Systems and Devices for Minimally Invasive Image Guided Surgery

背景：以导管为基础的微创心血管介入治疗已被迅速采用，全世界每年实施的手术超过1000万例。然而，传统的方法在导管定位、跟踪和导航方面存在明显的局限性。这些限制主要是由于设备的长度，灵活性，与解剖结构的接触，以及从体外远程操作。另一个挑战是，这些手术通常以2D投影x射线图像为指导，缺乏3D可视化和解剖背景。为了解决这些挑战，我们提出了一个新概念：可扩展电缆驱动并联机械手（X-CADPAM）。与传统的刚性连接机器人不同，电缆驱动的并联机器人利用电缆进行驱动和定位，因此具有特定的优势：更大的工作空间，高有效载荷重量比，低制造和装配成本。然而，它们需要一个大框架来固定电缆，这限制了它们的应用。通过使用可收缩的可扩展框架（例如，在导管内），允许通过狭窄的通道，然后在到达所需的目标区域后打开，我们可以利用cadpam的特定优点，同时克服其由于大尺寸而导致的访问限制。目的：本研究项目旨在从根本上研究x - cadpam并发展：1)使其小型化并适合心血管干预的方法；2)建立其运动学模型，设计和开发其模型识别和位置控制的系统和方法；3)应用X-CADPAM概念设计和开发新型成像仪器，克服传统成像设备的局限性，实现完整的基于图像的导航平台。方法：我们将开发使X-CADPAM小型化的设计，首先到12Fr (4mm)，然后到6-9Fr。我们将设计和开发电缆张紧机构和传感机构，并将所有组件集成在导管内。然后将系统的运动学建模，并开发自适应跟踪方法，以允许系统参数识别和鲁棒位置跟踪和控制。X-CADPAM概念还将用于在进行测量时将超声波换能器定位在不同位置，从而实现大视场图像重建。这将使前瞻导管和全图像引导增强虚拟导航框架的创建成为可能。工作意义：本研究将增强我们在小型化x - cadpam的设计、建模、开发和控制方面的知识，并使其能够在难以达到目标的情况下应用。提出的研究将有助于克服传统的基于导管的干预在转向、跟踪和图像引导方面的局限性。

Background:Minimally invasive catheter-based cardiovascular interventions have been rapidly adopted and more than 10 million procedures are performed each year worldwide. However, conventional methods suffer from significant limitations in catheter positioning, tracking, and navigation. These limitations are primarily due to the device's long length, flexibility, engagement with the anatomy, and their remote manipulation from outside the body. A further challenge is that these procedures are typically guided with 2D projection x-ray images that lack 3D visualization and anatomical context. To address these challenges we propose the use of a new concept: expandable cable-driven parallel manipulators (X-CADPAM). Unlike conventional robots with rigid links, cable-driven parallel manipulators utilize cables for actuation and positioning and therefore offer specific advantages: larger workspaces, high payload-weight ratio, and low manufacturing and assembly costs. However, they require a large frame to anchor the cables which limit their applications. By using an expandable frame that can be contracted (e.g., within a catheter) to permit travel through a narrow passageway, and then opened once the desired target area is reached, we can take advantage of the specific benefits of CADPAMs while overcoming their limitation in access due to their large size. Objectives: This research program aims to fundamentally investigate X-CADPAMs and develop: 1) methods for their miniaturization at sizes suitable for cardiovascular interventions; 2) model their kinematics and design and develop systems and methods for their model identification and position control; and 3) applying the X-CADPAM concept to design and develop novel imaging instruments overcoming the limitations of conventional imaging devices and enabling a complete image-based navigation platform. Approach: We will develop designs that enable miniaturization of the X-CADPAM, first to 12Fr (4mm) and then to 6-9Fr. We will design and develop the cable tensioning mechanisms and sensing mechanisms and integrate all components within a catheter. Then the system's kinematics will be modeled, and adaptive tracking methods will be developed to permit system parameter identification and robust position tracking and control. The X-CADPAM concept will also be used to position ultrasound transducers at various locations while making measurements, therefore, enabling a large field of view image reconstruction. This will enable the creation of forward-looking catheters and full image-guided augmented virtuality navigation framework. Significance of the work: This research will enhance our knowledge on the design, modeling, development, and control of miniaturized X-CADPAMS and will enable their application in scenarios where the target is difficult to reach. The proposed research will help overcome the limitations of conventional catheter-based interventions with regards to steering, tracking, and image guidance.