Catheter associated urinary tract infections (CAUTI) are among the most common nonpayment hospital acquired conditions. Inexperienced health care providers placing indwelling urinary catheters are associated with an increased risk of CAUTI. The creation of high-fidelity simulators may reduce CAUTI risk during critical early learning. As a first step toward the creation of accurate simulators our group set out to characterize the mechanical aspects of urethral catheterization. This work presents an inexpensive, yet practical means of acquiring motion and force data from urethral catheter insertion procedures using OpenCV ArUco markers. Evaluation of the video system’s accuracy was done to understand the performance characteristics within the boundaries of the procedure’s target workspace. The tracking accuracy was validated to be roughly ± 3 mm in the plane of the camera, and ± 10–25 mm along its axis depending on the distance. Feasibility of using this platform in a clinically relevant setting was demonstrated by capturing the force and motion data when performing urinary catheterization on cadaveric donors (N=2).

No abstract

Robot assisted surgery has been widely accepted by the medical community. Surgeons utilize robots in many different procedures worldwide. However, cardiothoracic surgeons do not regularly use robotic tools to aid them in performing even simple, catheter based procedures such as cardiac ablation or mapping. Some cardiac Monophasic Action Potentials (MAPs) and ablation catheters require a specific window of force to either effectively characterize or scar cardiac tissue. This is challenging to maintain through the cardiac cycle, so the application of a constant force is not a trivial task for surgeons. Robotic assistance to control the force applied to a catheter through ablation and mapping procedures is needed to improve the outcome for patients. The purpose of this work is to develop a single degree of freedom robot that controls the force applied to a beating swine heart. Rather than trying to predict the motion and timing of the heartbeat, or tracking its movement this robot senses and reacts to the force produced by the myocardium. Through the cardiac cycle, the robot applies a constant force to the surface of a beating heart. The kinematics of the cardiac tissue were characterized by utilizing piezoelectric transducers. Hardware to control the catheter motion was designed to fit most commercially available devices. The controller was designed by first building a mathematical model using measured data, and then a control law was implemented considering the heartbeat as disturbances to the system. Finally, testing was completed with dry runs, and in situ and ex-vivo testing in the Visible Heart® Laboratory.