Abstract
Needles are commonly used in the clinic for percutaneous procedures. The outcome of such procedures heavily depends on accurate placement of the needle. There are two main challenges to achieve high accuracy: First, aligning the needle with the targeted lesion, and second, compensating for the deflection of the needle in the tissue. In order to address these challenges, scientists have developed several robotic setups for needle steering. However, the subject is still under research and reliable implementations which can be used in clinical practice are not yet available. In this paper, we have taken some steps in order to bring needle steering closer to practice. A new hybrid control algorithm is developed, which enables us to control a flexible needle by combing base-manipulation and beveled-tip steering methods. A pre-operative path planner is developed which considers the clinical requirements. The proposed method is tested in the lung of a fresh-frozen human cadaver. The work-flow of the experiments are similar to the current clinical practice. Three experimental cases are used to evaluate the proposed steering algorithm. Experimental Case I shows that using the proposed steering algorithm controllability of the needle is increased. In Case II and Case III, the needle is steered in a gelatin phantom and a human cadaver, respectively. The targeting accuracy of 1.35±0.49mm in gelatin phantom and 1.97±0.89mm in cadave is achieved. A feasibility study is performed, in which a fine needle aspiration (FNA) needle is steered in the lungs of a human cadaver under computed tomography guidance. The targeting error for the feasibility study is 2.89±0.22mm. The results suggest that such a robotic system can be beneficial for clinical use and the patient receives less x-ray radiation.
Highlights
Percutaneous needle insertion is a common minimally invasive surgical procedure used for diagnostic and therapeutic purposes
We have presented a new algorithm to steer a flexible needle by combining tipbased control with the base-manipulation control
The algorithm is developed for a CT-compatible needle insertion setup, which has a remote-center-of-motion at the point of insertion
Summary
Percutaneous needle insertion is a common minimally invasive surgical procedure used for diagnostic and therapeutic purposes. A CT scan is acquired after every needle manipulation This procedure is commonly performed manually by clinicians, and can result in complications such as pneumothorax and pulmonary hemorrhage [4,5,6]. The needle deflection can be used to correct the initial orientation error during the insertion of the needle by rotating the base of the needle. This will decrease the amount of needle manipulations, and enables the clinicians to target even small lung nodules. Researchers have developed several robotic setups in order to assist clinicians perform needle placement accurately. The literature suggests that such systems can be beneficial for clinical use which are discussed below
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