Robotic System with Multiplexed DOF Control for Minimally Invasive Interventions

用于微创干预的具有多自由度控制的机器人系统

• 批准号: 8253123
• 负责人: Everette C Burdette
• 金额: $ 22.07万
• 依托单位: ACOUSTIC MEDSYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-06-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8253123
• 关键词: Ablation; Acoustics; Address; Agriculture; Application procedure; Area; Automation; Biopsy; Brachytherapy; Brain; Breast; Breathing; Catheters; Cerebral hemisphere hemorrhage; Clinical; Computer software; Controlled Environment; Deposition; Development; Devices; Diagnosis; Diagnostic; Diagnostic Procedure; Electronics; Engineering; Ensure; Evaluation; Exhibits; Fiber Optics; Financial compensation; Fluoroscopy; Freedom; Goals; Human body; Image; Injection of therapeutic agent; Intervention; Kidney; Laboratories; Liquid substance; Liver; Localized Disease; Location; Magnetic Resonance Imaging; Manuals; Medical; Medical Research; Medicine; Membrane; Modeling; Motion; Motor; Needles; Operative Surgical Procedures; Particulate; Patients; Phase; Positioning Attribute; Procedures; Prostate; Radioactive Seed Implantation; Research; Research Project Grants; Risk; Robot; Robotics; Safety; Site; Small Business Innovation Research Grant; Surgeon; System; Techniques; Testing; Therapeutic; Therapeutic Agents; Therapeutic procedure; Tissues; Treatment Efficacy; Ultrasonic Therapy; Ultrasonography; Universities; Validation; Vertebral column; Work; arm; base; cost; design; diagnostic accuracy; experience; improved; innovation; meter; minimally invasive; programs; research study; robotic device; sensor; software systems; tool; transmission process

DESCRIPTION (provided by applicant): Acoustic MedSystems proposes to develop an image-guided robot for MRI, CT and fluoroscopy guidance. The robot will be used for brain, prostate, liver, kidney, breast, and spine intervention. A general purpose robotic manipulator will be designed with development and implementation of a specific configuration for interventional medical biopsy and treatment use. The proposed program represents an innovation in clinical robotic interventions in several ways. It includes a cable-controlled drive and gear assembly linkage, so that actuators can be displaced from the robot motors and controller as much as several meters. Fiber-optic position sensors eliminate all electronics for sensing from the robot. These design innovations will make it possible to build small, purpose-specific robots. Although our proposed new robotic design and implementation is very well-suited to medical interventions, the concept is useful for a broad range of applications extending well beyond this initial application area. Multiple applications of the proposed single drive, multiple DOF robots can benefit from applying this concept and using possible standardized components that may be implemented with it. AMS is engaged in multiple medical research projects that include medical robots, and hence has become aware of many complications of using robots in clinical settings. We have a developed a conceptual approach for a robotic drive system that addresses these clinical issues, while also offering other design benefits and possible cost and size reductions for medical and non-medical robotics applications. PUBLIC HEALTH RELEVANCE: Minimally-invasive procedures are pervasive in medicine and further, needles and catheters are among the least invasive vehicles for accessing the interior of the human body. They can be used for diagnoses (e.g. biopsy), as well as interventions (e.g. injection of liquid therapeutic agents, insertion of surgical tools, radioactive seed implantation, thermal therapy, etc.). Accuracy in targeting the desired location is essential in nearly all procedures to ensure therapeutic or diagnostic efficacy and safety. It has been well-established that image-guided robotic devices are useful for aligning tools accurately with preoperatively planned insertion trajectories. A single robotic insertion has been shown to exhibit approximately half the error of a manual insertion by an experienced surgeon under Ultrasound guidance. However, initial robotic alignment of the device toward its target can never completely eliminate tip placement error, because there is no means of compensation for registration error (which can never be completely eliminated) or perturbations that occur during insertion, including tissue deformation, patient motion, breathing, deflection of a needle at membrane boundaries, etc. Furthermore, there are some locations that are inaccessible to straight-line trajectories (e.g. the pubic arch can obstruct a portion of the prostate in some patients during brachytherapy). These factors have motivated the recent development of steerable needles and surgical tools, and many mechanisms for steering have been proposed. To date, research has focused on tip placement accuracy assessment and model validation, which are necessary first steps toward interventional and diagnostic goals. However, inherent technical difficulties in existing systems have limited the efficacy and application of procedures, namely, 1) lack of adequate image guidance and 2) inadequate control of placement. Furthermore a third and very important issue is that in many cases, site access is limited, making the need for remote device control and location of drive mechanisms (motors, etc.) of paramount importance. The goal of this project is to address these three limitations by creating a system that combines a proprietary general purpose multi-degree-of-freedom precisely controllable robotic mechanism with e3D spatial tracking and image guidance. The proposed integrated robotic system will enable highly accurate tool placement and provide greater control at the target site. Compared to existing percutaneous techniques, this system could improve diagnostic accuracy, treatment efficacy, limit the risks of complications, and enable treatment in those patients who otherwise would have been precluded from the procedure.

描述（由申请人提供）：Acoustic MedSystems拟开发一种用于MRI、CT和荧光透视引导的图像引导机器人。该机器人将用于大脑、前列腺、肝脏、肾脏、乳房和脊柱的干预。将设计一种通用机器人操纵器，并开发和实施用于介入医学活检和治疗的特定配置。拟议的计划代表了临床机器人干预在几个方面的创新。它包括一个电缆控制的驱动器和齿轮组件联动，使致动器可以从机器人电机和控制器位移多达数米。光纤位置传感器消除了机器人的所有电子传感器。这些设计创新将使建造小型、特定用途的机器人成为可能。虽然我们提出的新机器人设计和实施非常适合医疗干预，但该概念适用于远远超出该初始应用领域的广泛应用。所提出的单驱动多自由度机器人的多种应用可以从应用这一概念和使用可能与它一起实施的可能的标准化组件中受益。AMS参与了包括医疗机器人在内的多个医疗研究项目，因此已经意识到在临床环境中使用机器人的许多并发症。我们已经开发了一种机器人驱动系统的概念方法，可以解决这些临床问题，同时还为医疗和非医疗机器人应用提供其他设计优势以及可能的成本和尺寸缩减。 公共卫生关系：微创手术在医学中是普遍的，并且此外，针和导管是用于进入人体内部的最小侵入性的工具之一。它们可用于诊断（例如活检）以及干预（例如注射液体治疗剂、插入手术工具、放射性粒子植入、热治疗等）。在几乎所有的手术中，精确定位所需位置是确保治疗或诊断有效性和安全性的关键。已经确定，图像引导的机器人装置对于将工具与术前计划的插入轨迹准确对准是有用的。单次机器人插入显示出的误差约为经验丰富的外科医生在超声引导下手动插入的一半。然而，装置朝向其目标的初始机器人对准永远不能完全消除尖端放置误差，因为没有补偿配准误差的手段（其永远不能被完全消除）或在插入期间发生的扰动，包括组织变形、患者运动、呼吸、针在膜边界处的偏转等。此外，存在一些直线轨迹不可接近的位置（例如，在近距离放射治疗期间，耻骨弓可能阻塞某些患者的前列腺的一部分）。这些因素推动了可操纵针和手术工具的最新发展，并且已经提出了许多用于操纵的机构。迄今为止，研究主要集中在尖端放置准确性评估和模型验证上，这是实现介入和诊断目标的必要的第一步。然而，现有系统中固有的技术困难限制了手术的有效性和应用，即，1）缺乏足够的图像引导和2）对放置的控制不足。此外，第三个并且非常重要的问题是，在许多情况下，现场访问是有限的，使得需要远程设备控制和驱动机构（电机等）的定位。至关重要该项目的目标是通过创建一个系统来解决这三个限制，该系统将专有的通用多自由度精确可控机器人机制与e3D空间跟踪和图像引导相结合。拟议的集成机器人系统将实现高度精确的工具放置，并在目标部位提供更大的控制。与现有的经皮技术相比，该系统可以提高诊断准确性，治疗效果，限制并发症的风险，并使那些本来会被排除在手术之外的患者能够接受治疗。