Pneumatically Attachable Flexible (PAF) Rails for track-guided imaging and organ manipulation

研究背景简介包括潜在影响机器人辅助部分肾切除术(RAPN)是一种外科手术，其中肾脏的一部分被移除，通常是由于肿块的存在。术前和术中的成像技术被用来识别和勾勒目标肿块，从而确定肾脏表面切除区域的边缘。插入式超声探头用于获取术中图像：探头通过套管针端口插入，用机器人辅助的腹腔镜夹持器抓住，然后在肾脏表面滑动。执行多次滑动来定义切除区域。这被标记为通过使用电灼工具刷卡来刷卡。在这一过程中，由于从靶器官表面滑脱，探头经常需要重新定位。此外，当靶肿块特别难到达位置时，定位可能不准确，因此可能需要重新定位肾脏。要成功地完成这一术前程序，通常需要一名技术高超的外科医生。在惠康/EPSRC介入和外科科学中心(Weiss)，由Danail Stoyanov教授领导的UCL外科机器人视觉(SRV)研究小组为RAPN中的插入式超声探头导航开发了一种新型软机器人解决方案：使用气动可连接柔性轨道(PAF Rail)，实现快速、轻松和准确的轨迹引导肾脏扫描。该系统利用一系列仿生的真空吸盘附着在肾脏侧表面。可以定制相同的系统，以用于类似的手术，例如部分肝切除术。该系统还显示出作为一种安全和多功能的软机器人器官牵引器的巨大潜力。具体目标是：-设计、原型和测试软机器人系统和传感器，包括但不限于PAF Rails系统及其衍生系统，为将其转化为临床铺平道路。-研究软测量解决方案，以支持多种成像模式。-调查拟议系统在临床实践中的整合情况，与临床医生和工程师以及工业合作伙伴联系，对幻影进行测试以及体外和体内测试。研究方法的新颖性PAF轨道系统是伦敦大学韦斯分校SRV研究组设计和开发的一种新型硬件/软件系统。鉴于拟议系统的新颖性和临床潜力，已在伦敦大学学院商业学院的支持下提交了PCT专利申请(PCT/GB2019/051463)。候选人将研究新的成像和器官操作策略，以从硬件和软件的角度优化系统。与EPSRC的战略和研究领域相一致拟议的项目通过提出一种在微创机器人辅助手术中进行手术中器官成像和操作的新方法，很好地与EPSRC物理干预前沿的重大挑战保持一致。拟议的系统将提高广泛的腹腔镜手术的准确性和安全性，提供更安全的器官-工具接口，从而降低患者侧的风险，同时也显著减少复杂手术的杀伤力。被研究的系统还有可能为器官重新定位和扫描等外科任务的自动化开辟道路。在交叉研究能力方面，该项目专注于外科应用机器人背景下的医疗器械设计和创新研究领域，同时还研究用于主动器官操作、成像的先进生物兼容硅材料。任何公司或合作者都涉及英国伦敦皇家自由医院，英国直觉外科，美国加利福尼亚州桑尼维尔

Brief description of the context of the research including potential impact Robotic-assisted partial nephrectomy (RAPN) is a surgical operation in which part of a kidney is removed, typically due to the presence of a mass. Pre-operative and intra-operative imaging techniques are used to identify and outline the target mass, and thus the margins of the resection area on the kidney surface. Drop-in ultrasound probes are used to acquire intra-operative images: the probe is inserted through a trocar port, grasped with a robotic-assisted laparoscopic gripper and swiped on the kidney surface. Multiple swipes are performed to define the resection area. This is marked swipe by swipe using an electrocautery tool. During this procedure the probe often requires repositioning because of slippage from the target organ surface. Furthermore, the localization can be inaccurate when the target mass is in particularly hard to reach locations, and thus kidney repositioning could be required. A highly skilled surgeon is typically required to successfully perform this pre-operatory procedure. In the Wellcome/EPSRC centre for Interventional and Surgical Sciences (WEISS) the UCL Surgical Robot Vision (SRV) research group led by Professor Danail Stoyanov has developed a novel soft robotic solution for the navigation of drop-in ultrasound probes in RAPN: the use of pneumatically attachable flexible rails (PAF rails) to enable swift, effortless, and accurate track-guided scanning of the kidney. The proposed system attaches on the kidney side surface with the use of a series of bio-inspired vacuum suckers. The same system can be customised to be used in similar procedures e.g. partial hepatectomy. The system has also shown significant potential as a safe and versatile soft robotic organ retractor. Aims and Objectives The specific objectives are to: - Design, prototype and test soft robotic systems and sensors, including but not limited to the PAF rails system and derivative systems of it, paving the way for their translation into clinics. - Investigate soft sensing solution to support multi-imaging modalities. - Investigate the integration of the proposed system in clinical practice, liaising with clinicians and engineers as well as with industrial partners to conduct testing on phantoms as well as ex vivo and in vivo testing. Novelty of Research Methodology The PAF rail system is a novel hardware/software system designed and developed in the SRV research group at UCL WEISS. Given the novelty and the clinical potential of the proposed system, a PCT patent application (PCT/GB2019/051463) has been filed with the support of UCL-Business. The candidate will investigate novel imaging and organ manipulation strategies to optimise the system from the point of view of the hardware and the software. Alignment to EPSRC's strategies and research areas The proposed project well aligns with the EPSRC grand challenge of the Frontiers of Physical Intervention by proposing a novel approach to intra-operative organ imaging and manipulation in minimally invasive robotic-assisted surgery. The proposed system will improve the accuracy and the safety of a wide range of laparoscopic procedures providing a safer organ-tool interface, hence, reducing the risks on the patient side, while also significantly deskilling complex procedures. The investigated system has also the potential to open the way to the automation of surgical tasks like organ repositioning and scanning. In terms of cross-cutting research capabilities this project remits in the research area of Medical Device Design and Innovation in the context of robotics for surgical applications, while also investigating advanced biocompatible silicone materials for active organ manipulation, imaging.Any companies or collaborators involved Royal Free Hospital, London, UK Intuitive Surgical, Sunnyvale, CA, US