Mechatronics in Medicine

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• Journal article
  Tan Z, Dini D, Rodriguez y Baena F, Forte Aet al., 2018,

  Composite hydrogel: A high fidelity soft tissue mimic for surgery

  , Materials and Design, Vol: 160, Pages: 886-894, ISSN: 0264-1275

  Accurate tissue phantoms are difficult to design due to the complex non-linear viscoelastic properties of real soft tissues. A composite hydrogel, resulting from a mix of poly(vinyl) alcohol and phytagel, is able to reproduce the viscoelastic responses of different soft tissues due to its compositional tunability. The aim of this work is to demonstrate the flexibility of the composite hydrogel in mimicking the interactions between surgical tools and various soft tissues, such as brain, lung and liver. Therefore compressive stiffness, insertion forces and frictional forces were used as matching criteria to determine the hydrogel compositions for each soft tissue. A full map of the behaviour of the synthetic material is provided for these three characteristics and the compositions found to best match the mechanical response of brain, lung and liver are reported. The optimised hydrogel samples are then tested and shown to mimic the behaviour of the three tissues with unprecedented fidelity. The effect of each hydrogel constituent on the compressive stiffness, needle insertion and frictional forces is also detailed in this work to explain their individual contributions and synergistic effects. This study opens important opportunities for the realisation of surgical planning and training devices and tools for in-vitro tissue testing.

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• Journal article
  Franco E, Rodriguez y Baena F, Astolfi A, 2018,

  Robust balancing control of flexible inverted-pendulum systems

  , Mechanism and Machine Theory, Vol: 130, Pages: 539-551, ISSN: 0094-114X

  This work studies the balancing control problem for flexible inverted-pendulum systems and investigates the relationship between system parameters and robustness to disturbances. To this end, a new energy-shaping controller with adaptive disturbance-compensation for a class of underactuated mechanical systems is presented. Additionally, a method for the identification of key system parameters that affect the robustness of the closed-loop system is outlined. The proposed approach is applied to the flexible pendulum-on-cart system and a simulation study is conducted to demonstrate its effectiveness. Finally, the control problem for a classical pendulum-on-cart system with elastic joint is discussed to highlight the similarities with its flexible-link counterpart.

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• Conference paper
  Watts T, Secoli R, Rodriguez y Baena F, 2018,

  Needle Steerability Measures: Definition and Application for Optimized Steering of the Programmable Bevel-tip Needle

  , 2018 IEEE International Conference on Robotics and Biomimetics (IEEE ROBIO 2018)
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• Journal article
  Liu H, Auvinet E, Giles J, Rodriguez y Baena Fet al., 2018,

  Augmented reality based navigation for computer assisted hip resurfacing: a proof of concept study

  , Annals of Biomedical Engineering, Vol: 46, Pages: 1595-1605, ISSN: 0090-6964

  Implantation accuracy has a great impact on the outcomes of hip resurfacing such as recovery of hip function. Computer assisted orthopedic surgery has demonstrated clear advantages for the patients, with improved placement accuracy and fewer outliers, but the intrusiveness, cost, and added complexity have limited its widespread adoption. To provide seamless computer assistance with improved immersion and a more natural surgical workflow, we propose an augmented-reality (AR) based navigation system for hip resurfacing. The operative femur is registered by processing depth information from the surgical site with a commercial depth camera. By coupling depth data with robotic assistance, obstacles that may obstruct the femur can be tracked and avoided automatically to reduce the chance of disruption to the surgical workflow. Using the registration result and the pre-operative plan, intra-operative surgical guidance is provided through a commercial AR headset so that the user can perform the operation without additional physical guides. To assess the accuracy of the navigation system, experiments of guide hole drilling were performed on femur phantoms. The position and orientation of the drilled holes were compared with the pre-operative plan, and the mean errors were found to be approximately 2 mm and 2°, results which are in line with commercial computer assisted orthopedic systems today.

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• Journal article
  Garriga Casanovas A, Collison I, Rodriguez y Baena F, 2018,

  Towards a common framework for the design of soft robotic manipulators with fluidic actuation

  , Soft Robotics, Vol: 5, Pages: 622-649, ISSN: 2169-5172

  Soft robotic manipulators with fluidic actuation are devices with easily deformable structures that comprise a set of chambers that can be pressurized to achieve structural deflection. These devices have experienced a rapid development in recent years, which is not least due to the advantages they offer in terms of robustness, affordability, and compliance. Nowadays, however, soft robotic manipulators are designed mostly by intuition, which complicates design improvement and hampers the advancement of the field. In this paper, a general study of the the design of soft robotic manipulators with fluidic actuation is presented, using an analytical derivation. The study relies on a novel approach that is applicable to a general design, and thus provides a common framework for the design of soft robots. In the study, two design layouts of interest are first justified, which correspond to extending and contracting devices. Design principles for each of the layouts are subsequently derived, both for planar and 3D scenarios, and considering operation to support any external loading and to provide any desired deflection. These principles are found to agree with the main design trends in literature, although they also highlight the potential for improvement in specific aspects of the design geometry and stiffness distribution. The principles are used to identify the most suitable design for both extending and contracting devices in 2D and 3D, and extract insight into their behavior.. To showcase the use of these design principles, a prototypical scenario in minimally invasive surgery requiring a manipulator segment capable of bending in any direction is defined, where the objective is to maximize its lateral force. The principles are applied to determine the most suitable design. These also highlight the need for numerical analysis to optimize two design parameters. Finite element simulations are developed, and their results are reported.

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• Conference paper
  Tan Z, Forte A, Rodriguez y Baena F, Dini Det al., 2018,

  Needle-tissue interactions during convection enhanced drug delivery in neurosurgery

  , International Conference on BioTribology
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• Conference paper
  Watts T, Secoli R, Rodriguez y Baena F, 2018,

  Modelling the deformation of biologically inspired flexible structures for needle steering

  , The first International Congress for the Advancement of Mechanism, Machine, Robotics and Mechatronics Sciences 2017, Publisher: Springer, Pages: 67-80, ISSN: 2211-0984

  Recent technical advances in minimally invasive surgery have been enabled by the development of new medical instruments and technologies. To date, the vast majority of mechanisms used within a clinical context are rigid, contrasting with the compliant nature of biological tissues. The field of robotics has seen an increased interest in flexible and compliant systems, and in this paper we investigate the behaviour of deformable multi-segment structures, which take their inspiration from the ovipositor design of parasitic wood wasps. These configurable structures have been shown to steer through highly compliant substrates, potentially enabling percutaneous access to the most delicate of tissues, such as the brain. The model presented here sheds light on how the deformation of the unique structure is related to its shape, and allows comparison between different potential designs. A finite element study is used to evaluate the proposed model, which is shown to provide a good fit (root-mean-square deviation 0.2636 mm for 4-segment case). The results show that both 3-segment and 4-segment designs are able to achieve deformation in all directions, however the magnitude of deformation is more consistent in the 4-segment case.

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• Journal article
  Matheson E, Secoli R, Burrows C, Leibinger A, Rodriguez y Baena Fet al., 2018,

  Cyclic motion control for programmable bevel-tip needles to reduce tissue deformation

  , Journal of Medical Robotics Research, Vol: 4, ISSN: 2424-905X

  Robotic-assisted steered needles aim to accurately control the deflection of the flexible needle’s tip to achieve accurate path following. In doing so, they can decrease trauma to the patient, by avoiding sensitive regions while increasing placement accuracy. This class of needle presents more complicated kinematics compared to straight needles, which can be exploited to produce specific motion profiles via careful controller design and tuning. Motion profiles can be optimized to minimize certain conditions such as maximum tissue deformation and target migration, which was the goal of the formalized cyclic, low-level controller for a Programmable Bevel-tip Needle (PBN) presented in this work. PBNs are composed of a number of interlocked segments that are able to slide with respect to one another. Producing a controlled, desired offset of the tip geometry leads to the corresponding desired curvature of the PBN, and hence desired path trajectory of the system. Here, we propose a cyclical actuation strategy, where the tip configuration is achieved over a number of reciprocal motion cycles, which we hypothesize will reduce tissue deformation during the insertion process. A series of in vitro, planar needle insertion experiments are performed in order to compare the cyclic controller performance with the previously used direct push controller, in terms of targeting accuracy and tissue deformation. It is found that there is no significant difference between the target tracking performance of the controllers, but a significant decrease in axial tissue deformation when using the cyclic controller.

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• Conference paper
  Secoli R, Rodriguez y Baena F, 2018,

  Experimental validation of curvature tracking with a programmable bevel-tip steerable needle

  , International Symposium on Medical Robotics, Publisher: IEEE

  Needle steering systems are a topic of increasing research interest due to the many potential advantages associated with the ability to reach deep-seated targets while avoiding obstacles. Existing embodiments, such as those designed around a fixed bevel tip, are necessarily disruptive to the substrate, with the potential to cause a target to move away from the insertion trajectory, as well as potentially increasing the extent of tissue trauma at the needle interface, when compared to straight needles. To alleviate these issues, we proposed a biologically inspired design, which can steer without the need for duty-cycle spinning along the insertion axis or any active mechanisms at the tip. In this work, we demonstrate for the first time that our needle is able to steer within a deformable substrate, along with a user-defined trajectory in three-dimensional space. A simplified kinematic model is reported, which is subsequently used to design an adaptive strategy enabling the tracking of arbitrary curvatures along any given reference plane. Experimental results in gelatin are used to validate our model, as well as the performance of the controller under laboratory conditions.

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• Book chapter
  Brett PN, Du X, Assadi MZ, Rodriguez y Baena F, Liu F, Hinchliffe R, Thompson Met al., 2018,

  Design and experimental demonstration of a mechatronic solution for endovascular catheters

  , Mechatronics and Machine Vision in Practice 3, Pages: 247-252

  This paper describes a mechatronics approach that provides vascular surgeons with the perception of movement and tissue interaction in the vicinity of the tip of a catheter in endovascular procedures. The current system described is experimental and used in phantom units. It integrates 3D visualization generated from scan with real-time tactile sensing in the vicinity of the tip of the catheter to update on the nature of tissue interaction, the curvature and relative orientation of the catheter sleeve and guide wire. This approach offers superior perception by the clinician, in contrast with current application of catheters used in this application. By being well informed of conditions at the working environment of the catheter tip the clinician will be able to administer therapies with greater precision in the surgical task and within a reduced operating time. The approach will reduce risk for patients and significantly reduce risks for the clinician, who is currently exposed to high doses of ionizing radiation during the process of catheter guidance.

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