A parallel wire robot for epicardial interventions

Cable Tension Optimization for an Epicardial Parallel Wire Robot

HeartPrinter is a novel under-constrained 3-cable parallel wire robot designed for minimally invasive epicardial interventions. The robot adheres to the beating heart using vacuum suction at its anchor points, with a central injector head that operates within the triangular workspace formed by the anchors, and is actuated by cables for multipoint direct gene therapy injections. Minimizing cable tensions can reduce forces on the heart at the anchor points while supporting rapid delivery of accurate injections and minimizing procedure time, risk of damage to the robot, and strain to the heart. However, cable tensions must be sufficient to hold the injector head's position as the heart moves and to prevent excessive cable slack. We pose a linear optimization problem to minimize the sum of cable tension magnitudes for HeartPrinter while ensuring the injector head is held in static equilibrium and the tensions are constrained within a feasible range. We use Karush-Kuhn-Tucker optimality conditions to derive conditional algebraic expressions for optimal cable tensions as a function of injector head position and workspace geometry, and we identify regions of injector head positions where particular combinations of cable tensions are optimally at minimum allowable tensions. The approach can rapidly solve for the minimum set of cable tensions for any robot workspace geometry and injector head position and determine whether an injection site is attainable.

Introducer Design Concepts for an Epicardial Parallel Wire Robot

Background

Cardiac gene therapies lack effective delivery methods to the myocardium. While direct injection has demonstrated success over a small region, homogenous gene expression requires many injections over a large area. To address this need, we developed a minimally invasive flexible parallel wire robot for epicardial interventions. To accurately deploy it onto the beating heart, an introducer mechanism is required.

Methods

Two mechanisms are presented. Assessment of the robot's positioning, procedure time, and pericardium insertion forces are performed on an artificial beating heart.

Results

Successful positioning was demonstrated. The mean procedure time was 230 ± 7 seconds for mechanism I and 259 ± 4 seconds for mechanism II. The mean pericardium insertion force was 2.2 ± 0.4 N anteriorly and 3.1 ± 0.4 N posteriorly.

Conclusion

Introducer mechanisms demonstrate feasibility in facilitating the robot's deployment on the epicardium. Pericardium insertion forces and procedure times are consistent and reasonable.

Miniature parallel robot with submillimeter positioning accuracy for minimally invasive laser osteotomy

To overcome the physical limitations of mechanical bone cutting in minimally invasive surgery, we are developing a miniature parallel robot that enables positioning of a pulsed laser with an accuracy below 0.25 mm and minimizes the required manipulation space above the target tissue. This paper presents the design, control, device characteristics, functional testing, and performance evaluation of the robot. The performance of the robot was evaluated within the scope of a path-following experiment. The required accuracy for continuous cuts was achieved and reached 0.176 mm on the test bench.

Physiological motion modeling for organ-mounted robots

BACKGROUND

Organ-mounted robots passively compensate heartbeat and respiratory motion. In model-guided procedures, this motion can be a significant source of information that can be used to aid in localization or to add dynamic information to static preoperative maps.

METHODS

Models for estimating periodic motion are proposed for both position and orientation. These models are then tested on animal data and optimal orders are identified. Finally, methods for online identification are demonstrated.

RESULTS

Models using exponential coordinates and Euler-angle parameterizations are as accurate as models using quaternion representations, yet require a quarter fewer parameters. Models which incorporate more than four cardiac or three respiration harmonics are no more accurate. Finally, online methods estimate model parameters as accurately as offline methods within three respiration cycles.

CONCLUSIONS

These methods provide a complete framework for accurately modelling the periodic deformation of points anywhere on the surface of the heart in a closed chest.

Parallel Force/Position Control of an Epicardial Parallel Wire Robot

Gene therapies for heart failure have emerged in recent years, yet they lack an effective method for minimally invasive, uniform delivery. To address this need we developed a minimally invasive parallel wire robot for epicardial interventions. Accurate and safe interventions using this device require control of force in addition to injector position. Accounting for the nonidealities of the device design, however, yields nonlinear and underconstrained statics. This work solves these equations and demonstrates the efficacy of using this information in a parallel control scheme, which is shown to provide superior positioning compared to a position-only controller.

Toward hybrid force/position control for the Cerberus epicardial robot

Gene therapies have emerged as a promising treatment for congestive heart failure, yet they lack a method for minimally invasive, uniform delivery. To address this need we developed Cerberus, a minimally invasive parallel wire robot for cardiac interventions. Prior work on Cerberus was limited to controlling the device using only position feedback. In order to ensure safety for both the patient and the device, as well as to improve the performance of the device, this paper presents work on enhancing the existing system with force feedback capabilities. By modeling the statics of the system and developing a tension distribution optimization technique, existing position control schemes were modified to a hybrid force/position controller. Experimental results show that using a hybrid force-position control scheme as opposed to position decreases positioning error by 38%.

Auto-Calibration for a Planar Epicardial Wire Robot

Gene therapies have emerged as a promising treatment for congestive heart failure, yet they lack a method for minimally invasive, uniform delivery. To address this need we developed Cerberus, a minimally invasive parallel wire robot for cardiac interventions. Prior work on controlling the movement of Cerberus required accurate knowledge of device geometry. In order to determine the geometry of the device in vivo, this paper presents work on developing an auto-calibration procedure to measure the geometry of the robot using force sensors to move injector. The presented auto-calibration routine is able to identify the shape of the device to within 0.5 mm and 0.9°.