In-bore prostate transperineal interventions with an MRI-guided parallel manipulator: system development and preliminary evaluation

Abstract

Background The robot-assisted minimally-invasive surgery is well recognized as a feasible solution for diagnosis and treatment of the prostate cancer in human. Methods In this paper the kinematics of a parallel 4 Degrees-of-Freedom (DOF) surgical manipulator designed for minimally invasive in-bore prostate percutaneous interventions through the patient's perineum. The proposed manipulator takes advantage of 4 sliders actuated by MRI-compatible piezoelectric motors and incremental rotary encoders. Errors, mostly originating from the design and manufacturing process, need to be identified and reduced before the robot is deployed in the clinical trials. Results The manipulator has undergone several experiments to evaluate the repeatability and accuracy of the needle placement which is an essential concern in percutaneous prostate interventions. Conclusion The acquired results endorse the sustainability, precision (about 1 mm in air (in x or y direction) at the needle's reference point) and reliability of the manipulator.

An MRI-Guided Telesurgery System Using a Fabry-Perot Interferometry Force Sensor and a Pneumatic Haptic Device

“…Due to the nature of the closed-loop motion control, this procedure might simplify the needle steering procedure while enhancing the targeting accuracy. A clinical-grade variant of the described slave robot based on the same control system is currently in clinical trials at the Brigham and Womens Hospital, Harvard Medical School [5]. It is expected that the teleoperation system would represent the next phase of our clinical effort to further explore its potential for reducing procedure time and ensuring accuracy.…”

Development of an MRI-compatible needle driver for in-bore prostate biopsy

“…The precision assessment of the base robot had already been studied in [15]. The goal in this experiment was to analyze the repeatability and accuracy of the needle driver module.…”

“…This mechanism was designed under the size and material constraints set by MRI compatibility as reported in our previous work [14]. More details including the design, kinematics and MRI compatibility can be found in [15]. Yet, there is currently ongoing work evaluating the effects of device on the MR image quality by inspecting signal-to-noise ratio and the geometric distortion based on the NEMA standards [17].…”

“…The robotic system: (a) The base robot adjusts the orientation and position of the needle guide, and is currently under clinical validation [15]. (b) The needle driver module inserts and rotates the biopsy gun through the needle guide, and triggers it for taking a tissue sample from a clinical target accurately.…”

Image-Guided Biopsy in the Era of Personalized Cancer Care: Proceedings from the Society of Interventional Radiology Research Consensus Panel

“…To date, a handful of research teams have developed clinically viable systems for ioMRI interventional procedures in the fields of neurosurgery [73], prostate interventions [74,75], and percutaneous interventions [76] with varying levels of complexity and integration into the workflow. Several of these systems have undergone clinical trials.…”