A Review of Robotic and OCT-Aided Systems for Vitreoretinal Surgery

Ahronovich, Elan Z.; Simaan, Nabil; Joos, Karen M.

doi:10.1007/s12325-021-01692-z

Cited by 20 publications

(11 citation statements)

References 83 publications

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“…This technology also has good imaging results in related ophthalmic surgery in recent studies, which can help surgeons obtain more precise position feedback during the manipulation of medical robots. [213,214] The magnetic microcannula for subretinal injections presented by Charreyron et al allowed flexible position control and could perform subretinal injections in ex vivo porcine eyes with the assistance of OCT. The experimental results showed that OCT visualization could navigate the robotic intubation precisely and safely in most areas of the posterior eye.…”

Section: Sensing and Localizationmentioning

confidence: 99%

Magnetically Actuated Continuum Medical Robots: A Review

Yang

Cao

et al. 2023

Advanced Intelligent Systems

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The magnetic field has unique advantages in manipulating miniature robots working inside the human body, such as high transparency to biological tissue and good controllability for field generation. Generally, the actuated magnetic robot can be classified into two categories: tethered devices like intravascular microcatheters and untethered devices like helical swimmers. Among these, the tethered devices have a long history and good clinical application prospects, considering their high‐dose delivery and easy removal after the procedure. As an evolution of traditional continuum medical devices, the integration with magnetic actuation provides them with better scalability and improved dexterity. Although rapidly developed in the last two decades, the field of tethered magnetic robots requires further advancements in terms of design, fabrication, modeling, and control, especially for clinical applications. Herein, the recent progress of magnetically actuated continuum medical robots is focused on, intending to offer readers a comprehensive survey of the state‐of‐the‐art technologies and an information collection for future system design.

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Section: Sensing and Localizationmentioning

confidence: 99%

Magnetically Actuated Continuum Medical Robots: A Review

Yang

Cao

et al. 2023

Advanced Intelligent Systems

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“…[35] The use of robotic technologies in vitreoretinal surgery has been investigated to overcome the barriers of perception, tremor, and dexterity. [36,37] Moreover, the use of CTR for this application has been proposed in Refs. [38][39][40][41] The benefits of robotics in vitreoretinal surgery include the use of tremor filtration that can help overcome natural human limitations, improve dexterity, enable in vivo navigation without direct visibility, enable high precision/safety, and enable possible long-distance teleoperation procedures by a specialist.…”

Section: Vitreoretinal Deployment With the Possibility Of Optical Coh...mentioning

confidence: 99%

The Caturo: A Submillimeter Diameter Glass Concentric Tube Robot with High Curvature

Nwafor

Laurent

Rougeot

et al. 2022

Advanced Intelligent Systems

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Concentric tube robots (CTRs), referred to as active cannulas in medicine, are among the smallest members of the continuum (i.e., continuously flexible) robot family. [1,2] They comprise concentrically precurved tubes nested into each other (Figure 1A). Due to the arrangement of the tubes, when actuated (translation/rotation at its proximal end), the configuration of the backbone of the robot changes as the tubes elastically interact. [3] It has evolved tremendously from manual to automated systems over time; the earliest prototype was developed around 1985. This early prototype consisted of a straight outer tube and a precurved interior wire (the Mammalok). Eventually, this prototype progressed to a motorized version in 2005. [4] The structural component of the active part, which only has concentric tubes, makes further miniaturization possible when compared to other members of the continuum robot family [with a tendon, rod, and disk and no shape memory alloy (SMA), electroactive polymers (EAP), or pneumatic backbone actuated type of continuum robots]. [1,5] Many proposed CTR applications primarily focus on clinical intervention due to CTRs' dexterity and ability to be deployed throughout hard-toreach surgical sites, where existing straight and rigid minimally invasive surgery (MIS) instruments are unable to reach. In fact, their inherent compliance enables them to be safely implemented into medical environments. [1,4] These proposed applications include: skull base surgery, abdominal surgery, neurosurgery, cardiac surgery, transvascular surgery, natural orifice surgery, and urological surgery, as reviewed in Refs. [5,6] Most proposed applications of CTRs are still exclusively used for medical interventions. However, these applications could also be used outside of medicine.The design and fabrication of CTR tubes over the years have depended on Nitinol. Nitinol is flexible, with elastic strain that can reach 8-11%; it has superelasticity, which makes it possible to be precurved into any given shape through heat setting. [1,7] The Nitinol tube can be constrained into a desired shape or mold either with an air furnace or by electric joule heating. CTR has some technical limitations in terms of the commercially available diameters, which determine its obtainable radius of curvature. The fabrication and bending process used to precurve the Nitinol CTR tubes require heating in a furnace (typically 500 °C for 20 min). A patterned engraved steel mold is used to constrain the tube in the desired shape, which may not permit patient-specific, fast, and on-site fabrication. In addition, the spring-back effect makes it difficult to precisely control the obtained curvature. The advances made in 3D additive manufacturing paved the way for the use of polymers and plastics in CTR tube prototyping. For medical applications, the possibility for on-site and direct fabrication approach constitutes a major advantage in patient-specific and procedure-specific scenarios

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“…3 This motivated the first work combining robotics and OCT to assist in ophthalmic procedures and to improve image acquisition through stabilization of the OCT probe with respect to the target. 4 Similar to ophthalmology, the vast majority of prior work in the use of OCT in the digestive system was focused on improving the diagnosis of digestive diseases. 5 The advancement of new imaging methods enabled early diagnosis, which in turn allowed minimally invasive treatment with flexible endoscopes in the gut.…”

Section: Introductionmentioning

confidence: 99%

“…The obtained detailed information about the structure of the eye in healthy and diseased conditions enabled new treatment approaches that required extreme precision of gestures 3 . This motivated the first work combining robotics and OCT to assist in ophthalmic procedures and to improve image acquisition through stabilization of the OCT probe with respect to the target 4 . Similar to ophthalmology, the vast majority of prior work in the use of OCT in the digestive system was focused on improving the diagnosis of digestive diseases 5 .…”

Section: Introductionmentioning

confidence: 99%

Automatic intraluminal scanning with a steerable endoscopic optical coherence tomography catheter for gastroenterology applications

Caravaca-Mora

Zanne

Liao

et al. 2023

J. Optical Microsystems

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Significance: Endoscopic optical coherence tomography (OCT) enables real-time optical biopsy of human organs. Endoscopic probes require miniaturization of optics, which in turn limits field of view. When larger imaging areas are needed such as in the gastrointestinal tract, the operator must manually scan the probe over the tissue to extend the field of view, often resulting in an imperfect scanning pattern and increased risk of missing lesions. Automatic scanning has the potential to extend the field of view of OCT, allowing the user to focus on image interpretation during real-time observations. Aim: This work proposes an automatic scanning using a steerable OCT catheter integrated with a robotized interventional flexible endoscope. The aim is to extend the field of view of a lowprofile OCT probe while improving scanning accuracy and maintaining a stable endoscope's position during minimally invasive treatment of colorectal lesions.Approach: A geometrical model of the steerable OCT catheter was developed for estimating the volume of the accessible workspace. Experimental validation was done using electromagnetic tracking of the catheter's positions. An exemplary scanning path was then selected within the available workspace to evaluate motion performance with the robotized steerable OCT catheter. Automatic scanning is compared to a teleoperated one and a manual scanning with a nonrobotized flexible endoscope. Spectral arc length, scanning area, spacing between scan trajectories, and time are metrics used to quantify performance. Results:The available scanning workspace was experimentally estimated to be 255 cm 3 . The automatic scanning mode provided the highest accuracy and smoothness of motion with spectral arc length of −3.18, covered area of 10.11 cm 2 , 1.54 mm spacing between 15 sweep trajectories, maximum translation of 27.99 mm, and time to finish of 3.11s.Conclusions: Automatic modality improved the accuracy of scanning within a large workspace. The robotic capability provided better control to the user to define spacing resolution of scanning patterns.

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A Review of Robotic and OCT-Aided Systems for Vitreoretinal Surgery

Cited by 20 publications

References 83 publications

Magnetically Actuated Continuum Medical Robots: A Review

Magnetically Actuated Continuum Medical Robots: A Review

The Caturo: A Submillimeter Diameter Glass Concentric Tube Robot with High Curvature

Automatic intraluminal scanning with a steerable endoscopic optical coherence tomography catheter for gastroenterology applications

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