Ultrasound 3D reconstruction of malignant masses in robotic-assisted partial nephrectomy using the PAF rail system: a comparison study

Abstract

Purpose In robotic-assisted partial nephrectomy (RAPN), the use of intraoperative ultrasound (IOUS) helps to localise and outline the tumours as well as the blood vessels within the kidney. The aim of this work is to evaluate the use of the pneumatically attachable flexible (PAF) rail system for US 3D reconstruction of malignant masses in RAPN. The PAF rail system is a novel device developed and previously presented by the authors to enable track-guided US scanning. Methods We present a comparison study between US 3D reconstruction of masses based on: the da Vinci Surgical System kinematics, single-and stereo-camera tracking of visual markers embedded on the probe. An US-realistic kidney phantom embedding a mass is used for testing. A new design for the US probe attachment to enhance the performance of the kinematic approach is presented. A feature extraction algorithm is proposed to detect the margins of the targeted mass in US images. Results To evaluate the performance of the investigated approaches the resulting 3D reconstructions have been compared to a CT scan of the phantom. The data collected indicates that single camera reconstruction outperformed the other approaches, reconstructing with a sub-millimetre accuracy the targeted mass. Conclusions This work demonstrates that the PAF rail system provides a reliable platform to enable accurate US 3D reconstruction of masses in RAPN procedures. The proposed system has also the potential to be employed in other surgical procedures such as hepatectomy or laparoscopic liver resection.

Organ Shape Sensing using Pneumatically Attachable Flexible Rails in Robotic-Assisted Laparoscopic Surgery

“…The design of the PAF rail suction line used in this work is based on the optimisation study firstly presented in [12]. The structure of the PAF rail-tool interface is an improved version of the design proposed in [14], where the customised grasping slot is replaced by a continuous segmented fin, enabling grasping of the PAF rail at any point along it. We added a channel of 1 mm diameter along the internal perimeter of the rail to embed the shape sensing fibre, as shown in Fig.…”

“…In [13] the authors have investigated the autonomous deployment of the PAF rail on the surface of the organ and its use in intra-operative organ manipulation. In [14], Wang et al studied the 3D reconstruction of a mass embedded in a kidney phantom when the PAF rail guides the US probe. Accurate shape sensing of the PAF rail within the surgical field could further improve the deployment of this system on the targeted organ surface while autonomously controlling the probes' trajectory.…”

“…Embedding sensors in the soft robot can give the information needed to meet said control challenges, but these sensors must have the ability to bend, twist, and contort in tandem with the soft robot. In surgical soft robotics, the most common sensing methods are external vision-based systems using intraoperative imaging, [14], [15], electromagnetic tracking, [15] [16], needle-based [17] and catheter-based interventions [18], [19]. But all these techniques present some drawbacks.…”

Accelerating Surgical Robotics Research: A Review of 10 Years With the da Vinci Research Kit

“…The final category of publications relates to technologies that can enhance the surgeon's awareness [31], [211] and perception from a visual point of view; for example, using eye-gaze trackers [76], [78] to personalize a surgeon's experience or combining different imaging techniques, such as ultrasounds [72], [181], to provide more intraoperative visual information but also from tactile sensing [120]- [122], [160], [251]. A significant research effort also targeted improving the teleoperation capabilities of the dVRK, taking into account time delay [23], possible master-slave misalignment [64], constrained workspace [35], shared control [41], or incorporating virtual environment guidance [55].…”

Autonomous pick-and-place using the dVRK

“…Figure 2 shows the set-up overview alongside the PAF rail, the two PSMs, the stereo endoscope and the porcine kidney. The black rail, presented by the authors in previous works [ 12 , 15 ], is attached to the kidney surface using a series of bio-inspired vacuum suckers. It is used as a guide on which the surgeon engages and slides the drop-in US probe (3D printed model) to identify vessels and resection margins.…”