Combined OCT distance and FBG force sensing cannulation needle for retinal vein cannulation: in vivo animal validation.

PURPOSE: Retinal vein cannulation is an experimental procedure during which a clot-dissolving drug is injected into an obstructed retinal vein. However, due to the fragility and minute size of retinal veins, such procedure is considered too risky to perform manually. With the aid of surgical robots, key limiting factors such as: unwanted eye rotations, hand tremor and instrument immobilization can be tackled. However, local instrument anatomy distance and force estimation remain unresolved issues. A reliable, real-time local interaction estimation between instrument tip and the retina could be a solution. This paper reports on the development of a combined force and distance sensing cannulation needle, and its experimental validation during in vivo animal trials. METHODS: Two prototypes are reported, relying on force and distance measurements based on FBG and OCT A-scan fibres, respectively. Both instruments provide an 80 [Formula: see text] needle tip and have outer shaft diameters of 0.6 and 2.3 mm, respectively. RESULTS: Both prototypes were characterized and experimentally validated ex vivo. Then, paired with a previously developed surgical robot, in vivo experimental validation was performed. The first prototype successfully demonstrated the feasibility of using a combined force and distance sensing instrument in an in vivo setting. CONCLUSION: The results demonstrate the feasibility of deploying a combined sensing instrument in an in vivo setting. The performed study provides a foundation for further work on real-time local modelling of the surgical scene. This paper provides initial insights; however, additional processing remains necessary.

Integrated high pressure microhydraulic actuation and control for surgical instruments.

To reduce the surgical trauma to the patient, minimally invasive surgery is gaining considerable importance since the eighties. More recently, robot assisted minimally invasive surgery was introduced to enhance the surgeon's performance in these procedures. This resulted in an intensive research on the design, fabrication and control of surgical robots over the last decades. A new development in the field of surgical tool manipulators is presented in this article: a flexible manipulator with distributed degrees of freedom powered by microhydraulic actuators. The tool consists of successive flexible segments, each with two bending degrees of freedom. To actuate these compliant segments, dedicated fluidic actuators are incorporated, together with compact hydraulic valves which control the actuator motion. Especially the development of microvalves for this application was challenging, and are the main focus of this paper. The valves distribute the hydraulic power from one common high pressure supply to a series of artificial muscle actuators. Tests show that the angular stroke of the each segment of this medical instrument is 90°.

2-Scale topography dry electrode for biopotential measurements.

The design and fabrication of a novel 2-scale topography dry electrode using macro and micro needles is presented. The macro needles enable biopotential measurements on hairy skin, the function of the micro needles is to decrease the electrode impedance even further by penetrating the outer skin layer. Also, a fast and reliable impedance characterization protocol is described. Based on this impedance measurement protocol, a comparison study is made between our dry electrode, 3 other commercial dry electrodes and a standard wet gel electrode. Promising results are already obtained with our electrodes which do not have skin piercing micro needles. For the proposed electrodes, three different conductive coatings (Ag/AgCl/Au) are compared. AgCl is found to be slightly better than Ag as coating material, while our Au coated electrodes have the highest impedance.

Implementation of an intuitive writing interface and a laparoscopic robot for gynaecological laser assisted surgery.

The research reported in this paper aims at applying the human handwriting skill to improve and facilitate the control of laser-assisted laparoscopic surgery operations performed by gynaecological surgeons. For the purpose, a laparoscopic robot was interfaced with a digitizing tablet. This interface, further called the intuitive writing interface (IWI), directly converts the hand trajectory, handwritten on the tablet, into an input signal to the robot. It replaces the traditional complex manipulations performed by the surgeon during manual laparoscopic surgery by natural handwriting. It provides the surgeon with an intuitive 'what-you-draw-is-what-you-cut' control facility by employing his/her familiar handwriting skills to control the laser ablation process accurately. The system was successfully built and tested in vitro. Performance tests on the robot resulted in tracking errors in the order of 1 mm in the target plane at an ablation speed of 20 mm/s. The high accuracy of the system was successfully demonstrated by cutting characters 4 mm high on an apple. These results indicate that laser ablation performance is upgraded by the IWI to the accuracy levels of human handwriting, which is much higher than can be obtained with manual laser laparoscopy. Safety features include the use of pen contact with the tablet as a safety switch, and back drivability in the robot joints for easy manual positioning and evacuation in case of emergency.

High torque ultrasonic motors for hand prosthetics: current status and trends.

This paper presents the work carried out at the Instituto de Automática Industrial, in the framework of the EU MANUS project and with the co-operation of the Katholieke Universiteit of Leuven, to develop a specifically designed TWUM for driving our prototype of hand prosthesis. The application of TWUM to prosthetic devices has clear advanteges, namely, noiseless operation, self-braking drive, high torque and low speed characteristics. Here we analyse main actuation advantages, point out main drawbacks of this technology and describe our research in the area of specific design of TWUM for high torque actuation, improved control characteristics and enhanced overall performance. We intend to provide a concurrent approach to the overall actuator design involving electronics, mechanical design as well as improved control strategies having in mind the prosthetic application.

Shape memory and superelastic alloys: the new medical materials with growing demand.

Shape memory and superelasticity are novel properties not exhibited by common materials. In recent years, these properties and the alloys exhibiting them have found widespread use as new medical materials, in devices such as diagnostic and therapeutic catheters of different kinds, stents, needle wire localisers, orthodontic arch wires, implantable drug delivery system etc. The reasons for this trend and the future potential of these materials in medical applications will be explained in this presentation.