Development and Application of a New Steady-Hand Manipulator for Retinal Surgery

Abstract

Abstract-This paper describes the development and initial testing of a new and optimized version of a steady-hand manipulator for retinal microsurgery. In the steady-hand paradigm, the surgeon and the robot share control of a tool attached to the robot through a force sensor. The robot controller senses forces exerted by the operator on the tool and uses this information in various control modes to provide smooth, tremor-free, precise positional control and force scaling. The steady-hand manipulator reported here has been specifically designed with the unique constraints of retinal microsurgery in mind. In particular, the system makes use of a compact wrist design that places the bulk of the robot away from the operating field. The resulting system has high efficacy, flexibility and ergonomics while meeting the accuracy and safety requirements of microsurgery. We have now tested this robot on a biological model system and we report a protocol for reliably cannulating ∼80 µm OD veins (the size of veins in the human retina) using the system.

Intraoperative Visualization of Anatomical Targets in Retinal Surgery

“…Leng et al [13] reported that the chorioallantoic membrane (CAM) of a 12 days old chicken embryo is a good test model system for retinal surgery since at around this age the secondary veins on the surface of the CAM are of a size that closely matches the size of the veins on the human retina. A previously collected video recording of a CAM vein cannulation procedure (under IRB approval, [14]) was used to asses the tracking algorithm. Under these conditions we noticed a tracking processing speed of 31-33 FPS.…”

Robot-assisted intraocular surgery: development of the IRISS and feasibility studies in an animal model

“…16 Another adaptation, the Microhand (consisting of four fingers), was designed to mimic a human hand while being pneumatically controlled, allowing titration of grasping force. 17 The steady-hand manipulator 18,19 and Micron 20 were two independently developed instruments capable of tremor filtration for microsurgical procedures. Japanese collaborators recently created a prototype robotic system designed to aid in vitreoretinal surgery.…”

Single Fiber Optical Coherence Tomography Microsurgical Instruments for Computer and Robot-Assisted Retinal Surgery

“…The position resolution is 1µm and measured repeatability is about ± 1 µm for range of motion required for this experiment (<2mm). This robot was chosen for experimental convenience, and would be replaced in actual practice by a system similar to [9][10]. The robot is interfaced to a PC workstation through a commercial motion controller (Galil DMC 1886).…”

“…Compared to alternative approaches, CP-OCT is simple, robust, and affordable [8], and also permits an extremely compact tool design. This "A-mode" sensing capability can either be used with conventional free-hand instruments or (as here) can be combined with a robotic microsurgery platform such as the JHU EyeRobot [9] or the CMU Micron [10]. When integrated with a robot, this instrument may be scanned to produce images of the local anatomy or integrated in various ways to the control the robot.…”