sEMG-based Motion Recognition for Robotic Surgery Training - A Preliminary Study.

Robotic surgery represents a major breakthrough in the evolution of medical technology. Accordingly, efficient skill training and assessment methods should be developed to meet the surgeon's need of acquiring such robotic skills over a relatively short learning curve in a safe manner. Different from conventional training and assessment methods, we aim to explore the surface electromyography (sEMG) signal during the training process in order to obtain semantic and interpretable information to help the trainee better understand and improve his/her training performance.

Robot-guided osteotomy in fibula free flap mandibular reconstruction: a preclinical study.

Various methods currently exist to guide fibular osteotomy positioning in fibula free flap mandibular reconstruction, but patient-specific navigation methods and cutting guides require experience, and may be time-consuming and/or expensive. This study describes a robot-guided osteotomy technique for mandible reconstruction using a fibula free flap according to virtual preoperative planning. The method was assessed on five 3D-printed models and a cadaveric model.

Contactless surface registration of featureless anatomy using structured light camera: application to fibula navigation in mandible reconstruction.

Purpose: Mandibular reconstruction using fibula free flap is a challenging surgical procedure. To assist osteotomies, computer-assisted surgery (CAS) can be used. Nevertheless, precise registration is required and often necessitates anchored markers that disturb the patient and clinical flow.

Miniaturized Endoscopic 2D US Transducer for Volumetric Ultrasound Imaging of the Auditory System.

Objective: In this paper, we focus on the carrying out and validation of minimally invasive three-dimensional (3D) ultrasound (US) imaging of the auditory system, which is based on a new miniaturized endoscopic 2D US transducer.

Methods: This unique probe consists of a 18 MHz 24 elements curved array transducer with a distal diameter of 4 mm so it can be inserted into the external auditory canal. Typical acquisition is achieved by rotating such a transducer around its own axis using a robotic platform.

Fibular registration using surface matching in navigation-guided osteotomies: a proof of concept study on 3D-printed models.

Purpose: Fibula free flap is currently used in mandibular reconstruction. The main difficulties involved in this surgery concern mandible shaping and therefore, osteotomy positioning on the fibula. The use of navigation could help in osteotomy positioning, but accurate registration is required.

Feasibility of Cochlea High-frequency Ultrasound and Microcomputed Tomography Registration for Cochlear Computer-assisted Surgery: A Testbed.

Introduction: There remains no standard imaging method that allows computer-assisted surgery of the cochlea in real time. However, recent evidence suggests that high-frequency ultrasound (HFUS) could permit real-time visualization of cochlear architecture. Registration with an imaging modality that suffers neither attenuation nor conical deformation could reveal useful anatomical landmarks to surgeons.

Sparse-view CBCT reconstruction via weighted Schatten p-norm minimization.

A novel iterative algorithm is proposed for sparse-view cone beam computed tomography (CBCT) reconstruction based on the weighted Schatten p-norm minimization (WSNM). By using the half quadratic splitting, the sparse-view CBCT reconstruction task is decomposed into two sub-problems that can be solved through alternating iteration: simple reconstruction and image denoising. The WSNM that fits well with the low-rank hypothesis of CBCT data is introduced to improve the denoising sub-problem as a regularization term.

HFUS Imaging of the Cochlea: A Feasibility Study for Anatomical Identification by Registration with MicroCT.

Cochlear implantation consists in electrically stimulating the auditory nerve by inserting an electrode array inside the cochlea, a bony structure of the inner ear. In the absence of any visual feedback, the insertion results in many cases of damages of the internal structures. This paper presents a feasibility study on intraoperative imaging and identification of cochlear structures with high-frequency ultrasound (HFUS).

Towards 3D Ultrasound Guided Needle Steering Robust to Uncertainties, Noise, and Tissue Heterogeneity.

This paper presents a new solution for 3D steering of flexible needles guided by 3D B-mode ultrasound imaging. It aims to realize a robust steering, by accounting for uncertainties, noise and tissue heterogeneities, while limiting tissue-related disturbances. The proposed solution features interconnected state observer, automatic needle tip segmentation and path planning algorithms.

Transrectal ultrasound image-based real-time augmented reality guidance in robot-assisted laparoscopic rectal surgery: a proof-of-concept study.

Purpose: Surgical treatments for low-rectal cancer require careful considerations due to the low location of cancer in rectums. Successful surgical outcomes highly depend on surgeons' ability to determine clear distal margins of rectal tumors. This is a challenge for surgeons in robot-assisted laparoscopic surgery, since tumors are often concealed in rectums and robotic surgical instruments do not provide tactile feedback for tissue diagnosis in real time.

Fast And Simple Automatic 3D Ultrasound Probe Calibration Based On 3D Printed Phantom And An Untracked Marker.

Tracking the pose of an ultrasound (US) probe is essential for an intraoperative US-based navigation system. The tracking requires mounting a marker on the US probe and calibrating the probe. The goal of the US probe calibration is to determine the rigid transformation between the coordinate system (CS) of the image and the CS of the marker mounted on the probe.

Automatic Robotic Steering of Flexible Needles from 3D Ultrasound Images in Phantoms and Ex Vivo Biological Tissue.

Robotic control of needle bending aims at increasing the precision of percutaneous procedures. Ultrasound feedback is preferable for its clinical ease of use, cost and compactness but raises needle detection issues. In this paper, we propose a complete system dedicated to robotized guidance of a flexible needle under 3D ultrasound imaging.

Evaluation of contactless human-machine interface for robotic surgical training.

Purpose: Teleoperated robotic systems are nowadays routinely used for specific interventions. Benefits of robotic training courses have already been acknowledged by the community since manipulation of such systems requires dedicated training. However, robotic surgical simulators remain expensive and require a dedicated human-machine interface.

Design and evaluation of an actuated knee implant for postoperative ligament imbalance correction.

In Total Knee Arthroplasty (TKA), the collateral ligament tensioning stage cannot be standardised for all patients and relies heavily on the surgeon's experience and perception. Intraoperative inaccuracies are practically unavoidable and may give rise to severe postoperative complications, leading to the need for revision surgery already a few years after primary TKA. This work proposes a novel instrumented tibial component able to detect collateral ligament laxity conditions right after primary TKA and, if needed, to compensate for them in the postoperative period.

Enhanced position-force tracking of time-delayed teleoperation for robotic-assisted surgery.

The advance of minimally invasive surgery has been empowered by new medical/surgical robotic systems towards achieving less invasiveness, smaller or even no scars. Wireless communication possesses great potential to be utilized in miniaturized surgical robotic system. However time delay is inevitably introduced in the control loop which causes stability issues for robotic-assisted surgeries.

Motion prediction using dual Kalman filter for robust beating heart tracking.

A novel prediction method for robust beating heart tracking is proposed. The dual time-varying Fourier series is used to model the heart motion. The frequency parameters and Fourier coefficients in the model are estimated respectively by using a dual Kalman filter scheme.

Using rotation for steerable needle detection in 3D color-Doppler ultrasound images.

This paper demonstrates a new way to detect needles in 3D color-Doppler volumes of biological tissues. It uses rotation to generate vibrations of a needle using an existing robotic brachytherapy system. The results of our detection for color-Doppler and B-Mode ultrasound are compared to a needle location reference given by robot odometry and robot ultrasound calibration.

Unsupervised Trajectory Segmentation for Surgical Gesture Recognition in Robotic Training.

Dexterity and procedural knowledge are two critical skills that surgeons need to master to perform accurate and safe surgical interventions. However, current training systems do not allow us to provide an in-depth analysis of surgical gestures to precisely assess these skills. Our objective is to develop a method for the automatic and quantitative assessment of surgical gestures.

A miniaturised actuation system embedded in an instrumented knee implant for postoperative ligament imbalance correction.

During Total Knee Arthroplasty surgery, the orthopaedic surgeon has to set up proper balance conditions for the two lateral ligaments of the knee. Such ligament tensioning procedure is performed manually and mainly depends on the surgeon's experience. Unfortunately, inaccuracies are unavoidable and may give rise to serious postoperative complications.

Scaled position-force tracking for wireless teleoperation of miniaturized surgical robotic system.

Miniaturized surgical robotic system presents promising trend for reducing invasiveness during operation. However, cables used for power and communication may affect its performance. In this paper we chose Zigbee wireless communication as a means to replace communication cables for miniaturized surgical robot.

Synthesis of optimal electrical stimulation patterns for functional motion restoration: applied to spinal cord-injured patients.

We investigated the synthesis of electrical stimulation patterns for functional movement restoration in human paralyzed limbs. We considered the knee joint system, co-activated by the stimulated quadriceps and hamstring muscles. This synthesis is based on optimized functional electrical stimulation (FES) patterns to minimize muscular energy consumption and movement efficiency criteria.

Viscoelastic model based force control for soft tissue interaction and its application in physiological motion compensation.

Controlling the interaction between robots and living soft tissues has become an important issue as the number of robotic systems inside the operating room increases. Many researches have been done on force control to help surgeons during medical procedures, such as physiological motion compensation and tele-operation systems with haptic feedback. In order to increase the performance of such controllers, this work presents a novel force control scheme using Active Observer (AOB) based on a viscoelastic interaction model.

On the use of fixed-intensity functional electrical stimulation for attenuating essential tremor.

A great proportion of essential tremor (ET) patients have not so far been able to receive functional benefits from traditional therapies. In this regard, the use of functional electrical stimulation (FES) has been proposed for reducing tremor amplitude by stimulating muscles in antiphase with respect to the trembling motion. Although some studies have reported success in terms of tremor attenuation, drawbacks still exist that prevent the method from being used in real-life applications.

Robotic endoscopic sinus and skull base surgery: review of the literature and future prospects.

Objective: There has been a considerable growth in the indications of endonasal surgery that now include malignant tumours of the nasal fossae and anterior and middle cranial fossa. However, new limitations have also been identified, such as bleeding and cerebrospinal fluid leak, as well as the need to use several instruments simultaneously. Can robotics provide solutions to these problems?

Method: Review of the literature based on the three main databases: Medline, Pubmed and Cochrane.

Innovative endoscopic sino-nasal and anterior skull base robotics.

Purpose: Design a compact, ergonomic, and safe endoscope positioner dedicated to the sino-nasal tract, and the anterior and middle-stage skull base.

Methods: A motion and force analysis of the surgeon's movement was performed on cadaver heads to gather objective data for specification purposes. An experimental comparative study was then performed with three different kinematics, again on cadaver heads, in order to define the best architecture satisfying the motion and force requirements.