Fully Actuated Body-Mounted Robotic System for MRI-Guided Lower Back Pain Injections: Initial Phantom and Cadaver Studies.
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ABSTRACT:
SUBMITTER: Li G
PROVIDER: S-EPMC7971162 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:This paper reports the development of a fully actuated robotic assistant for magnetic resonance imaging (MRI)-guided precision conformal ablation of brain tumors using an interstitial high intensity needle-based therapeutic ultrasound (NBTU) ablator probe. The robot is designed with an eight degree-of-freedom (DOF) remote center of motion (RCM) manipulator driven by piezoelectric actuators, five for aligning the ultrasound thermal ablator to the target lesions and three for inserting and orienting the ablator and its cannula to generate a desired ablation profile. The 8-DOF fully actuated robot can be operated in the scanner bore during imaging; thus, alleviating the need of moving the patient in or out of the scanner during the procedure, and therefore potentially reducing the procedure time and streamlining the workflow. The free space positioning accuracy of the system is evaluated with the OptiTrack motion capture system, demonstrating the root mean square (RMS) error of the tip position to be 1.11±0.43mm. The system targeting accuracy in MRI is assessed with phantom studies, indicating the RMS errors of the tip position to be 1.45±0.66mm and orientation to be 1.53±0.69°. The feasibility of the system to perform thermal ablation is validated through a preliminary ex-vivo tissue study with position error less than 4.3mm and orientation error less than 4.3°.
| S-EPMC8117662 | biostudies-literature
Project description:Background: Damaged cardiac tissues could potentially be regenerated by transplanting bioengineered cardiac patches to the heart surface. To be fully paradigm-shifting, such patches may need to be transplanted using minimally invasive robotic cardiac surgery (not only traditional open surgery). Here, we present novel robotic designs, initial prototyping and a new surgical operation for instruments to transplant patches via robotic minimally invasive heart surgery. Methods: Robotic surgical instruments and automated control systems were designed, tested with simulation software and prototyped. Surgical proof-of-concept testing was performed on a pig cadaver. Results: Three robotic instrument designs were developed. The first (called "Claw" for the claw-like patch holder at the tip) operates on a rack and pinion mechanism. The second design ("Shell-Beak") uses adjustable folding plates and rods with a bevel gear mechanism. The third ("HeartStamp") utilizes a stamp platform protruding through an adjustable ring. For the HeartStamp, rods run through a cylindrical structure designed to fit a uniportal Video-Assisted Thorascopic Surgery (VATS) surgical port. Designed to work with or without a sterile sheath, the patch is pushed out by the stamp platform as it protrudes. Two instrument robotic control systems were designed, simulated in silico and one of these underwent early 'sizing and learning' prototyping as a proof-of-concept. To reflect real surgical conditions, surgery was run "live" and reported exactly (as-it-happened). We successfully picked up, transferred and released a patch onto the heart using the HeartStamp in a pig cadaver model. Conclusion: These world-first designs, early prototypes and a novel surgical operation pave the way for robotic instruments for automated keyhole patch transplantation to the heart. Our novel approach is presented for others to build upon free from restrictions or cost-potentially a significant moment in myocardial regeneration surgery which may open a therapeutic avenue for patients unfit for traditional open surgery.
| S-EPMC8804503 | biostudies-literature
Project description:Upscaling motor protein activity to perform work in man-made devices has long been an ambitious goal in bionanotechnology. The use of hierarchical motor assemblies, as realized in sarcomeres, has so far been complicated by the challenges of arranging sufficiently high numbers of motor proteins with nanoscopic precision. Here, we describe an alternative approach based on actomyosin cortex-like force production, allowing low complexity motor arrangements in a contractile meshwork that can be coated onto soft objects and locally activated by ATP. The design is reminiscent of a motorized exoskeleton actuating protein-based robotic structures from the outside. It readily supports the connection and assembly of micro-three-dimensional printed modules into larger structures, thereby scaling up mechanical work. We provide an analytical model of force production in these systems and demonstrate the design flexibility by three-dimensional printed units performing complex mechanical tasks, such as microhands and microarms that can grasp and wave following light activation.
| S-EPMC9156402 | biostudies-literature
Project description:Introduction Conventional microscopes have certain limitations in terms of posture and ergonomics. Monitor-based exoscopes could solve this problem and thereby lead to less work-related sick leave for surgeons. Research question The aim of this study was to assess the ergonomics, usability, and neurosurgeon's comfort of a novel three-dimensional head-mounted display-based exoscope in a standardized setting. Material & Methods 34 neurosurgeons participated in a workshop on the exoscope, which features a head-mounted display and a head gesture-triggered control panel. After completion of a custom-made 10-step microsurgical exercise, image quality and comfort were assessed using a questionnaire. The participants' posture during the exercise was analyzed using a video motion analysis software. Results 34 participants (median neurosurgical experience: 6 years) were included. The median time to complete the exercise was 12 min [IqR 9.4, 15.0]. Younger participants (p = 0.005) and those with video game experience (p = 0.03) had a significantly steeper learning curve. The median overall satisfaction was at 80% in general and 82% for image quality. The median upper body as well as the median head coronal displacement from the neutral axis were 0°. Participants with less microsurgical experience showed less head/body displacement during the exercise (p = 0.01). Discussion and conclusion Using the microsurgical training tool, we were able to depict a steep learning curve with a sufficient learnability of the most relevant commands. The exoscope excelled in usability, image quality as well as in ergonomic and favorable posture and could thus become an alternative to conventional microscopes due to the potentially elevated surgeons' comfort. Highlights • Overall, the participants were satisfied with the exoscope usability (80%) and image quality (82%).• The custom-made microsurgical exercise tool is an efficient tool for assessment of the participant's performance with the head-mounted display-based exoscope.• Younger participants with video games experience showed a steeper learning curve for the performance of the microsurgical training tool.• After performing theexercise, 88% of the participants felt safe to use the HMD-based exoscope in the OR.
| S-EPMC9560643 | biostudies-literature
Project description:Muscle architecture is an important component to typical musculoskeletal models. Previous studies of human muscle architecture have focused on a single joint, two adjacent joints, or an entire limb. To date, no study has presented muscle architecture for the upper and lower limbs of a single cadaver. Additionally, muscle architectural parameters from elderly cadavers are lacking, making it difficult to accurately model elderly populations. Therefore, the purpose of this study was to present muscle architecture of the upper and lower limbs of a 104 year old female cadaver. The major muscles of the upper and lower limbs were removed and the musculotendon mass, tendon mass, musculotendon length, tendon length, pennation angle, optimal fascicle length, physiological cross-sectional area, and tendon cross-sectional area were determined for each muscle. Data from this complete cadaver are presented in table format. The data from this study can be used to construct a musculoskeletal model of a specific individual who was ambulatory, something which has not been possible to date. This should increase the accuracy of the model output as the model will be representing a specific individual, not a synthesis of measurements from multiple individuals. Additionally, an elderly individual can be modeled which will provide insight into muscle function as we age.
| S-EPMC5199092 | biostudies-literature
Project description:PurposeTo propose and validate a fully automated multicriterial treatment planning solution for a CyberKnife® equipped with an InCiseTM 2 multileaf collimator.MethodsThe AUTO BAO plans are generated using fully automated prioritized multicriterial optimization (AUTO MCO) of pencil-beam fluence maps with integrated noncoplanar beam angle optimization (BAO), followed by MLC segment generation. Both the AUTO MCO and segmentation algorithms have been developed in-house. AUTO MCO generates for each patient a single, high-quality Pareto-optimal IMRT plan. The segmentation algorithm then accurately mimics the AUTO MCO 3D dose distribution, while considering all candidate beams simultaneously, rather than replicating the fluence maps. Pencil-beams, segment dose depositions, and final dose calculations are performed with a stand-alone version of the clinical dose calculation engine. For validation, AUTO BAO plans were generated for 33 prostate SBRT patients and compared to reference plans (REF) that were manually generated with the commercial treatment planning system (TPS), in absence of time pressure. REF plans were also compared to AUTO RB plans, for which fluence map optimization was performed for the beam angle configuration used in the REF plan, and the segmentation could use all these beams or only a subset, depending on the dosimetry.ResultsAUTO BAO plans were clinically acceptable and dosimetrically similar to REF plans, but had on average reduced numbers of beams ((beams in AUTO BAO)/(beams in REF) (relative improvement): 24.7/48.3 (-49%)), segments (59.5/98.9 (-40%)), and delivery times (17.1/22.3 min. (-23%)). Dosimetry of AUTO RB and REF were also similar, but AUTO RB used on average fewer beams (38.0/48.3 (-21%)) and had on average shorter delivery times (18.6/22.3 min. (-17%)). Delivered Monitor Units (MU) were similar for all three planning approaches.ConclusionsA new, vendor-independent optimization workflow for fully automated generation of deliverable high-quality CyberKnife® plans was proposed, including BAO. Compared to manual planning with the commercial TPS, fraction delivery times were reduced by 5.3 min. (-23%) due to large reductions in beam and segment numbers.
| S-EPMC8457110 | biostudies-literature
Project description:UnlabelledRecently, a transoral robotic-assisted technique to access the thyroid gland has been introduced. Despite the advantages this approach may have over other minimally invasive and robotic-assisted techniques, we found that the placement of the camera through the floor of mouth led to restricted freedom of movement. We describe our modification to this technique to overcome this problem. In a study using two fresh human cadavers, the camera port of the da Vinci robot was placed in the midline oral vestibule instead of the floor of the mouth. A transoral thyroidectomy and central neck dissection was successfully performed. Our modification led to an unfettered view of the central neck and allowed for a total thyroidectomy and central neck dissection. Our modification of transoral robotic-assisted thyroidectomy provides superior access to the central compartment of the neck over other robotic-assisted thyroidectomy techniques.Electronic supplementary materialThe online version of this article (doi:10.1007/s11701-011-0287-2) contains supplementary material, which is available to authorized users.
| S-EPMC3214254 | biostudies-literature
Project description:Pose estimation methods for robotically guided magnetic actuation of capsule endoscopes have recently enabled trajectory following and automation of repetitive endoscopic maneuvers. However, these methods face significant challenges in their path to clinical adoption including the presence of regions of magnetic field singularity, where the accuracy of the system degrades, and the need for accurate initialization of the capsule's pose. In particular, the singularity problem exists for any pose estimation method that utilizes a single source of magnetic field if the method does not rely on the motion of the magnet to obtain multiple measurements from different vantage points. We analyze the workspace of such pose estimation methods with the use of the point-dipole magnetic field model and show that singular regions exist in areas where the capsule is nominally located during magnetic actuation. Since the dipole model can approximate most magnetic field sources, the problem discussed herein pertains to a wider set of pose estimation techniques. We then propose a novel hybrid approach employing static and time-varying magnetic field sources and show that this system has no regions of singularity. The proposed system was experimentally validated for accuracy, workspace size, update rate and performance in regions of magnetic singularity. The system performed as well or better than prior pose estimation methods without requiring accurate initialization and was robust to magnetic singularity. Experimental demonstration of closed-loop control of a tethered magnetic device utilizing the developed pose estimation technique is provided to ascertain its suitability for robotically guided capsule endoscopy. Hence, advances in closed-loop control and intelligent automation of magnetically actuated capsule endoscopes can be further pursued toward clinical realization by employing this pose estimation system.
| S-EPMC6108552 | biostudies-literature
Project description:PurposeThe da Vinci SP robotic surgical system (Intuitive Surgical) offers pure SP with 4 lumens, which accommodates the fully-wristed endoscope and 3 arms with multijoint feature. We herein present our initial experience of the da Vinci SP surgical system in robotic single-site cholecystectomy.MethodsThirty consecutive patients with a preoperative diagnosis of gallstones and/or chronic cholecystitis who underwent robotic SP cholecystectomy (RSPC) using da Vinci SP surgical system from January to May 2019 were reviewed. The perioperative outcomes were assessed and compared with those performed using Si-robotic single-site surgical system.ResultsMean docking time was 5.2 minutes. The mean actual dissection time was 14.6 minutes while the mean operation time was 75.1 minutes. Postoperative course was unremarkable and patients were discharged after a mean hospital stay of 1.5 days. In comparative analysis, operation time (109.5 ± 30.0 minutes vs. 75.1 ± 17.5 minutes, P = 0.001), docking time (11.9 ± 4.3 minutes vs. 5.2 ± 1.9 minutes, P = 0.001), actual dissection time (34.6 ± 18.4 minutes vs. 14.6 ± 5.1 minutes, P = 0.001), console time (58.7 ± 23.0 minutes vs. 32.4 ± 11.6 minutes, P = 0.001), immediate postoperative pain (4.6 ± 1.3 vs. 3.2 ± 1.0, P = 0.001), and pain prior to discharge (2.0 ± 0.6 vs. 1.4 ± 0.0, P = 0.002) were significantly improved in RSPC.ConclusionRSPC is feasible, safe, and effective. The perioperative outcomes are better compared with Si-robotic single-site surgical systems.
| S-EPMC7791187 | biostudies-literature
Project description:Introduction:For a long time, the comprehensive application of minimally invasive techniques in lower gastrointestinal (GI) surgery was substantially impaired by inherent anatomical and technical complexities. Recently, several new techniques such as robotic operating platforms and transanal total mesorectal excision (taTME) have revolutionized the minimally invasive approach. This review aims to depict the current state of the art and evaluates the advantages and drawbacks in regard to perioperative outcome and quality of oncological resection. Methods:A systematic literature search was performed using the search terms 'colorectal cancer', 'rectal cancer', 'minimally invasive surgery', 'laparoscopic surgery', and 'robotic' to identify relevant studies reporting on robotic surgery (RS) either alone or in comparison to laparoscopic surgery (LS). Publications on taTME were analyzed separately. Results:69 studies reporting on RS with a total of 20,872 patients, and 17 articles on taTME including 881 patients, were identified. Conclusion:Both RS and taTME can facilitate a minimally invasive approach for lower GI surgery in an increasing number of patients. Furthermore, combining both techniques might become an auspicious approach in selected patients; further prospective and randomized trials are needed to verify its benefits over conventional laTME.
| S-EPMC5869491 | biostudies-literature