C omputed tomography (CT)-guided interventions such as biopsy, catheter drainage, and radiofrequency ablation are widely used as minimally invasive diagnostic and therapeutic procedures. The use of CT fluoroscopy helps to reduce the procedure time, patient radiation dose, and complications, particularly in risky locations near large vessels and the gastrointestinal tract. Reported success rates of conventional CT and CT fluoroscopy-guided biopsies range from 90%-100% and 83%-100%, respectively (1-3). However, CT-guided interventions are time-consuming procedures and should be performed by experienced interventional radiologists. In addition, significant radiation exposures occur to medical personnel when CT fluoroscopic guidance is used.Recently, development of the robotic surgery platform has provided a tool that can overcome many of the limitations of conventional surgery. Augmented dexterity enabled by the endowristed movements, software filtration of the surgeon's movements, and enhanced vision provided by the stereoscopic camera combine to allow steady and careful dissection and prompt and precise suturing (4, 5). These advantages of the robotic system can also enable accurate targeting with diverse angulation of the robotic arm in CT-guided biopsy and tumor ablation. Furthermore, robotic intervention can potentially decrease procedure time and radiation exposure to both patients and doctors (6).We developed a robotic system with path-planning and needle-placement functions under CT guidance. The purpose of this experiment was to assess the stability and accuracy of our CT-guided intervention robot using an abdominal phantom. Methods Robot systemThe interventional robotic system used in this study is a master-slave type robotic system for CT-guided needle intervention jointly developed by our hospital and a manufacturer (Fig. 1). I N T E R V E N T I O N A L R A D I O LO G Y O R I G I N A L A R T I C L E PURPOSEWe aimed to evaluate the accuracy of a needle-placement robot for biopsy and radiofrequency ablation on an abdominal phantom. METHODSA master-slave robotic system has been developed that includes a needle-path planning system and a needle-inserting robot arm with computed tomography (CT) and CT fluoroscopy guidance. For evaluation of its accuracy in needle placement, a commercially available abdominal phantom (Model 057A; CIRS Inc.) was used. The liver part of the phantom contains multiple spherical simulated tumors of three different size spheres. Various needle insertion trials were performed in the transverse plane and caudocranial plane two nodule sizes (10 mm and 20 mm in diameter) to test the reliability of this robot. To assess accuracy, a CT scan was performed after each trial with the needle in situ. RESULTSThe overall error was 2 mm (0-2.6 mm), which was calculated as the distance from the planned trajectory before insertion to the actual needle trajectory after insertion. The standard deviations of the insertions on two nodules (10 mm and 20 mm in diameter) were 0.5 mm and 0.2 mm, respect...
This paper describes the continued development of the Robotic EndoLaryngeal (Robo-ELF) Scope System, a simple clinically usable robot for manipulating flexible endoscopes, particularly in laryngeal surgery. The system includes a robot with three active and two passive degrees of freedom, a five degree of freedom passive positioning arm, a malleable scope shaft support, and a custom joystick controller. The Robo-ELF Scope allows a surgeon to control a flexible endoscope with only one hand and also to release the controls and perform bimanual surgery if desired. We have evaluated the Robo-ELF Scope system in both phantom and cadaver studies and found it superior to hand manipulation of flexible endoscopes and conventional rigid endoscopes.
A highly sensitive fluorescence endoscope using ESME was developed and successfully tested. The experimental results indicated that the method enabled high-quality image acquisition in a very low illumination environment. This system is effective for the observation of faint fluorescence in the heart and is useful for the intraoperative examination of the heart status.
Arrhythmia surgery is performed to treat serious arrhythmia such as atrial fibrillation and ventricular tachycardia unable to be treated by catheter ablation. Mapping devices are needed to find electrical abnormal regions. Open heart surgery is invasive for patient's body. Recently, endoscopic arrhythmia surgery is reported as minimally invasive surgery. Existing mapping device can be used only in open heart surgery. There is no mapping device available under endoscopic surgery. We developed a local multi-electrode array to measure epicardial electrophysiological data under endoscopic surgery. However, it can obtain the propagation only in the local area not in the global area. We recorded single beat electrical activities at different time and different location and mapped them onto a three-dimensional heart model. The phase shifts in local potentials were synchronized in reference to the ECG. Location errors due to heart beat and deformation were corrected by a propagation registration method assuming the continuous propagation in the heart. Both registration errors and the distribution of propagation decreased in simulation data. Continuous propagation was obtained in experimental data. Global propagation of excitation can be obtained from local isopotential maps.
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