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Homing sensors: (left) front view of the actuation unit showing the placement of the rotational and translational sensors, (right) side view of the actuation unit showing the reflective fiducial.
Source publication
Lung cancer is one of the most prevalent and deadly forms of cancer, claiming more than 154,000 lives in the USA per year. Accurate targeting and biopsy of pulmonary abnormalities is key for early diagnosis and successful treatment. Many cancerous lesions originate in the peripheral regions of the lung which are not directly accessible from the bro...
Contexts in source publication
Context 1
... trigger when a protrusion on the carriage breaks the optical path of the sensor. Rotational reflective sensors (OPB608V Reflective Sensor, TT Electronics) are placed on plastic support arms mounted to the chassis so that they align with the gear hub when the translational sensor is triggered (Figure 3), and a reflective homing mark on the gear hub indicates the rotational home position. The homing protocol, which initiates upon system power-up, is carried out as follows: (1) each carrier is retracted until the chassis-mounted translational sensor associated with that carriage is activated, establishing a home position on the linear axis, (2) the rotational degree of freedom is advanced unidirectionally until the chassis-mounted rotational sensor is triggered ( Figure 3(right)), thereby establishing home position on the rotational axis. ...
Context 2
... reflective sensors (OPB608V Reflective Sensor, TT Electronics) are placed on plastic support arms mounted to the chassis so that they align with the gear hub when the translational sensor is triggered (Figure 3), and a reflective homing mark on the gear hub indicates the rotational home position. The homing protocol, which initiates upon system power-up, is carried out as follows: (1) each carrier is retracted until the chassis-mounted translational sensor associated with that carriage is activated, establishing a home position on the linear axis, (2) the rotational degree of freedom is advanced unidirectionally until the chassis-mounted rotational sensor is triggered ( Figure 3(right)), thereby establishing home position on the rotational axis. To quantify the accuracy of the homing protocol, we conducted 12 repeatability tests on each axis. ...
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Background
Identification of small pulmonary nodules is challenging in a limited intrathoracic field during minimally invasive video‐assisted thoracoscopic surgery (VATS), and preoperative localization is required. Various techniques have been reported with some failure and complications. Here, we compare the feasibility and safety between electrom...
Citations
... Swaney et al. proposed a robotic system utilizing concentric tubes and a steerable needle with magnetic tracking, enabling precise movement through the bronchial wall [10]. Similarly, Amack et al. designed a concentric tubular robot with a compact, modular, and multi-stage mechanism to deploy a steerable needle through a standard flexible bronchoscope [11]. Duan et al. developed a bronchoscope robot with a small end-effector composed of a nickel-titanium tube, achieving three degrees of freedom in motion [12]. ...
... Medical robotics are capable of conducting minimally invasive interventions on internal organs located in confined areas [15,19,20,21,22,23,24,25]. Relevant scholars have also worked on robotassisted transbronchial lung biopsy [14,26,27]. In this paper, taking a different approach, a flexible robot with minimized end effector diameter, three DOFs and manual/automatic control mode is proposed aiming to overcome the aforementioned limitations. ...
Transbronchial lung biopsy is an effective and less-invasive treatment for the early diagnosis of lung cancer. However, the limited dexterity of existing endoscopic instruments and the complexity of bronchial access prevent the application of such procedures mainly for biopsy and diagnosis. This paper proposes a flexible robot for transbronchial lung biopsy with a cable-driven mechanism-based flexible manipulator. The robotic system of transbronchial lung biopsy is presented in detail, including the snake-bone end effector, the flexible catheters and the actuation unit. The kinematic analysis of the snake-bone end effector is conducted for the master-slave control. The experimental results show that the end effector reaches the target nodule through a narrow and tortuous pathway in a bronchial model. In conclusion, the proposed robotic system contributes to the field of advanced endoscopic surgery with high flexibility and controllability.
... Distinct from the conventional robot construction concept, the modular robot is a collection or assembly of several autonomous robotic units, where these separated units can connect each other to act as a whole entity, and more importantly, can reconfigure its morphologies and behaviors to adapt to different environments and tasks. Since the concept of cellular robot (CEBOT) in 1988 15 , as a long-term goal with exciting potential for payoffs, scientists have made lots of efforts in the modular robot, including compact unit design 16,17 , reliable connection components 18,19 , effective algorithms coordination [20][21][22] , and on-site extensibility 23,24 . However, under the critical constraints of space and energy consumption, constructing modular robot at small-scale is still very difficult limited by the lack of conscious approaching, diverse docking, and selective detaching strategies between micro units (Table 1). ...
Modular robot that can reconfigure architectures and functions has advantages in unpredicted environment and task. However, the construction of modular robot at small-scale remains a challenge since the lack of reliable docking and detaching strategies. Here we report the concept of milli-scale cellular robot (mCEBOT) achieved by the heterogeneous assembly of two types of units (short and long units). Under the magnetic field, the proposed mCEBOT units can not only selectively assemble (e.g., end-by-end and side-by-side) into diverse morphologies corresponding to the unstructured environments, but also configure multi-modes motion behaviors (e.g., slipping, rolling, walking and climbing) based on the on-site task requirements. We demonstrate its adaptive mobility from narrow space to high barrier to wetting surface, and its potential applications in hanging target taking and environment exploration. The concept of mCEBOT offers new opportunities for robot design, and will broaden the field of modular robot in both miniaturization and functionalization. Modular robots with reconfigurable architectures show advantages in unpredicted environments. Here Yang et al. propose a heterogeneous assembly concept for cellular robot construction at millimeter scales, which can simultaneously reconfigure their morphologies and behaviours to conduct versatile tasks on demand.
... The robot was validated on a phantom consisting of a bronchial tree (made from plastic tubes) that was embedded in a phantom parenchyma (gelatin) and on ex vivo porcine wall tissue. Amack et al. [95] improved the concept of accessing the peripheral lung by designing a more compact, modular, multi-stage robot to retrieve biopsies from lesions in the peripheral regions of the lung. The improved version included a quickconnect mechanism, which allowed the rapid tool interchange employing a similar concept as in [20]. ...
Continuum robots are snake-like systems able to deliver optimal therapies to pathologies deep inside the human cavity by following 3D complex paths. They show promise when anatomical pathways need to be traversed thanks to their enhanced flexibility and dexterity and show advantages when deployed in the field of single-port surgery. This PhD thesis concerns the development and modelling of multi-arm and hybrid continuum robots for medical interventions. The flexibility and steerability of the robot’s end-effector are achieved through concentric tube technology and push/pull technology. Medical robotic prototypes have been designed as proof of concepts and testbeds of the proposed theoretical works.System design considers the limitations and constraints that occur in the surgical procedures for which the systems were proposed for. Specifically, two surgical applications are considered. Our first prototype was designed to deliver multiple tools to the eye cavity for deep orbital interventions focusing on a currently invasive intervention named Optic Nerve Sheath Fenestration (ONSF). This thesis presents the end-to-end design, engineering and modelling of the prototype. The developed prototype is the first suggested system to tackle the challenges (limited workspace, need for enhanced flexibility and dexterity, danger for harming tissue with rigid instruments, extensive manipulation of the eye) arising in ONSF. It was designed taking into account the clinical requirements and constraints while theoretical works employing the Cosserat rod theory predict the shape of the continuum end-effector. Experimental runs including ex vivo experimental evaluations, mock-up surgical scenarios and tests with and without loading conditions prove the concept of accessing the eye cavity. Moreover, a continuum robot for thoracic interventions employing push/pull technology was designed and manufactured. The developed system can reach deep seated pathologies in the lungs and access regions in the bronchial tree that are inaccessible with rigid and straight instruments either robotically or manually actuated. A geometrically exact model of the robot that considers both the geometry of the robot and mechanical properties of the backbones is presented. It can predict the shape of the bronchoscope without the constant curvature assumption. The proposed model can also predict the robot shape and micro-scale movements accurately in contrast to the classic geometric model which provides an accurate description of the robot’s differential kinematics for large scale movements.
... We implemented and evaluated our learning-based method on a robotic needle steering system previously presented in [12], designed to perform lung tumor biopsy through a bronchoscope. The steerable needle used was manufactured out of superelastic Nitinol measuring 1:24 mm OD, 1:0 mm ID, 1:3 m long (EuroFlex GmbH), fabricated using the method described in [13], and deployed through a clinical bronchoscope (Ambu USA). ...
Steerable needles are a promising technology for delivering targeted therapies in the body in a minimally invasive fashion via controlled, actively steered insertions.
... The robotic biopsy was introduced in the following anatomical sites: the bone [1], lung [2], breast [3], brain or brainstem [4], prostate [5•], and liver [6]. In addition, needle approaches can be extrapolated for treatment purposes such as thermal ablation [6] or brachytherapy. ...
Purpose of the review
Robotics is a rapidly advancing field, and its introduction in healthcare can have a multitude of benefits for clinical practice. Especially, applications depending on the radiologist’s accuracy and precision, such as percutaneous interventions, may profit. This paper provides an overview of recent robot-assisted percutaneous solutions.
Recent findings
Percutaneous interventions are relatively simple and the quality of the procedure increases a lot by introducing robotics due to the improved accuracy and precision. The success of the procedure is heavily dependent on the ability to merge pre- and intraoperative images, as an accurate estimation of the current target location allows to exploit the robot’s capabilities.
Summary
Despite much research, the application of robotics in some branches of healthcare is not commonplace yet. Recent advances in percutaneous robotic solutions and imaging are highlighted, as they will pave the way to more widespread implementation of robotics in clinical practice.
... Data Collection and Network Training: We implemented and evaluated our learning-based method on a robotic needle steering system previously presented in [12], designed to perform lung tumor biopsy through a bronchoscope. The steerable needle used was manufactured out of superelastic Nitinol measuring 1.24 mm OD, 1.0 mm ID, 1.3 m long (EuroFlex GmbH), fabricated using the method described in [13], and deployed through a clinical bronchoscope (Ambu USA). ...
Steerable needles are a promising technology for delivering targeted therapies in the body in a minimally-invasive fashion, as they can curve around anatomical obstacles and hone in on anatomical targets. In order to accurately steer them, controllers must have full knowledge of the needle tip's orientation. However, current sensors either do not provide full orientation information or interfere with the needle's ability to deliver therapy. Further, torsional dynamics can vary and depend on many parameters making steerable needles difficult to accurately model, limiting the effectiveness of traditional observer methods. To overcome these limitations, we propose a model-free, learned-method that leverages LSTM neural networks to estimate the needle tip's orientation online. We validate our method by integrating it into a sliding-mode controller and steering the needle to targets in gelatin and ex vivo ovine brain tissue. We compare our method's performance against an Extended Kalman Filter, a model-based observer, achieving significantly lower targeting errors.
... The robot was validated on phantom consisting of a bronchial tree (made from plastic tubes) that was embedded in a phantom parenchyma (gelatin) and on ex vivo porcine wall tissue. Amack et al. (127) improved the concept of accessing the peripheral lung by designing a more compact, modular, multi-stage robot to retrieve biopsies from lesions in the peripheral regions of the lung. The improved version included a quick-connect mechanism, which allowed the rapid tool interchange employing a similar concept as (115). ...
Continuum robots can traverse anatomical pathways to intervene in regions deep inside the human body. They are able to steer along 3D curves in confined spaces and dexterously handle tissues. Concentric tube robots (CTRs) are continuum robots that comprise a series of precurved elastic tubes that can be translated and rotated with respect to each other to control the shape of the robot and tip pose. CTRs are a rapidly maturing technology that has seen extensive research over the past decade. Today, they are being evaluated as tools for a variety of surgical applications, as they can offer precision and manipulability in tight workspaces. This review provides an exhaustive classification of research on CTRs based on their clinical applications and highlights approaches for modeling, control, design, and sensing. Competing approaches are critically presented, leading to a discussion of future directions to address the limitations of current research and its translation to clinical applications.
Expected final online publication date for the Annual Review of Control, Robotics, and Autonomous Systems, Volume 5 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
... This requires a specific, predetermined setup, different than the workflow of handheld tools. Recent efforts to enable portable CTRs include prototypes with reduced number of tubes and actuated DOF, leading to limited tip control capabilities [24], [25], [26], [27], [28], with some of them remaining too heavy to be hand-held. In addition, several user input mechanisms have been considered and evaluated for use with continuum robots, including joysticks and triggers [24], [23], haptic interfaces [29], [21], 3D mouse and gamepads [30], in combination with tip pose control algorithms, that still have practical limitations [31]. ...
Minimally invasive surgery is of high interest for interventional medicine since the smaller incisions can lead to less pain and faster recovery for patients. The current standard-of-care involves a range of affordable, manual, hand-held rigid tools, whose limited dexterity and range of adoptable shapes can prevent access to confined spaces. In contrast, recently developed roboticized tools that can provide increased accessibility and dexterity to navigate and perform complex tasks often come at the cost of larger, heavier, and grounded devices that are teleoperated, posing a new set of challenges. In this article, we propose a new hand-held concentric tube robot with an associated position control method that has the dexterity and precision of large roboticized devices, while maintaining the footprint of a traditional hand-held tool. The device shows human-in-the-loop control performance that meets the requirements of the targeted application, percutaneous abscess drainage. In addition, a small user study illustrates the advantage of combining rigid body motion of the device with more precise motions of the tip, thus showing the potential to bridge the gap between traditional hand-held tools and grounded robotic devices.
... This requires a specific, predetermined setup, different than the workflow of handheld tools. Recent efforts to enable portable CTRs include prototypes with reduced number of tubes and actuated DOF, leading to limited tip control capabilities [24], [25], [26], [27], [28], with some of them remaining too heavy to be hand-held. In addition, several user input mechanisms have been considered and evaluated for use with continuum robots, including joysticks and triggers [24], [23], haptic interfaces [29], [21], 3D mouse and gamepads [30], in combination with tip pose control algorithms, that still have practical limitations [31]. ...
Minimally invasive surgery is of high interest for interventional medicine, since the smaller incisions can lead to less pain and faster recovery for patients. The current standard-of-care involves a range of affordable, manual, hand-held rigid tools, whose limited dexterity and range of adoptable shapes can prevent access to confined spaces. In contrast, recently developed roboticized tools that can provide increased accessibility and dexterity to navigate and perform complex tasks, often come at the cost of larger, heavier, grounded devices that are teleoperated, posing a new set of challenges. In this paper, we propose a new hand-held concentric tube robot with an associated position control method that has the dexterity and precision of large roboticized devices, while maintaining the footprint of a traditional hand-held tool. The device shows human-in-the-loop control performance that meets the requirements of the targeted application, percutaneous abscess drainage. In addition, a small user study illustrates the advantage of combining rigid body motion of the device with more precise motions of the tip, thus showing the potential to bridge the gap between traditional hand-held tools and grounded robotic devices.
