Robotic Guidance Research Articles

Robot-guided Ventriculoperitoneal Shunt in Slit-like Ventricles.

Ventriculoperitoneal shunt (VPS) is the most common procedure used in the management of hydrocephalus regardless of the etiology. The standard free-hand technique is used for the placement of VPS in patients with enlarged ventricles. In patients with very small ventricles, CSF access through ventriculostomy becomes challenging and free-hand technique may be associated with high failure rates. In these situations, stereotactic-guided VPS becomes very useful. To validate and describe the technique of robotic-guided VPS in cases with very small ventricles. Three patients underwent VPS with robotic guidance between 2016 and 2019. One patient with a diagnosis of occipital meningocele, who later developed recalcitrant CSF leak from the operative site, and two other patients were diagnosed with idiopathic intracranial hypertension (IIH). Plain CT brain with 1-mm slice thickness acquired prior to the surgery was uploaded into the ROSA machine (Zimmer Biomet Warsaw, Indiana). The trajectory for the VPS is created on the robotic software presurgery. The patient is placed in the supine position with head turned to the side contralateral to VPS insertion and fixed with Mayfield clamp. Registration of the patient is done with the robot. The placement of the VPS is commenced with the robotic arm in the predetermined trajectory. Ventricle was hit in a single attempt in all the cases. CSF leak stopped in the case with meningocele; headache, and visual acuity improved in both the cases of IIH. Robotic-guidance provides a safe and accurate method of VPS placement even in the presence of slit-like ventricles.

Guidance and Digital Attitude Control of Mini-satellites and Space Robots

Abstract The information mini-satellites (for communication, geodesy, radio- and optoelectronic Earth-observing et al.) and the free-flying space robots (used for servicing both the mini-satellites and manned orbital space stations as well as assembling the large space structures) have some principal problems with respect to their spatial attitude guidance and control. In the paper these problems are considered and obtained results are presented.

A Kinetic Simulator For Distributed Mechanically Linked Marine Vehicles

Abstract The possibility of performing high-level simulations based on a kinetic model is an important step in the implementation of navigation, guidance, and control systems for marine robots. In the framework of the EUMR TNA project DINGOS, we strive to enhance a simulation tool under MATLAB/Simulink for the CNR catamaran-like vehicle SWAMP (Shallow Water Autonomous Multipurpose Platform) ASV. The vehicle can be separated into two hull vessels that can operate independently, but also with different physical connection between them (like fixed pole or rubber band). In the paper, we will describe the physical modelling of the different connection types in a 3DOF system, the implementation into the existing simulation tool for the whole vehicle, and show the results achieved in simulation runs where different connection types can be chosen and parameterized.

Deep learning-driven catheter tracking from bi-plane X-ray fluoroscopy of 3D printed heart phantoms

Minimally invasive surgery (MIS) has changed not only the performance of specific operations but also the more effective strategic approach to all surgeries. Expansion of MIS to more complex surgeries demands further development of new technologies, including robotic surgical systems, navigation, guidance, visualizations, dexterity enhancement, and 3D printing technology. In the cardiovascular domain, 3D printed modeling can play a crucial role in providing improved visualization of the anatomical details and guide precision operations as well as functional evaluation of various congenital and congestive heart conditions. In this work, we propose a novel deep learning-driven tracking method for providing quantitative 3D tracking of mock cardiac interventions on custom-designed 3D printed heart phantoms. In this study, the position of the tip of a catheter is tracked from bi-plane fluoroscopic images. The continuous positioning of the catheter relative to the 3D printed model was co-registered in a single coordinate system using external fiducial markers embedded into the model. Our proposed method has the potential to provide quantitative analysis for training exercises of percutaneous procedures guided by bi-plane fluoroscopy.

Method of a pulling motion model for Robotic Walking Guidance Based on Human-to-Human Motion Analysis

Method of a pulling motion model for Robotic Walking Guidance Based on Human-to-Human Motion Analysis

Open source machine vision platform for manufacturing and robotics

Abstract The paper describes the design and implementation of an open source machine vision platform for visual robot guidance and automated product inspection in manufacturing, based on OpenCV library. Using this platform, the rigid, industry-specific organization of material flows can be relaxed, shop floor resources becoming reality-aware. The main functionalities are: acquisition of video streams from multiple sources, image analysis at scene level, part recognition, locating and interaction with industrial equipment using standard, open communication protocols. The paper describes design aspects: system architecture, data acquisition and standardization of the image representation used by the analysis algorithms and object recognition module and input/output interaction protocols for a set of predefined cases. Results are reported for an implementation of the platform using a commercial image acquisition device and an industrial robot.

Reduction in complication and revision rates for robotic-guided short-segment lumbar fusion surgery: results of a prospective, multi-center study.

Studies evaluating robotic guidance in lumbar fusion are limited primarily to evaluation of screw accuracy and perioperative complications. This is the first study to evaluate granular differences in short and long-term complication and revision rate profiles between robotic (RG) fluoroscopic (FG) guidance for minimally invasive short-segment lumbar fusions. A retrospective analysis of a prospective, multi-center database was performed. Complications were subdivided into surgical (further subcategorized into adjacent segment disease, new-onset back pain, radiculopathy, motor-deficit, hardware failure, pseudoarthrosis), wound, and medical complications. Complication and revision rates were compared between RG and FG groups cumulatively at 30, 90days, and 1 year. 374 RG and 111 FG procedures were performed. RG was associated with an 86.25, 83.20, and 69.42% cumulative reduction in complication rate at 30, 90days, and 1 year, respectively, compared to FG (p < 0.001). At all follow-up points, new-onset radiculopathy and medical complications were most prevalent in both groups. The greatest reductions in complication rates were seen for new-onset back pain (88.13%; p = 0.001) and wound complications (95.05%; p < 0.001) at 30days, new-onset motor deficits (90.11%; p = 0.004) and wound complications (85.16%; p < 0.001) at 90days, and new-onset motor deficits (85.16%; p = 0.002), wound (85.16%; p < 0.001), and medical complications (75.72%; p < 0.001) at 1 year. RG was associated with a 92.58% (p = 0.002) reduction in revision rate at 90days and a 66.08% (p = 0.026) reduction at 1 year. RG was associated with significant reductions in postoperative complication rates at all follow-up time points and significant reductions in revision rates at 90days and 1 year.

Research on robot guidance methods using two types of laser rangefinders

Research on robot guidance methods using two types of laser rangefinders

Intraoperative image guidance for endoscopic spine surgery.

Endoscopic spine surgery is a burgeoning component of the minimally invasive spine surgeon’s armamentarium. The goals of minimally invasive, and likewise endoscopic, spine surgery include providing equivalent or better patient outcomes compared to conventional open surgery, while minimizing soft tissue disruption, blood loss, postoperative pain, recovery time, and time to return to normal activities. A multitude of indications for the utilization of endoscopy throughout the spinal axis now exist, with applications for both decompression as well as interbody fusion. That being said, spinal endoscopy requires many spine surgeons to learn a completely new skill set and the associated learning curve may be substantial. Fluoroscopy is most common imaging modality used in endoscopic spine surgery for the localization of spinal pathology and endoscopic access. Recently, the use of navigation has been reported to be effective, with preliminary data supporting decreased operative times and radiation exposure, as well as providing for improvements in the associated learning curve. A further development is the recent interest in combining robotic guidance with spinal endoscopy, particularly with respect to endoscopic-assisted lumbar fusion. While there is currently a paucity of literature evaluating these image modalities, they are gaining traction, and future research and innovation will likely focus on these new technologies.

The current state of navigation in robotic spine surgery.

The advent and widespread adoption of pedicle screw instrumentation prompted the need for image guidance in spine surgery to improve accuracy and safety. Although the conventional method, fluoroscopy, is readily available and inexpensive, concerns regarding radiation exposure and the drive to provide better visual guidance spurred the development of computer-assisted navigation. Contemporaneously, a non-navigated robotic guidance platform was also introduced as a competing modality for pedicle screw placement. Although the robot could provide high precision trajectory guidance by restricting four of the six degrees of freedom (DOF), the lack of real-time depth control and high capital acquisition cost diminished its popularity, while computer-assisted navigation platforms became increasingly sophisticated and accepted. The recent integration of real-time 3D navigation with robotic platforms has resulted in a resurgence of interest in robotics in spine surgery with the recent introduction of numerous navigated robotic platforms. The currently available navigated robotic spine surgery platforms include the ROSA Spine Robot (Zimmer Biomet Robotics formerly Medtech SA, Montpellier, France), ExcelsiusGPS® (Globus Medical, Inc., Audubon, PA, USA), Mazor X spine robot (Medtronic Navigation Louisville, CO; Medtronic Spine, Memphis, TN; formerly Mazor Robotics, Caesarea, Israel) and TiRobot (TINAVI Medical Technologies, Beijing, China). Here we provide an overview of these navigated spine robotic platforms, existing applications, and potential future avenues of implementation.

The Facts and Myths for the Use of Lasers in Orthopedic Surgery.

For the past three decades, laser use has been investigated, mainly on implant applications, as well as hard and soft tissue processing on orthopedics. However, despite significant technological advances and achievements in Biophotonics, lasers have yet to emerge as a successful tool for hard-tissue manipulation (e.g., osseous tissue). Indeed, a careful search in relevant literature reveals a limited number of laser-based clinical applications in orthopedics, except for the low-level laser therapy applications. In this review article, we give a brief overview of the biophysical mechanisms of bone tissue and biocompatible implants laser surgery and, in parallel, we summarize some specific pre-clinical and clinical laser applications in orthopedics. Taking into consideration the complexity of laser-based applications in inhomogeneous musculoskeletal biostructures and/or implants, it is justified to state that applying laser radiation is still an open field of multidisciplinary research before performing interventions in clinical praxis. The evidence from this study indicates the need for more experimental and theoretical studies regarding light transport on soft and hard tissues, in order to further enhance safe and efficient laser applications in orthopedics. This undoubtedly implies the need for developing modern light delivery devices for laser surgery, by means of implementing robotic guidance, specialized for medical procedures on various anatomic structures. The aforementioned studies could eventually revolutionize the clinical applications of laser technology in orthopedics.

System design of a guidance robot

System design of a guidance robot

The Navigation System for Guidance Robots that Can Switch its Guidance Method Anytime

The Navigation System for Guidance Robots that Can Switch its Guidance Method Anytime

Autonomous Tracking Control for Four-Wheel Independent Steering Robot Based on Improved Pure Pursuit

Autonomous tracking control is one of the fundamental challenges in the field of robotic autonomous navigation, especially for future intelligent robots. In this paper, an improved pure pursuit control method is proposed for the path tracking control problem of a four-wheel independent steering robot. Based on the analysis of the four-wheel independent steering model, the kinematic model and the steering geometry model of the robot are established. Then the path tracking control is realized by considering the correlation between the look-ahead distance and the velocity, as well as the lateral error between the robot and the reference path. The experimental results demonstrate that the improved pure pursuit control method has the advantages of small steady-state error, fast response and strong robustness, which can effectively improve the accuracy of path tracking.

Initiation of a Robotic Program in Spinal Surgery: Experience at a Three-Site Medical Center

ObjectiveTo highlight the early experience of implementing a robotic spine surgery program at a three-site medical center, evaluating the impact of increasing experience on the operative time and number of procedures performed. Patients and MethodsA retrospective chart review of patients undergoing robotic screw placement between September 4, 2018, and October 16, 2019, was conducted. Baseline characteristics as well as intraoperative and post-operative outcomes were obtained. ResultsFor a total of 77 patients, the mean age (SD) was 55.7 years (11.5) and 49.4% (n=38) were female. A total of 402 screws were placed (384 pedicle screws, 18 cortical screws) using robotic guidance with a median of two operative levels (interquartile range [IQR], 1 to 2). Median (IQR) estimated blood loss was 100 mL (50 to 200 mL) and the median (IQR) operative time was 224 minutes (193 to 307 minutes). With accrual of surgical experience, operative time declined significantly (R=-0.39; P<.001) whereas the number of procedures performed per week increased (R=0.30; P=.05) throughout the study period. Median (IQR) length of hospital stay following surgery was 2 days (IQR, 2 to 3 days). There were two screws requiring revision intraoperatively. No postoperative revisions were required, and no complications were encountered related to screw placement. ConclusionEarly experience at our institution using a spinal robot has demonstrated no requirement for postoperative screw revisions and no complications related to screw malposition. The increased operative times were reduced as the frequency of procedures increased. Moreover, procedural times diminished over a short period with a weekly increasing number of procedures.

A Novel Robotic Guidance System With Eye-Gaze Tracking Control for Needle-Based Interventions

The robotic technologies have been widely used in the operating room for decades. Among them, needle-based percutaneous interventions have attracted much attention from engineering and medical communities. However, the currently used robotic systems for interventional procedures are too cumbersome, requiring a large footprint in the operating room. Recently developed light-weight puncture robotic systems for needle positioning are able to reduce the size, but has the limitation of awkward ergonomics. In this article, we design a compact robotic guidance system that could accurately realize the needle position and orientation within the operating room. The eye-gaze tracking-based approach is proposed to control the position and orientation of the needle toward the desired location in a more intuitive manner, and the forward and inverse kinematics of this 4-DoF robot are analyzed. The robot operating system (ROS)-based experimental studies are performed to evaluate the needle placement accuracy during interventional therapy. The result indicated the effectiveness of the proposed robotic hardware and the eye-gaze-based control framework, which can achieve a distance error of the robot’s end effector to the target point within 1 mm.

Rancang Bangun Sistem Navigasi Robot Beroda Pemandu Disabilitas Netra Menggunakan Metode Waypoint

Robotics has become a popular field of research for developing medical and human aids, including visually impaired people. This paper presents problem-solving of creating a robot that can guide visually impaired people outdoor using a Global Positioning System (GPS)-based navigation system with a waypoint method. This study uses Linkit ONE, which is equipped with a GPS as a determinant of the earth’s ordinate position, added with a compass module to determine the robot’s direction and a rotary encoder sensor to minimize the error of the robot’s position. There are two tests with four waypoints. Firstly, it is a test with no obstacles and holes. Secondly, it is the test with obstacles and holes. The first test results obtained an average error of waypoint-1 0.54 m(meters), waypoint-2 1.2 m, waypoint-3 1,9 m, and waypoint-4 1.7 m. Meanwhile, the second test results yielded an average error of waypoint-1 1.26 m, waypoint-2 2.18 m, waypoint-3 2.52 m, and waypoint-4 2,44 m. Therefore, the visual disability guidance robot with this waypoint method has good accuracy because the average error value of the robot is under a radius of 2 m when there are no obstacles and holes and under a radius of 3 m when there are obstacles and holes.

Fluoroscopy time analysis of a prospective, multi-centre study comparing robotic- and fluoroscopic-guided placement of percutaneous pedicle screw instrumentation for short segment minimally invasive lumbar fusion surgery.

As minimally invasive spine surgery becomes more widespread, concerns regarding radiation exposure to surgeons and patients alike have become a growing concern. Robotic guidance has been developed as a way to increase the accuracy of instrumentation while decreasing radiation burden. A retrospective analysis of a large, multi-centre, prospective study comparing robotic-guided (RG) to fluoroscopic-guided (FG) (Multi-centre, Partially Randomized, Controlled Trial of MIS Robotic vs. Freehand in Short Adult Degenerative Spinal Fusion Surgeries) was performed to evaluate for differences in radiation exposure between study groups. RG was associated with 78.3% (p<0.001) and 79.8% (p<0.001) reduction in total and per screw fluoroscopy times, respectively, as compared to FG. RG was also associated with a 50.8% (p<0.001) reduction in total operative fluoroscopy time. RG was associated with significantly lower fluoroscopy times compared to FG. This suggests that utilization of robotic navigation systems may result in decreased operative radiation exposure, which is a growing concern for surgeons performing minimally invasive spine surgery.

Novel C-arm based planning spine surgery robot proved in a porcine model and quantitative accuracy assessment methodology.

We assessed pedicle screw accuracy utilizing a novel navigation-based spine surgery robotic system by comparing planned pathways with placed pathways in a porcine model. We placed three mini screws per vertebra for accuracy evaluation and used a reference frame for registration in four pigs (46 screws in 23 vertebrae). We planned screw paths and performed screw insertion under robot guidance. Using C-arm and CT images, we evaluated accuracy by comparing the 3D distance of the placed screw head/tip from the planned screw head/tip and 3D angular offset. Mean registration deviation between the preoperative 3D space (C-arm) and postoperative CT scans was 0.475 ± 0.119 mm. The average offset from preoperative plan to final placement was 4.8 ± 2.0 mm from the head (tail), 5.3 ± 2.3 mm from the tip and 3.9 ± 2.4 degrees of angulation. Our spine surgery robot showed good accuracy in executing an intended planned trajectory and screw path. This faster and more accurate robotic system will be applied in future studies, first in cadavers and subsequently in the clinical field.

Episodic Self-Imitation Learning with Hindsight

Episodic self-imitation learning, a novel self-imitation algorithm with a trajectory selection module and an adaptive loss function, is proposed to speed up reinforcement learning. Compared to the original self-imitation learning algorithm, which samples good state–action pairs from the experience replay buffer, our agent leverages entire episodes with hindsight to aid self-imitation learning. A selection module is introduced to filter uninformative samples from each episode of the update. The proposed method overcomes the limitations of the standard self-imitation learning algorithm, a transitions-based method which performs poorly in handling continuous control environments with sparse rewards. From the experiments, episodic self-imitation learning is shown to perform better than baseline on-policy algorithms, achieving comparable performance to state-of-the-art off-policy algorithms in several simulated robot control tasks. The trajectory selection module is shown to prevent the agent learning undesirable hindsight experiences. With the capability of solving sparse reward problems in continuous control settings, episodic self-imitation learning has the potential to be applied to real-world problems that have continuous action spaces, such as robot guidance and manipulation.