Mechatronics in Medicine

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• Journal article
  Munford MJ, Baena FRY, Bowyer S, 2019,

  Stereoscopic near-infrared fluorescence imaging: a proof of concept toward real-time depth perception in surgical robotics

  , Frontiers in Robotics and AI, Vol: 6, ISSN: 2296-9144

  The increasing use of surgical robotics has provoked the necessity for new medical imaging methods. Many assistive surgical robotic systems influence the surgeon's movements based on a model of constraints and boundaries driven by anatomy. This study aims to demonstrate that Near-Infrared Fluorescence (NIRF) imaging could be applied in surgical applications to provide subsurface mapping of capillaries beneath soft tissue as a method for imaging active constraints. The manufacture of a system for imaging in the near-infrared wavelength range is presented, followed by a description of computational methods for stereo-post-processing and data acquisition and testing used to demonstrate that the proposed methods are viable. The results demonstrate that it is possible to use NIRF for the imaging of a capillary submersed up to 11 mm below a soft tissue phantom, over a range of angles from 0° through 45°. Phantom depth has been measured to an accuracy of ±3 mm and phantom angle to a constant accuracy of ±1.6°. These findings suggest that NIRF could be used for the next generation of medical imaging in surgical robotics and provide a basis for future research into real-time depth perception in the mapping of active constraints.

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• Journal article
  Zhan W, Rodriguez y Baena F, Dini D, 2019,

  Effect of tissue permeability and drug diffusion anisotropy on convection-enhanced delivery

  , Drug Delivery, Vol: 26, Pages: 773-781, ISSN: 1071-7544

  Although convection-enhanced delivery (CED) can successfully facilitate a bypass of the blood brain barrier, its treatment efficacy remains highly limited in clinic. This can be partially attributed to the brain anisotropic characteristics that lead to the difficulties in controlling the drug spatial distribution. Here, the responses of six different drugs to the tissue anisotropy are examined through a parametric study performed using a multiphysics model, which considers interstitial fluid flow, tissue deformation and interlinked drug transport processes in CED. The delivery outcomes are evaluated in terms of the penetration depth and delivery volume for effective therapy. Simulation results demonstrate that the effective penetration depth in a given direction can be improved with the increase of the corresponding component of anisotropic characteristics. The anisotropic tissue permeability could only reshape the drug distribution in space but has limited contribution to the total effective delivery volume. On the other hand, drugs respond in different ways to the anisotropic diffusivity. The large delivery volumes of fluorouracil, carmustine, cisplatin and doxorubicin could be achieved in relatively isotropic tissue, while paclitaxel and methotrexate are able to cover enlarged regions into anisotropic tissues. Results obtained from this study serve as a guide for the design of CED treatments.

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• Journal article
  Watts TE, Secoli R, Rodriguez y Baena F, 2019,

  A mechanics-based model for 3D steering of programmable bevel-tip needles

  , IEEE Transactions on Robotics, Vol: 35, Pages: 371-386, ISSN: 1552-3098

  We present a model for the steering of programmable bevel-tip needles, along with a set of experiments demonstrating the 3D steering performance of a new, clinically viable, 4-segment, pre-production prototype. A multi-beam approach, based on Euler-Bernoulli beam theory, is used to model the novel multi-segment design of these needles. Finite element simulations for known loads are used to validate the multi-beam deflection model. A clinically sized (2.5 mm outer diameter), 4-segment programmable bevel-tip needle, manufactured by extrusion of a medical-grade polymer, is used to conduct an extensive set of experimental trials to evaluate the steering model. For the first time, we demonstrate the ability of the 4-segment needle design to steer in any direction with a maximum achievable curvature of 0.0192±0.0014 mm⁻¹. Finite element simulations confirm that the multi-beam approach produces a good model fit for tip deflections, with a root-mean-square deviation (RMSD) in modeled tip deflection of 0.2636 mm. We perform a parameter optimization to produce a best-fit steering model for the experimental trials, with a RMSD in curvature prediction of 1.12×10⁻³ mm⁻¹.

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• Journal article
  Pinzi M, Galvan S, Rodriguez y Baena F, 2019,

  The adaptive hermite fractal tree (AHFT): a novel surgical 3D path planning approach with curvature and heading constraints

  , International Journal of Computer Assisted Radiology and Surgery, Vol: 14, Pages: 659-670, ISSN: 1861-6429

  PurposeIn the context of minimally invasive neurosurgery, steerable needles such as the one developed within the Horizon2020-funded EDEN2020 project (Frasson et al. in Proc Inst Mech Eng Part H J Eng Med 224(6):775–88, 2010. https://doi.org/10.1243/09544119JEIM663; Secoli and y Baena in IEEE international conference on robotics and automation, 2013) aspire to address the clinical challenge of better treatment for cancer patients. The direct, precise infusion of drugs in the proximity of a tumor has been shown to enhance its effectiveness and diffusion in the surrounding tissue (Vogelbaum and Aghi in Neuro-Oncology 17(suppl 2):ii3–ii8, 2015. https://doi.org/10.1093/neuonc/nou354). However, planning for an appropriate insertion trajectory for needles such as the one proposed by EDEN2020 is challenging due to factors like kinematic constraints, the presence of complex anatomical structures such as brain vessels, and constraints on the required start and target poses.MethodsWe propose a new parallelizable three-dimensional (3D) path planning approach called Adaptive Hermite Fractal Tree (AHFT), which is able to generate 3D obstacle-free trajectories that satisfy curvature constraints given a specified start and target pose. The AHFT combines the Adaptive Fractal Tree algorithm’s efficiency (Liu et al. in IEEE Robot Autom Lett 1(2):601–608, 2016. https://doi.org/10.1109/LRA.2016.2528292) with optimized geometric Hermite (Yong and Cheng in Comput Aided Geom Des 21(3):281–301, 2004. https://doi.org/10.1016/j.cagd.2003.08.003) curves, which are able to handle heading constraints.ResultsSimulated results demonstrate the robustness of the AHFT to perturbations of the target position and target heading. Additionally, a simulated preoperative environment, where the surgeon is able to select a desired entry pose on the patient’s skull, confirms the ability of the method to generate multiple feasible trajectories for a patient-specific case

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• Conference paper
  Matheson E, Watts T, Secoli R, Rodriguez y Baena Fet al., 2019,

  Cyclic motion control for programmable bevel-tip needles 3D steering: a simulation study

  , ROBIO - IEEE International Conference on Robotics and Biomimetics, Publisher: IEEE

  Flexible, steerable, soft needles are desirable inMinimally Invasive Surgery to achieve complex trajectorieswhile maintaining the benefits of percutaneous interventioncompared to open surgery. One such needle is the multi-segmentProgrammable Bevel-tip Needle (PBN), which is inspired by themechanical design of the ovipositor of certain wasps. PBNscan steer in 3D whilst minimizing the force applied to thesurrounding substrate, due to the cyclic motion of the segments.Taking inspiration also from the control strategy of the wasp toperform insertions and lay their eggs, this paper presents thedesign of a cyclic controller that can steer a PBN to produce adesired trajectory in 3D. The performance of the controller isdemonstrated in simulation in comparison to that of a directcontroller without cyclic motion. It is shown that, while thesame steering curvatures can be attained by both controllers,the time taken to achieve the configuration is longer for thecyclic controller, leading to issues of potential under-steeringand longer insertion times.

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• Journal article
  Garriga Casanovas A, Rodriguez y Baena F, 2019,

  Kinematics of continuum robots with constant curvature bending and extension capabilities

  , Journal of Mechanisms and Robotics, Vol: 11, ISSN: 1942-4302

  Continuum robots are becoming increasingly popular due to the capabilities they offer, especially when operating in cluttered environments, where their dexterity, maneuverability, and compliance represent a significant advantage. The subset of continuum robots that also belong to the soft robots category has seen rapid development in recent years, showing great promise. However, despite the significant attention received by these devices, various aspects of their kinematics remain unresolved, limiting their adoption and obscuring their potential. In this paper, the kinematics of continuum robots with the ability to bend and extend are studied, and analytical, closed-form solutions to both the direct and inverse kinematics are presented. The results obtained expose the redundancies of these devices, which are subsequently explored. The solution to the inverse kinematics derived here is shown to provide an analytical, closed-form expression describing the curve associated with these redundancies, which is also presented and analyzed. A condition on the reachable end-effector poses for robots with six actuation degrees-of-freedom (DOFs) is then distilled. The kinematics of robot layouts with over six actuation DOFs are subsequently considered. Finally, simulated results of the inverse kinematics are provided, verifying the study.

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• Journal article
  Ng KCG, Daou HE, Bankes MJK, Rodriguez y Baena F, Jeffers JRTet al., 2019,

  Hip Joint Torsional Loading Before and After Cam Femoroacetabular Impingement Surgery

  , AMERICAN JOURNAL OF SPORTS MEDICINE, Vol: 47, Pages: 420-430, ISSN: 0363-5465
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  • Citations: 14
• Conference paper
  Virdyawan V, Rodriguez y Baena F, 2019,

  Vessel pose estimation for obstacle avoidance in needle steering surgery using multiple forward looking sensors

  , 2018 IEEE/RSJ International Conference on Intelligent Robots and Systems, Publisher: IEEE

  During percutaneous interventions in the brain, puncturing a vessel can cause life-threatening complications. To avoid such a risk, current research has been directed towards the development of steerable needles. However, there is a risk that vessels of a size which is close to or smaller than the resolution of commonly used preoperative imaging modalities (0.59 x 0.59 x 1 mm) would not be detected during procedure planning, with a consequent increase in risk to the patient. In this work, we present a novel ensemble of forward-looking sensors based on laser Doppler flowmetry, which are embedded within a biologically inspired steerable needle to enable vessel detection during the insertion process. Four Doppler signals are used to classify the pose of a vessel in front of the advancing needle with a high degree of accuracy (2$^{\circ}$ and 0.1 mm RMS errors), where relative measurements between sensors are used to correct for ambiguity. By using a robotic-assisted needle insertion process, and thus a precisely controlled insertion speed, we also demonstrate how the setup can be used to discriminate between tissue bulk motion and vessel motion. In doing so, we describe a sensing apparatus applicable to a variety of needle steering systems, with the potential to eliminate the risk of haemorrhage during percutaneous procedures.

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• Journal article
  El Daou H, Ng KCG, Van Arkel R, Jeffers JRT, Rodriguez y Baena Fet al., 2019,

  Robotic hip joint testing: Development and experimental protocols

  , MEDICAL ENGINEERING & PHYSICS, Vol: 63, Pages: 57-62, ISSN: 1350-4533
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  • Citations: 10
• Journal article
  Aledo J, Baena F, Blasco E, Llanos C, Medina IV, Vallaure Jet al., 2019,

  Picture book. <i>The support of culture (selection)</i>

  , ESCRITURA E IMAGEN, Vol: 15, Pages: 185-201, ISSN: 1885-5687
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