Precisely positioning the tip of an instrument inserted through an orifice with a free wrist robot: application to prostate biopsies

Chalard, R; Reversat, David; Morel, Guillaume; Mozer, Pierre; Vitrani, Marie-Aude

doi:10.1007/s11548-018-1718-6

Cited by 9 publications

(11 citation statements)

References 17 publications

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“…The latter are modeled as linear springs. This work was extended to instrument positioning by Chalard et al [11], where the deformation of the entry point is taken into account to refine the Jacobian matrix between the proximal and the distal ends of the instrument. Gijbels et al [12] introduce a robotic manipulator dedicated to assisting the insertion of a needle during retinal-vein cannulation.…”

Section: Related Workmentioning

confidence: 99%

Design of haptic guides for pre-positioning assistance of a comanipulated needle

Gurnel

Marchal

Launay

et al. 2019

2019 IEEE International Conference on Systems, Man and Cybernetics (SMC)

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In minimally-invasive procedures like biopsy, the physician has to insert a needle into the tissues of a patient to reach a target. Currently, this task is mostly performed manually and under visual guidance. However, manual needle insertion can result in a large final positioning error of the tip that might lead to misdiagnosis and inadequate treatment. A way to solve this limitation is to use shared control; a gestureassistance paradigm that combines the cognitive skills of the operator with the precision, stamina and repeatability of a robotic or haptic device. In this paper, we propose to assist the physician with a haptic device that holds the needle and generates mechanical guides during the phase of manual needle pre-positioning. In the latter, the physician has to place the tip of the needle on a planned entry point, with a pre-defined angle of incidence. From this pre-operative information and also from intra-operative measurements, we propose to generate haptic cues, known as virtual fixtures, to guide the physician towards the desired position and orientation of the needle. It takes the form of five haptic guides, each one implementing virtual fixtures. We conducted a user study where those guides were compared to the unassisted reference gesture. The most constraining guide, in terms of assisted degrees of freedom, was highlighted as the one that provides the best results in terms of performance and user experience.

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Section: Related Workmentioning

confidence: 99%

Design of haptic guides for pre-positioning assistance of a comanipulated needle

Gurnel

Marchal

Launay

et al. 2019

2019 IEEE International Conference on Systems, Man and Cybernetics (SMC)

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“…A main limitation of all these approaches is that it rely on a model that does not always correspond to the reality: in many cases, minimizing the interaction forces at the entry port is not equivalent to perfectly pivoting around a fixed point. In a previous work, [7], we have shown that when urologists perform a prostate biopsy while minimizing the forces in the rectum it is not possible to define a fixed point A around which the ultrasound probe rotates independently from the penetration depth. Therefore, minimizing −→ AR , either through installation, registration, or control, is not appropriate and may lead to non minimal forces at the insertion area.…”

Section: Introductionmentioning

confidence: 99%

“…Rather, the mechanical behavior of the insertion area also influences the tip position. In a previous paper, [7], we have evidenced this problem and proposed to identify the mapping between the wrist velocity, W and the tip velocityṪ . This identification allowed to compute the desired displacement of point W from the desired displacement at point T .…”

Section: Introductionmentioning

confidence: 99%

Fast and accurate intracorporeal targeting through an anatomical orifice exhibiting unknown behavior

Chalard

Reversat

Morel

et al. 2020

2020 IEEE International Conference on Robotics and Automation (ICRA)

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Surgery may involve precise instrument tip positioning in a minimally invasive way. During these operations, the instrument is inserted in the body through an orifice. The movements of the instrument are constrained by interaction forces arising at the orifice level. The physical constraints may drastically vary depending on the patient's anatomy. This introduces uncertainties that challenge the positioning task for a robot. Indeed, it raises an antagonism: On one side, the required precision appeals for a rigid behavior. On the other side, forces applied at the entry point should be limited, which requires softness. In this paper we choose to minimize forces at the orifice by using a passive ball joint wrist to manipulate the instrument. From a control perspective, this leads to consider the task as a 3 DOF wrist center positioning problem, whose softness can be achieved through conventional low impedance control. However, positioning the wrist center, even with a high static precision, does not allow to achieve a high precision of the instrument tip positioning when the orifice behavior is not known. To cope with this problem, we implement a controller that servos the tip position by commanding the wrist position. In order to deal with uncertainties, we exploit an adaptive control scheme that identifies in real-time the unknown mapping between the wrist velocity and the tip velocity. Both simulations and in vitro experimental results show the efficiency of the control law.

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“…The results show that the use of manipulator has a statistically significant increase in biopsy accuracy. 21…”

Section: Introductionmentioning

confidence: 99%

Design and Performance Evaluation of Passive Interlocking Posture Adjustment Mechanism for Transrectal Ultrasound Probe

Jiang

Min

Zhang

et al. 2019

J. Mech. Med. Biol.

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In the current prostate biopsy procedure, it is necessary for the doctor to hold the ultrasonic probe during the entire process. This increases the fatigue degree of the doctor, and the motion of the ultrasonic probe is more likely to cause damage to the anus of the patient. A medical device that can assist doctors in prostate scans and biopsy puncture devices was developed. We focused on the passive interlocking transrectal ultrasonic probe posture adjustment mechanism. Based on the posture adjustment mechanism, a passive interlocking transrectal ultrasound probe position and posture adjustment mechanism capable of assisting the doctor in prostate scanning and puncture intervention was designed. The passive interlocking posture adjustment mechanism with a seven-degree-of-freedom (DOF) interlocking mechanism was designed and can meet the requirements of doctors. The physical prototype of the passive interlocking transrectal ultrasonic probe posture adjustment mechanism was developed and commissioned. The locking torque and braking torque of the mechanism were measured. The results showed that the ultrasonic probe can achieve reliable locking and effectively meet the operation requirements.

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Precisely positioning the tip of an instrument inserted through an orifice with a free wrist robot: application to prostate biopsies

Abstract: Errors obtained by processing the clinical data reach 7.5 mm at the tip in average. Errors obtained with the laboratory apparatus drop from 2.4 mm in average to 0.8 mm when using real-time model update.

Cited by 9 publications

References 17 publications

Design of haptic guides for pre-positioning assistance of a comanipulated needle

Design of haptic guides for pre-positioning assistance of a comanipulated needle

Fast and accurate intracorporeal targeting through an anatomical orifice exhibiting unknown behavior

Design and Performance Evaluation of Passive Interlocking Posture Adjustment Mechanism for Transrectal Ultrasound Probe

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