsA randomized, patient-blind, prospective study of 300 patients who underwent various operations was performed. One hundred patients were assigned to the laryngoscopic intubation group (laryngoscopy group), and 200 patients were assigned to the blind intubation group (blind group).ResultsThe total intubation success rate in the blind group was similar to that in the laryngoscopy group (100% vs. 99%, respectively; p=0.33). Oxygen saturation by pulse oximetry in both groups was maintained at >98%. The intubation time was significantly shorter in the blind group than in the laryngoscopy group (9.7±3.4 s vs. 23.0±5.8 s, respectively; p<0.001). Postoperative complication rates were significantly lower in the blind group than in the laryngoscopy group. Recovery time from these symptoms was significantly shorter in the blind group than in the laryngoscopy group (p=0.004).ConclusionsPyriform sinus localization-assisted blind orotracheal intubation was shown to be more effective than conventional laryngoscopic orotracheal intubation in terms of success rate, intubation time, and postoperative complication rate. Moreover, it is less affected by common risk factors; thus, this method may be more beneficial in patients with difficult airways.
| S-EPMC4186215 | biostudies-literature
Project description:BackgroundThe field of robotic surgery is still continuously advancing, with several cutting-edge robotic systems currently under development. This study aimed to present the methodology and perioperative outcomes of robot-assisted radical cystectomy (RARC) and intracorporeal urinary diversion (ICUD) in patient with muscle invasive bladder cancer (MIBC) by utilizing the hinotori Surgical Robot System, a recently developed robot-assisted surgical platform.Case descriptionA 79-year-old man with MIBC, cT2N0M0, received RARC and ICUD after two courses of neoadjuvant chemotherapy. We performed RARC and ICUD using hinotori, with a total operation time of 476 minutes. The insufflation time was 424 minutes, and the console time was 396 minutes. Total blood loss was 562 mL and no blood transfusion was necessary. During the perioperative period, a paralytic ileus occurred, although no severe adverse events were observed. The pathological examination showed ypT0N0M0, and no recurrence was observed by computed tomography scan up to 8 months postoperatively.ConclusionsThis report demonstrates the successfully implementation of RARC and ICUD using the hinotori system, without perioperative adverse effects. While further exploration is required to assess the long-term and large-scale implications of RARC and ICUD using hinotori on oncologic and functional outcomes, these initial findings suggest that the hinotori Surgical Robot System holds promise as an application for RARC and ICUD in patients with MIBC.
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Project description:[This corrects the article DOI: 10.1155/2019/6909547.].
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Project description:Robot-assisted kidney transplantation is feasible; however, concerns have been raised about possible increases in warm ischemia times. We describe a novel intra-abdominal cooling system to continuously cool the kidney during the procedure. Porcine kidneys were procured by standard open technique. Groups were as follows: Robotic renal transplantation with (n = 11) and without (n = 6) continuous intra-abdominal cooling and conventional open technique with intermittent 4°C saline cooling (n = 6). Renal cortex temperature, magnetic resonance imaging, and histology were analyzed. Robotic renal transplantation required a longer anastomosis time, either with or without the cooling system, compared to the open approach (70.4 ± 17.7 min and 74.0 ± 21.5 min vs. 48.7 ± 11.2 min, p-values < 0.05). The temperature was lower in the robotic group with cooling system compared to the open approach group (6.5 ± 3.1°C vs. 22.5 ± 6.5°C; p = 0.001) or compared to the robotic group without the cooling system (28.7 ± 3.3°C; p < 0.001). Magnetic resonance imaging parenchymal heterogeneities and histologic ischemia-reperfusion lesions were more severe in the robotic group without cooling than in the cooled (open and robotic) groups. Robot-assisted kidney transplantation prolongs the warm ischemia time of the donor kidney. We developed a novel intra-abdominal cooling system that suppresses the noncontrolled rewarming of donor kidneys during the transplant procedure and prevents ischemia-reperfusion injuries.
| S-EPMC5763420 | biostudies-literature