Design, modeling, and preliminary evaluation of a 3D-printed wrist-hand grasping orthosis for stroke survivors.

Stroke causes neurological and physical impairment in millions of people around the world every year. To better comprehend the upper-limb needs and challenges stroke survivors face and the issues associated with existing technology and formulate ideas for a technological solution, the authors conversed with 153 members of the ecosystem (60 neuro patients, 30 caregivers, and 63 medical providers). Patients fell into two populations depending on their upper-limb impairment: spastic (stiff, clenched hands) and flaccid (limp hands).

A Safe Framework for Quantitative In Vivo Human Evaluation of Image Guidance.

We present a new framework for in vivo image guidance evaluation and provide a case study on robotic partial nephrectomy. This framework (called the "bystander protocol") involves two surgeons, one who solely performs the therapeutic process without image guidance, and another who solely periodically collects data to evaluate image guidance. This isolates the evaluation from the therapy, so that in-development image guidance systems can be tested without risk of negatively impacting the standard of care.

Patient-specific, touch-based registration during robotic, image-guided partial nephrectomy.

Image-guidance during partial nephrectomy enables navigation within the operative field alongside a 3-dimensional roadmap of renal anatomy generated from patient-specific imaging. Once a process is performed by the human mind, the technology will allow standardization of the task for the benefit of all patients undergoing robot-assisted partial nephrectomy. Any surgeon will be able to visualize the kidney and key subsurface landmarks in real-time within a 3-dimensional simulation, with the goals of improving operative efficiency, decreasing surgical complications, and improving oncologic outcomes.

Comparing the accuracy of the da Vinci Xi and da Vinci Si for image guidance and automation.

Background: Current laparoscopic surgical robots are teleoperated, which requires high fidelity differential motions but does not require absolute accuracy. Emerging applications, including image guidance and automation, require absolute accuracy. The absolute accuracy of the da Vinci Xi robot has not yet been characterized or compared to the Si system, which is now being phased out.

Toward Practical and Accurate Touch-Based Image Guidance for Robotic Partial Nephrectomy.

Partial nephrectomy involves removing a tumor while sparing surrounding healthy kidney tissue. Compared to total kidney removal, partial nephrectomy improves outcomes for patients but is underutilized because it is challenging to accomplish minimally invasively, requiring accurate spatial awareness of unseen subsurface anatomy. Image guidance can enhance spatial awareness by displaying a 3D model of anatomical relationships derived from medical imaging information.

Bond Graph Modeling of Mechanical Circulatory Support Device-Cardiovascular System Interactions.

Though mechanical circulatory support (MCS) devices, such as ventricular assist devices and total artificial hearts (TAH), provide heart failure patients with bridges to heart transplantation or are alternatives to transplantation, device performance, and corresponding control strategies are often difficult to evaluate. Difficulties arise due to the complex interaction of multiple domains-i.e.

Circulatory loop design and components introduce artifacts impacting in vitro evaluation of ventricular assist device thrombogenicity: A call for caution.

Mechanical circulatory support (MCS) devices continue to be hampered by thrombotic adverse events (AEs), a consequence of device-imparted supraphysiologic shear stresses, leading to shear-mediated platelet activation (SMPA). In advancing MCS devices from design to clinical use, in vitro circulatory loops containing the device under development and testing are utilized as a means of assessing device thrombogenicity. Physical characteristics of these test circulatory loops may also contribute to inadvertent platelet activation through imparted shear stress, adding inadvertent error in evaluating MCS device thrombogenicity.

Fiber Optic Shape Sensing for Soft Robotics.

While soft material actuators can undergo large deformations to execute very complex motions, what is critically lacking in soft material robotic systems is the ability to collect high-resolution shape information for sophisticated functions such as environmental mapping, collision detection, and full state feedback control. This work explores the potential of a nearly commercial fiber optic shape sensor (FOSS) and presents the first demonstrations of a monolithic, multicore FOSS integrated into the structure of a fiber-reinforced soft actuator. In this pilot study, we report an open loop sensorized soft actuator capable of submillimeter position feedback that can detect the soft actuator's shape, environmental shapes, collision locations, and material stiffness properties.

Characterization and Control of a Pneumatic Motor for MR-conditional Robotic Applications.

Magnetic Resonance (MR) guided interventional robots have recently been developed for a variety of surgeries, such as biopsy, ablation, and brachytherapy. The actuators and encoders that power and track such robots must be MR-conditional. In this paper, we propose an MR-conditional pneumatic motor with an integrated and custom-built fiber-optical encoder that provides powerful and accurate actuation.

Optimization of Curvilinear Needle Trajectories for Transforamenal Hippocampotomy.

Background: The recent development of MRI-guided laser-induced thermal therapy (LITT) offers a minimally invasive alternative to craniotomies performed for tumor resection or for amygdalohippocampectomy to control seizure disorders. Current LITT therapies rely on linear stereotactic trajectories that mandate twist-drill entry into the skull and potentially long approaches traversing healthy brain. The use of robotically-driven, telescoping, curved needles has the potential to reduce procedure invasiveness by tailoring trajectories to the curved shape of the ablated structure and by enabling access through natural orifices.

Design, Additive Manufacture, and Control of a Pneumatic, MR-Compatible Needle Driver.

This paper reports the design, modeling, and control of an MR-compatible actuation unit comprising pneumatic stepper mechanisms. One helix-shaped bellows and one toroid-shaped bellows were designed to actuate in pure rotation and pure translation, respectively. The actuation unit is a two degree- of-freedom needle driver that translates and rotates the base of one tube of a steerable needle like a concentric tube robot.