Design and Performance Evaluation of a Minimally Invasive Telerobotic Platform for Transurethral Surveillance and Intervention

Goldman, Roger E.; Bajo, Andrea; MacLachlan, Lara S.; Pickens, Ryan B.; Herrell, S. Duke; Simaan, Nabil

doi:10.1109/tbme.2012.2226031

Cited by 81 publications

(58 citation statements)

References 30 publications

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“…The robot platform uses a steerable 5 mm flexible snake-like robot with three working channels. The fundamental design of these robots was first presented 6,7 in the context of distal dexterity for endoscopic and minimally invasive surgery. The scope of this pilot study was to demonstrate the basic surgical tasks, such as endoscopic complete surface visualization and coverage, energy delivery, and resection, during TURBT.…”

Section: Methodsmentioning

confidence: 99%

A Pilot Ex Vivo Evaluation of a Telerobotic System for Transurethral Intervention and Surveillance

Pickens

Bajo

Simaan

et al. 2015

Journal of Endourology

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Introduction: Transurethral resection of bladder tumor (TURBT) and pathological staging are both standard surgical therapies for nonmuscle-invasive bladder cancer and integral parts of the diagnostic evaluation and progression monitoring of all bladder tumors. We developed and tested a dexterous robot that can fit through a standard resectoscope for evaluation for possible en bloc resection of bladder tumors, especially tumors along the dome and anterior wall of the bladder. Materials and Methods: Our dexterous robot uses a continuum (snake-like) mechanical architecture with three working channels through which a fiberscope, biopsy graspers, and a holmium laser were placed. The continuum robot has two segments. Using indigo carmine, injections were performed through the detrusor muscle into the mucosa of the ex vivo bovine bladders at a total of 11 positions throughout all quadrants of the bladder. The snake robot was used in conjunction with the holmium laser to ablate nine of the lesions; two additional lesions were resected en bloc using the grasper and the laser down through the muscle layer. Results: Both experiments showed that the robotic system was able to directly visualize all 11 targets. In both the bladders, we were able to resect en bloc two tumors using the grasper and 200 lm holmium laser fiber down to the muscle layer indicating a good resection. All of the other targets were completely ablated using the holmium laser. Conclusion: The dexterous robot allowed for visualization as well as provided adequate ablation and en bloc resection of bladder lesions throughout the entire bladder.

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Section: Methodsmentioning

confidence: 99%

A Pilot Ex Vivo Evaluation of a Telerobotic System for Transurethral Intervention and Surveillance

Pickens

Bajo

Simaan

et al. 2015

Journal of Endourology

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“…Each segment consists from a central backbone surrounded by several secondary backbones that are pushed or pulled on to bend the segment. Our robot uses three circumferentially distributed NiTi secondary backbones for actuation in a manner similar to [7]. The robot tip is a spherical probe equipped with a magnetic tracker allowing for exact measurement of the robot tip location.…”

Section: Experimental Evaluationmentioning

confidence: 99%

Simultaneous Compliance and Registration Estimation for Robotic Surgery

Sanan

Tully

Bajo

et al. 2014

Robotics: Science and Systems X

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Abstract-Leveraging techniques pioneered by the SLAM community, we present a new filtering approach called simultaneous compliance and registration estimation or CARE. CARE is like SLAM in that it simultaneously determines the pose of a surgical robot while creating a map, but in this case, the map is a compliance map associated with a preoperative model of an organ as opposed to just positional information like landmark locations. The problem assumes that the robot is forcefully contacting and deforming the environment. This palpation has a dual purpose: 1) it provides the necessary geometric information to align or register the robot to a priori models, and 2) with palpation at varying forces, the stiffness/compliance of the environment can be computed. By allowing the robot to palpate its environment with varying forces, we create a force balanced spring model within a Kalman filter framework to estimate both tissue and robot position. The probabilistic framework allows for information fusion and computational efficiency. The algorithm is experimentally evaluated using a continuum robot interacting with two benchtop flexible structures.

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“…Recently, the feasibility of transurethral bladder access and laser resection has been demonstrated by Simaan et al using a continuously flexible multi-backbone robot [2], [3]. In this paper, we apply a different kind of continuously flexible robot (the concentric tube robot) to facilitate a new approach to the clinical condition that originally inspired Davies et al's work.…”

Section: Introductionmentioning

confidence: 99%

A multi-arm hand-held robotic system for transurethral laser Prostate surgery

Hendrick

Herrell

Webster

2014

2014 IEEE International Conference on Robotics and Automation (ICRA)

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Benign prostatic hyperplasia is the most common symptomatic disease in men. A new transurethral surgical intervention is available that has been shown to reduce bleeding, catheterization time, and hospitalization time in comparison to traditional Transurethral Resection of the Prostate (TURP). However, this new procedure, Holmium Laser Enucleation of the Prostate (HoLEP), is so challenging to accomplish that only a small number of expert surgeons are able to offer it. Toward facilitating broader use of HoLEP, we propose a new hand-held robotic system for the purpose of making the surgery easier to perform. In current HoLEP, the only way to aim the laser and/or manipulate tissue is to move the entire endoscope, stretching a large quantity of tissue. In contrast, our new robotic approach provides the surgeon with two concentric tube manipulators that can aim the laser and manipulate tissue simultaneously. The manipulators are deployed through a 5 mm working channel in a 26 French (8.66 mm) endoscope clinically used for transurethral procedures. This paper describes the design of the robot and experiments illustrating its ability to perform the motions expected to be useful in HoLEP.

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Design and Performance Evaluation of a Minimally Invasive Telerobotic Platform for Transurethral Surveillance and Intervention

Cited by 81 publications

References 30 publications

A Pilot Ex Vivo Evaluation of a Telerobotic System for Transurethral Intervention and Surveillance

A Pilot Ex Vivo Evaluation of a Telerobotic System for Transurethral Intervention and Surveillance

Simultaneous Compliance and Registration Estimation for Robotic Surgery

A multi-arm hand-held robotic system for transurethral laser Prostate surgery

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