Can coffee improve image guidance?

Abstract

Anecdotally, surgeons sometimes observe large errors when using image guidance in endonasal surgery. We hypothesize that one contributing factor is the possibility that operating room personnel might accidentally bump the optically tracked rigid body attached to the patient after registration has been performed. In this paper we explore the registration error at the skull base that can be induced by simulated bumping of the rigid body, and find that large errors can occur when simulated bumps are applied to the rigid body. To address this, we propose a new fixation method for the rigid body based on granular jamming (i.e. using particles like ground coffee). Our results show that our granular jamming fixation prototype reduces registration error by 28%-68% (depending on bump direction) in comparison to a standard Brainlab reference headband.

Coffee: the key to safer image-guided surgery—a granular jamming cap for non-invasive, rigid fixation of fiducial markers to the patient

“…It may be possible to adapt the basic granular jamming technique to an alternate form factor (see e.g. [15,18]), but further research will be required to assess the feasibility of doing so. Additionally, we note that the device is compatible with any patient, including those with long hair.…”

“…Additionally, surgeons report that there is an ongoing loss of neuronavigation accuracy after initial registration due to multiple different factors [14]; therefore, ensuring accurate registration throughout the entire procedure is important. Even in “good” cases, the average TRE observed by the authors was approximately 2 mm, which is larger than one would expect from a theoretical perspective, based on the patient-fiducial geometry and typical brow scan point collection error [18]. However, this level of error is easily explainable when one considers relative motion between the fiducial markers and the patient’s skull.…”

“…This paper presents an extension to our initial explorations into granular jamming [15,18] in which we positioned several granular jamming pads on the head, which were connected to one another with either a rigid or layer jamming frame. We showed that these can reduce TRE by over 50%.…”

“…Prior to our initial conference papers that served as preliminary studies for the current paper [15,18], granular jamming had not been applied to image-guided surgery. It has been used in the past as a robot gripper for industrial applications [1].…”

A Non-Axisymmetric Parallel Manipulator for Head Stabilisation in Vitreoretinal Surgery

“…During anterior segment ophthalmic surgery, for example, involuntary patient head motion can be as much as 11 mm [3]. Most researches that aim to mitigate head movement had focused on how to constraint the head, with examples such as the head fixation device for iRAM!S robot [4] and the Granular-Jamming Headband [5]. On the other hand, other approaches, such as countering head motion, were rarely explored.…”