Development of a needle insertion manipulator for central venous catheterization

Realization and Control of Robotic Injection Prototype With Instantaneous Remote Center of Motion Mechanism

OBJECTIVE

Although there have been studies conducted on the instantaneous remote center of motion (RCM) mechanism, the general closed-loop control method has not been studied. Thus, this article fills that gap and employs the advantages of this mechanism to develop a novel injection system.

METHODS

The injection prototype involves the instantaneous RCM mechanism, insertion unit and injection unit. The RCM system is investigated in the presence of time-varying axial stiffness of the screw drive and underactuated case. For safe interaction, compliance control is designed in the insertion system. The stability of all separate systems is investigated with the bounded parameter variation rate. The injection prototype and a robot end-effector were then combined to perform injection.

RESULTS

Our RCM prototype can achieve a large workspace, and its control effectiveness was verified by multiple frameworks and comparison with previous studies. Compliance-controlled insertion can achieve accurate depth regulation and zero-impedance control for manually operating the needle. With the help of three-dimensional reconstruction and hand/eye calibration, the manipulator can guide the injection prototype to a proper pose for injection of a face model.

CONCLUSION

The injection prototype was successfully designed. The effectiveness of the whole control system was verified by simulations and experiments. The particular robotic injection task can be performed by the prototype.

SIGNIFICANCE

This article provides alternative schemes for developing an instantaneous RCM system, screw drive-based surgical tool, and robotic insertion with small needles.

Ultrasound-guided needle insertion robotic system for percutaneous puncture

PURPOSE

Ultrasound (US)-guided percutaneous puncture technology can realize real-time, minimally invasive interventional therapy without radiation. The location accuracy of the puncture needle directly determines the precision and safety of the operation. It is a challenge for novices and young surgeons to perform a free-hand puncture guided by the ultrasound images to achieve the desired accuracy. This work aims to develop a robotic system to assist surgeons to perform percutaneous punctures with high precision.

METHODS

An US-guided puncture robot was designed to allow the mounting and control of the needle to achieve localization and insertion. The US probe fitted within the puncture robot was held by a passive arm. Moreover, the puncture robot was calibrated with a novel calibration method to achieve coordinate transformation between the robot and the US image. The system allowed the operators to plan the puncture target and puncture path on US images, and the robot performed needle insertion automatically. Five groups of puncture experiments were performed to verify the validity and accuracy of the proposed robotic system.

RESULTS

Assisted by the robotic system, the positioning and orientation accuracies of the needle insertion were 0.9 ± 0.29 mm and 0.76 ± 0.34°, respectively. These are improved compared with the results obtained with the free-hand puncture (1.82 ± 0.51 mm and 2.79 ± 1.32°, respectively). Moreover, the proposed robotic system can reduce the operation time and number of needle insertions (14.28 ± 3.21 s and one needle insertion, respectively), compared with the free-hand puncture (25.14 ± 6.09 s and 1.96 ± 0.68 needle insertions, respectively).

CONCLUSION

A robotic system for percutaneous puncture guided by US images was developed and demonstrated. The experimental results indicate that the proposed system is accurate and feasible. It can assist novices and young surgeons to perform the puncture operation with increased accuracy.

Review of Robotic Needle Guide Systems for Percutaneous Intervention

Numerous research groups in the past have designed and developed robotic needle guide systems that improve the targeting accuracy and precision by either providing a physical guidance for manual insertion or enabling a complete automated intervention. Here we review systems that have been reported in the last 11 years and limited to straight line needle interventions. Most systems fall under the category of image guided systems as they either use magnetic resonance image, computed tomography, ultrasound or a combination of these modalities for real time image feedback of the intervention path being followed. Actuation and control technology along with materials used for construction are the main aspects that differentiate these systems from each other and have been reviewed here. Image compatibility test details and results are also reviewed as they are used to ensure proper functioning of these systems under the respective imaging environments. We have also reviewed needle guide systems which either don't use any image feedback or have not reported any but provide physical guidance. Throughout this paper, we provide a comprehensive review of the technological aspects and trends in the field of robotic, straight line, needle guide intervention systems.

A hand-held robotic device for peripheral intravenous catheterization

Intravenous catheterization is frequently required for numerous medical treatments. However, this process is characterized by a high failure rate, especially when performed on difficult patients such as newborns and infants. Very young patients have small veins, and that increases the chances of accidentally puncturing the catheterization needle directly through them. In this article, we present the design, development and experimental evaluation of a novel hand-held robotic device for improving the process of peripheral intravenous catheterization by facilitating the needle insertion procedure. To our knowledge, this design is the first hand-held robotic device for assisting in the catheterization insertion task. Compared to the other available technologies, it has several unique advantages such as being compact, low-cost and able to reliably detect venipuncture. The system is equipped with an electrical impedance sensor at the tip of the catheterization needle, which provides real-time measurements used to supervise and control the catheter insertion process. This allows the robotic system to precisely position the needle within the lumen of the target vein, leading to enhanced catheterization success rate. Experiments conducted to evaluate the device demonstrated that it is also effective to deskill the task. Naïve subjects achieved an average catheterization success rate of 88% on a 1.5 mm phantom vessel with the robotic device versus 12% with the traditional unassisted system. The results of this work prove the feasibility of a hand-held assistive robotic device for intravenous catheterization and show that such device has the potential to greatly improve the success rate of these difficult operations.

Robot-assisted needle insertion for venous catheterization

Vein access can be challenging for a variety of patients. The development of robots-assisted central or peripheral veins puncture would facilitate life of health professionals and patients. New robots are under development for this purpose and probably they will become available for practical use in the near future. These techniques may decrease significantly the cost of medicine, which currently uses less informatics resources than other industries.

Design and Kinematic Analysis of a New End-Effector for a Robotic Needle Insertion-Type Intervention System

This paper presents a new end-effector as a key component for a robotic needle insertion-type intervention system and its kinematic analysis. The mechanism is designed as a spherical mechanism with a revolute joint and a curved sliding joint, and its links always move on the surface of a sphere. The remote centre of motion (RCM) of the designed mechanism is placed below the base of the mechanism to avoid contact with the patient's body, unlike the conventional end-effectors developed for needle insertion. For the proposed mechanism, the forward kinematics are solved in terms of input joint parameters and then the reverse kinematics are solved by using the cross-product relationship between each joint vector and a vector mutually perpendicular to the vectors. The kinematic solutions are confirmed by numerical examples.

A compliant parallel mechanism for needle intervention

This paper presents a compliant mechanism for fine motion of a medical robot for needle intervention procedure. The concept of this mechanism is created with the purpose of correcting a needle axis by translating a main robot for needle driving when an unexpected slip happens in needle insertion. In order to specify the concept, a planar compliant mechanism is designed so that the mechanism has maximized workspace for some given design condition. A simplified mathematical model for the designed mechanism is derived and then a pose controller is designed to track a desired trajectory in a plane, which is a similar situation that the compliant mechanism translates a needle driving robot to correct the direction of a needle. The simulation result shows good tracking performance.