225 results found
Laws SG, Souipas S, Davies BL, et al., 2020, Toward Automated Tissue Classification for Markerless Orthopaedic Robotic Assistance, IEEE Transactions on Medical Robotics and Bionics, Vol: 2, Pages: 537-540
A markerless computer aided orthopaedic platform will require a complex computer vision system to isolate and track rigid bodies used to localize a robot to a patient. Isolating rigid bodies such as bone requires accurate segmentation and this study explores using diffuse laser reflectivity to accurately classify tissue. Lasers (red at 650nm and infrared - IR - at 850nm) intersected four material types; cartilage, ligament, muscle and metal surgical tools within a controlled cadaveric setup. Images were captured with an infrared CMOS sensor, pre-processed to isolate laser centers, and resized to test information requirements. Images for both laser types were scaled from 5\times5 pixels to 30\times30 pixels and trained on a convolutional neural network, GoogLeNet. At sizes above 15\times15 pixels, the IR laser had a higher classification accuracy, reaching 97.8% at 30\times30 pixels, whereas the red laser peaked at 94.1%. It was shown as not possible to qualitatively identify materials that were not trained in the network based on their probability outputs. Further work will be performed to classify multiple points in a single scene as a step toward segmenting entire surgical views for markerless Computer Assisted Orthopedic Surgery (CAOS) systems.
Peripheral intravenous catheterization (PIVC) is pervasively needed in hospitals. However, given the levels of precision and controllability needed for PIVC, this operation suffers from very low success rates. For young patients, about half of the first insertions fail. Robotic systems have great potential to effectively assist the operation and improve the success rates, which has led to the recent development of different robots to automate PIVC. These robots are equipped with various sensors and actuators, resulting in expensive, complex, and grounded machines. Yet, fully automating the operation is neither needed nor desired, as current clinical preference is oriented toward keeping the practitioner involved and in control of the operation. Therefore, in this study we proposed an innovative smart hand-held robotic device, named CathBot, that enhances intra-operative control during PIVC with automatic features that guarantee very high success rates. It exploits an electrical impedance sensor to detect the venipuncture and a crank-slider mechanism to automate the subsequent cannula advancement and needle retraction. Here, CathBot is first characterized through engineering experiments that demonstrate its capability to successfully perform the whole PIVC operation on a realistic baby arm phantom without human involvement. Subsequent experiments evaluate the device with naïve subjects on the same realistic pediatric PIVC scenario. The results demonstrate that CathBot can significantly improve the PIVC performance. Naïve subjects achieved an average 86% success rate, and 80% of the subjects succeeded in their first attempt. These results demonstrate the technology has potential to greatly improve both the clinician's and the patient's PIVC experience.
Cheng Z, Davies BL, Caldwell DG, et al., 2018, A New Venous Entry Detection Method Based on Electrical Bio-impedance Sensing., Ann Biomed Eng, Vol: 46, Pages: 1558-1567
Peripheral intravenous catheterization (PIVC) is frequently required for various medical treatments. Over 1 billion PIVC operations are performed per year in the United States alone. However, this operation is characterized by a very low success rate, especially amongst pediatric patients. Statistics show that only 53% of first PIVC attempts are successful in pediatric patients. Since their veins are small and readily rupture, multiple attempts are commonly required before successfully inserting the catheter into the vein. This article presents and evaluates a novel venous entry detection method based on measuring the electrical bio-impedance of the contacting tissue at the tip of a concentric electrode needle (CEN). This detection method is then implemented in the design of a clinical device called smart venous entry indicator (SVEI), which lights up a LED to indicate the venous entry when the measured value is within the range of blood. To verify this detection method, two experiments are conducted. In the first experiment, we measured the bio-impedance during the insertion of a CEN into a rat's tail vein with different excitation frequencies. Then three classifiers are tested to discriminate blood from surrounding tissues. The experimental results indicate that with 100 kHz excitation frequency the blood bio-impedance can be identified with accuracy nearly 100%, demonstrating the feasibility and reliability of the proposed method for venous entry detection. The second experiment aims to assess the impact of SVEI on PIVC performance. Ten naive subjects were invited to catheterize a realistic baby arm phantom. The subjects are equally divided into two groups, where one group does PIVC with SVEI and the other group uses an ordinary IV catheter. The results show that subjects using SVEI can achieve much higher success rates (86%) than those performing PIVC in a conventional way (12%). Also, all subjects assisted by SVEI succeeded in their first trials while no one su
Cheng Z, Davies BL, Caldwell DG, et al., 2018, SDOP: A smart handheld device for over puncture prevention during pediatric peripheral intravenous catheterization, Pages: 1-6
Peripheral IntraVenous Catheterization (PIVC) is a very common procedure for medicinal infusion and blood sampling. Unfortunately, this operation suffers from very low success rates. Especially for young children, because their veins are very small and fragile, PIVC procedure is generally difficult and critical. One of the most difficult tasks during PIVC is to detect venipuncture and immediately stop the insertion. Because of the vague haptic sensing of venipuncture and difficulty in immediately stopping the insertion after venipuncture, over-puncture is a common reason for failure in pediatric PIVC. In this study, we propose a design of a handheld device to improve the catheter insertion procedure. This device integrates a venipuncture detection sensor based on electrical impedance measurement at the needle tip and a latch based disengage mechanism to provide a security guarantee by stopping the catheter advancement immediately after venipuncture. This key feature was assessed through user trials based on a realistic pediatric PIVC trainer mannequin. Results demonstrated the great advantage of SDOP, which was able to help even naïve users achieve success rates considerably higher than typical values reported for expert practitioners.
Davies BL, Zhuoqi C, Mattos L, et al., 2018, A hand-held robot for paediatric PIVC: Device design and pre-clinical trial., Journal of Medical Robotics Research
Cheng Z, Davies BL, Caldwell DG, et al., 2017, A hand-held robotic device for peripheral intravenous catheterization., Proc Inst Mech Eng H, Vol: 231, Pages: 1165-1177
Intravenous catheterization is frequently required for numerous medical treatments. However, this process is characterized by a high failure rate, especially when performed on difficult patients such as newborns and infants. Very young patients have small veins, and that increases the chances of accidentally puncturing the catheterization needle directly through them. In this article, we present the design, development and experimental evaluation of a novel hand-held robotic device for improving the process of peripheral intravenous catheterization by facilitating the needle insertion procedure. To our knowledge, this design is the first hand-held robotic device for assisting in the catheterization insertion task. Compared to the other available technologies, it has several unique advantages such as being compact, low-cost and able to reliably detect venipuncture. The system is equipped with an electrical impedance sensor at the tip of the catheterization needle, which provides real-time measurements used to supervise and control the catheter insertion process. This allows the robotic system to precisely position the needle within the lumen of the target vein, leading to enhanced catheterization success rate. Experiments conducted to evaluate the device demonstrated that it is also effective to deskill the task. Naïve subjects achieved an average catheterization success rate of 88% on a 1.5 mm phantom vessel with the robotic device versus 12% with the traditional unassisted system. The results of this work prove the feasibility of a hand-held assistive robotic device for intravenous catheterization and show that such device has the potential to greatly improve the success rate of these difficult operations.
Cheng Z, Davies BL, Caldwell DG, et al., 2016, A venipuncture detection system for robot-Assisted intravenous catheterization, Pages: 80-86, ISSN: 2155-1774
Vascular access is frequently required for patients admitted to hospitals. This requires a delicate process of intravenous (IV) catheterization that, as opposed to common believe, suffers from a high failure rate typically close to 30%. In case of special patients such as infants, the elderly, and people with diabetes or other health conditions that affect blood vessels, the challenge to achieve intravenous access is higher, leading to an even lower venipuncture success rate. Stopping the needle before the first vein wall or going completely through the vein are the common causes of failure, and can potentially cause severe damage to the soft tissue. In this study we propose a new robotic system to improve the venipuncture procedure. The system is based on a high resolution motion stage and a new detection system able to measure the electrical impedance of tissue around the IV needle tip. This detection system allows the discrimination of the different tissue types accessed during the insertion process, and a fast and robust detection of vein entry by detecting blood. This paper presents the design and development of this new robot-Assisted venipuncture system. Experiments in realistic phantoms were designed and undertaken for the system's evaluation, which also demonstrated the effective performance of the proposed venipuncture detection system.
Cheng Z, davies BL, 2015, Modelling needle forces during insertion into soft tissue, 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society of the IEEE Engineering in Medicine and Biology Society (EMBC'15)
Davies B, 2015, Robotic Surgery - A Personal View of the Past, Present and Future, INTERNATIONAL JOURNAL OF ADVANCED ROBOTIC SYSTEMS, Vol: 12, ISSN: 1729-8814
Bowyer SA, Davies BL, Rodriguez y Baena F, 2014, Active Constraints/Virtual Fixtures: A Survey, IEEE TRANSACTIONS ON ROBOTICS, Vol: 30, Pages: 138-157, ISSN: 1552-3098
Tse ZTH, Elhawary H, Rea M, et al., 2012, Haptic Needle Unit for MR-Guided Biopsy and Its Control, IEEE-ASME TRANSACTIONS ON MECHATRONICS, Vol: 17, Pages: 183-187, ISSN: 1083-4435
Davies BL, 2011, Robotic orthopedic surgery: From research to spin-off to acquisition, Pages: 138-157
Parittotokkaporn T, Thomas DG, Schneider A, et al., 2011, Microtextured Surfaces for Deep-Brain Stimulation Electrodes: A Biologically Inspired Design to Reduce Lead Migration, World Neurosurgery, Vol: 77, Pages: 569-576, ISSN: 1878-8750
OBJECTIVE: Hardware-related complications of deep brain stimulation (DBS) surgery have been reported with adverse effects in postoperative electrode migration. We report that the addition of microtextured features to the surface of a DBS-like probe can minimize the extent of electrode migration in ex vivo porcine brain. METHODS: A DBS lead and microtextured strips, mounted with a fiberoptic displacement sensor, were embedded 15-mm deep inside a cadaveric porcine brain through holes on the skull. The local displacement of brain tissue surrounding each strip was detected along the direction of insertion by the optical sensor while the porcine head simulated brain shift during rotation between supine and upright postures. RESULTS: The triangular toothed strip with protruding height of 250 mum enabled a better grip of the surrounding brain tissue than standard DBS lead, minimizing local brain displacement to 77 mum versus 326 mum respectively, when the porcine head was shifted from the supine to the upright position as the result of gravity. In addition, brain tissue damage resulting from the removal of toothed strips exhibited less-extensive tissue disruption, attributable to the microtextured surface. CONCLUSIONS: These preliminary results show that microtextured strips embedded into cadaveric porcine brain produce an anchoring effect on local tissue during brain shift, suggesting a way to reduce DBS lead migration without additional tissue damage beyond the strip geometry.
Tenzer Y, Bowyer S, Davies BL, et al., 2011, "Sticking" aspects of a haptic device with part-locking programmable brakes, Pages: 269-274
This paper outlines work on the development of a novel programmable rotary brake which can restrict motion of a mechanism moving in one direction whilst allowing free motion in other directions. The design, implementation and performance of a fully functional prototype are described along the work on incorporating the prototype into a 3 Degrees-Of-Freedom (DOF) haptic device. The ability of the haptic device to constrain the motion of the end-effector to point-constraint was investigated and the experiments have shown that the haptic device can implement virtual constraints without the need for a force sensor. The experiments also show that when an advanced control scheme is used the virtual wall is not felt as "sticky". © 2011 IEEE.
Tenzer Y, Davies BL, Rodriguez y Baena F, 2011, Four-State Rotary Joint Control: Results With a Novel Programmable Brake, Mechatronics, IEEE/ASME Transactions on, Vol: 17, Pages: 915-923, ISSN: 1083-4435
Parittotokkaporn T, Frasson L, Schneider A, et al., 2010, Insertion experiments of a biologically inspired microtextured and multi-part probe based on reciprocal motion., Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference, Pages: 3190-3193, ISSN: 1557-170X
While there have been significant advances in minimally invasive surgical instrumentation, the majority of tools still rely on a push from the back to aid insertion into the tissue, whether the process is manual or servo assisted. In this work, a novel approach to tool insertion is proposed which is based on the concept of a multi-part probe with at least three interlocking segments. By means of a sequential insertion process, where each segment is pushed further into the tissue while stabilized by the remaining stationary parts, the multi-part probe concept is shown to successfully "insinuate itself" within a synthetic soft tissue specimen without the need for an overall forward push. The presence of an anisotropic microtextured outer probe surface is also shown to affect the overall speed of insertion and can thus be used to optimize the interaction forces at the probe-tissue interface. A measured reduction in the force transferred to the back of the specimen also suggests that this approach to tool insertion may result in reduced tissue disruption, a result which could lead to less tissue damage and a reduction in target displacement.
Frasson L, Neubert J, Reina S, et al., 2010, Development and validation of a numerical model for cross-section optimization of a multi-part probe for soft tissue intervention., Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference, Pages: 3202-3205, ISSN: 1557-170X
The popularity of minimally invasive surgical procedures is driving the development of novel, safer and more accurate surgical tools. In this context a multi-part probe for soft tissue surgery is being developed in the Mechatronics in Medicine Laboratory at Imperial College, London. This study reports an optimization procedure using finite element methods, for the identification of an interlock geometry able to limit the separation of the segments composing the multi-part probe. An optimal geometry was obtained and the corresponding three-dimensional finite element model validated experimentally. Simulation results are shown to be consistent with the physical experiments. The outcome of this study is an important step in the provision of a novel miniature steerable probe for surgery.
Elhawary H, Tse ZT-H, Rea M, et al., 2010, Robotic System for Transrectal Biopsy of the Prostate Real-Time Guidance Under MRI, IEEE ENGINEERING IN MEDICINE AND BIOLOGY MAGAZINE, Vol: 29, Pages: 78-86, ISSN: 0739-5175
Ko SY, Davies BL, Rodriguez y Baena F, 2010, Two-Dimensional Needle Steering with a "Programmable Bevel" Inspired by Nature: Modeling Preliminaries, IEEE/RSJ International Conference on Intelligent Robots and Systems, Publisher: IEEE, Pages: 2319-2324, ISSN: 2153-0858
Yen P-L, Davies BL, 2010, Active constraint control for image-guided robotic surgery, PROCEEDINGS OF THE INSTITUTION OF MECHANICAL ENGINEERS PART H-JOURNAL OF ENGINEERING IN MEDICINE, Vol: 224, Pages: 623-631, ISSN: 0954-4119
Davies B, 2010, A review of the state-of-the-art of ‘smart’ systems in surgery, International Journal of Intelligent Systems Technologies and Applications, Vol: 8, Pages: 423-433, ISSN: 1740-8865
In recent years, there has been a considerable transition in smart systems for surgery. Originally systems were devised primarily from large industrial robots. There has been a gradual transition towards sensor rich devices which are much simpler, lower-cost and devised for specific surgical tasks. The history of this development is considered together with examples, and the reasons for this gradual transition are discussed. Specific details are given of the Acrobot ‘hands-on’ robot for orthopaedic surgery, which is an example of the gradual evolution of a medical robot from a large industrial robot carrying a second robot as an end effector, to a small, low cost smart system for specific tasks. © 2010 Inderscience Enterprises Ltd.
Frasson L, Parittotokkaporn T, Davies BL, et al., 2010, Early developments of a novel smart actuator inspired by nature, International Journal of Intelligent Systems Technologies and Applications, Vol: 8, Pages: 409-422, ISSN: 1740-8865
Current research at Imperial College focuses on the development of a novel neurosurgical probe for Minimally Invasive Surgery (MIS), which exploits the design of certain ovipositing wasps. While conventional instruments are rigid and only used to achieve straight-line trajectories, the biomimetic design will enable curved paths connecting any entry point to any target within the brain to be followed autonomously. This paper reports on the successful outcome of an early feasibility study, where two of the key concepts behind the design are investigated: a robotic actuator was developed to demonstrate effective soft tissue traversal by reciprocating custom-built anisotropic surface textures, without the need to apply an external force to push the tissue along. Then, custom-designed rigid probes with bio-inspired surface topographies were fabricated and tested on cadaveric porcine brain with the aim to characterise the insertion and extraction forces due to friction and tribological interaction with biological tissue. © 2010 Inderscience Enterprises Ltd.
Frasson L, Neubert J, Reina S, et al., 2010, Development and Validation of a Numerical Model for Cross-section Optimization of a Multi-Part Probe for Soft Tissue Intervention, 32nd Annual International Conference of the IEEE Engineering-in-Medicine-and-Biology-Society (EMBC 10), Publisher: IEEE, Pages: 3202-3205, ISSN: 1557-170X
Parittotokkaporn T, Frasson L, Schneider A, et al., 2010, Insertion Experiments of a Biologically Inspired Microtextured and Multi-Part Probe Based on Reciprocal Motion, 32nd Annual International IEEE EMBS Conference
Tenzer Y, Davies BL, Rodriguez y Baena F, 2010, Programmable differential brake for passive haptics, Robotics and Autonomous Systems, Pages: 249-255, ISSN: 0921-8890
This paper outlines work on a novel programmable braking system, which is widely applicable to most passive haptic applications and benefits from a simple design, theoretically infinite positional resolution and the ability to generate stiff collision forces, without the need for any explicit force measurements. Results are also given of a preliminary concept demonstrator which is based on a simple 2-Degrees-Of-Freedom (DOF) Revolute-Revolute (RR) manipulator incorporating the programmable brakes. Performance measures for the joint, as well as figures describing the ability of the 2-DOF prototype to constrain the end effector motion to a plane and a circle. are also provided. (C) 2009 Elsevier B.V. All rights reserved.
Rodriguez y Baena F, Davies B, 2010, Robotic surgery: from autonomous systems to intelligent tools, Robotica, Vol: 28, Pages: 163-170, ISSN: 0263-5747
A brief history of robotic surgery is provided, which describes the transition from autonomous robots to hands-on systems that are under the direct control of the surgeon. An example of the latter is the Acrobot (for active-constraint robot) system used in orthopaedics, whilst soft-tissue Surgery is illustrated by the daVinci telemanipulator system. Non-technological aspects of robotic surgery have often been a major impediment to their widespread clinical use. These are discussed in detail, together with the role of navigation systems, which are considered a major competitor to Surgical robots. A detailed description is then given of a registration method for robots to achieve improved accuracy. Registration is a major source of error in robotic surgery, particularly in orthopaedics. The paper describes the design and clinical implementation of a novel method, coined the bounded registration method, applied to minimally invasive registration of the femur. Results of simulations which compare the performance of bounded registration with a standard implementation of the iterative closest point algorithm are also presented, alongside a description of their application in the Acrobot hands-on robot, used clinically for uni-condylar knee arthroplasty.
Dogangil G, Davies BL, Rodriguez y Baena F, 2010, A review of medical robotics for minimally invasive soft tissue surgery, Vol: 224, Pages: 653-679, ISSN: 0954-4119
This paper provides an overview of recent trends and developments in medical robotics for minimally invasive soft tissue surgery, with a view to highlight some of the issues posed and solutions proposed in the literature. The paper includes a thorough review of the literature, which focuses on soft tissue surgical robots developed and published in the last five years (between 2004 and 2008) in indexed journals and conference proceedings. Only surgical systems were considered; imaging and diagnostic devices were excluded from the review. The systems included in this paper are classified according to the following surgical specialties: neurosurgery; eye surgery and ear, nose, and throat (ENT); general, thoracic, and cardiac surgery; gastrointestinal and colorectal surgery; and urologic surgery. The systems are also cross-classified according to their engineering design and robotics technology, which is included in tabular form at the end of the paper. The review concludes with an overview of the field, along with some statistical considerations about the size, geographical spread, and impact of medical robotics for soft tissue surgery today.
Hamed AM, Tse ZTH, Young I, et al., 2009, Applying tactile sensing with piezoelectric materials for minimally invasive surgery and magnetic-resonance-guided interventions, PROCEEDINGS OF THE INSTITUTION OF MECHANICAL ENGINEERS PART H-JOURNAL OF ENGINEERING IN MEDICINE, Vol: 223, Pages: 99-110, ISSN: 0954-4119
Parittotokkaporn T, Frasson L, Schneider A, et al., 2009, Soft tissue traversal with zero net force: Feasibility study of a biologically inspired design based on reciprocal motion, ROBIO 2008, IEEE International Conference on Robotics and Biomimetics, Publisher: IEEE, Pages: 80-85
Frasson L, Reina S, Davies BL, et al., 2009, Design Optimisation of a Biologically Inspired MultiPart Probe for Soft Tissue Surgery, 11th International Congress of the IUPESM/World Congress on Medical Physics and Biomedical Engineering, Publisher: SPRINGER, Pages: 307-310, ISSN: 1680-0737
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