Ultrasound-guided needle insertion robotic system for percutaneous puncture

Ultrasound (US)-guided percutaneous puncture technology can realize real-time, minimally invasive interventional therapy without radiation. The location accuracy of the puncture needle directly determines the precision and safety of the operation. It is a challenge for novices and young surgeons to perform a free-hand puncture guided by the ultrasound images to achieve the desired accuracy. This work aims to develop a robotic system to assist surgeons to perform percutaneous punctures with high precision. An US-guided puncture robot was designed to allow the mounting and control of the needle to achieve localization and insertion. The US probe fitted within the puncture robot was held by a passive arm. Moreover, the puncture robot was calibrated with a novel calibration method to achieve coordinate transformation between the robot and the US image. The system allowed the operators to plan the puncture target and puncture path on US images, and the robot performed needle insertion automatically. Five groups of puncture experiments were performed to verify the validity and accuracy of the proposed robotic system. Assisted by the robotic system, the positioning and orientation accuracies of the needle insertion were 0.9 ± 0.29 mm and 0.76 ± 0.34°, respectively. These are improved compared with the results obtained with the free-hand puncture (1.82 ± 0.51 mm and 2.79 ± 1.32°, respectively). Moreover, the proposed robotic system can reduce the operation time and number of needle insertions (14.28 ± 3.21 s and one needle insertion, respectively), compared with the free-hand puncture (25.14 ± 6.09 s and 1.96 ± 0.68 needle insertions, respectively). A robotic system for percutaneous puncture guided by US images was developed and demonstrated. The experimental results indicate that the proposed system is accurate and feasible. It can assist novices and young surgeons to perform the puncture operation with increased accuracy.

[1]  Pierre Hellier,et al.  Confhusius: A robust and fully automatic calibration method for 3D freehand ultrasound , 2005, Medical Image Anal..

[2]  Ron Alterovitz,et al.  Experimental evaluation of ultrasound-guided 3D needle steering in biological tissue , 2014, International Journal of Computer Assisted Radiology and Surgery.

[3]  Navid Shahriari,et al.  Ultrasound-guided three-dimensional needle steering in biological tissue with curved surfaces. , 2015, Medical engineering & physics.

[4]  H Ashrafian,et al.  The evolution of robotic surgery: surgical and anaesthetic aspects , 2017, British journal of anaesthesia.

[5]  Mustafa Z. Mahmoud,et al.  Evolution of Robot-assisted ultrasound-guided breast biopsy systems , 2018 .

[6]  Won-Ho Shin,et al.  Surgical Robot System for Single-Port Surgery With Novel Joint Mechanism , 2013, IEEE Transactions on Biomedical Engineering.

[7]  Moshe Shoham,et al.  Ultrasound-Guided Robot for Flexible Needle Steering , 2010, IEEE Transactions on Biomedical Engineering.

[8]  Gregory S. Chirikjian,et al.  Ultrasound Probe and Needle-Guide Calibration for Robotic Ultrasound Scanning and Needle Targeting , 2013, IEEE Transactions on Biomedical Engineering.

[9]  Emad M Boctor,et al.  Three‐dimensional ultrasound‐guided robotic needle placement: an experimental evaluation , 2008, The international journal of medical robotics + computer assisted surgery : MRCAS.

[10]  A. M. Priester,et al.  Robotic ultrasound systems in medicine , 2013, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[11]  Nassir Navab,et al.  Robotic ultrasound-guided facet joint insertion , 2018, International Journal of Computer Assisted Radiology and Surgery.

[12]  Dan Stoianovici,et al.  Robotic Transrectal Ultrasound Guided Prostate Biopsy , 2019, IEEE Transactions on Biomedical Engineering.

[13]  Nassir Navab,et al.  Dual-robot ultrasound-guided needle placement: closing the planning-imaging-action loop , 2016, International Journal of Computer Assisted Radiology and Surgery.

[14]  Qiang Huang,et al.  An ultrasound-directed robotic system for microwave ablation of liver cancer , 2009, Robotica.

[15]  Robotic assistance with needle guidance. , 2015, British journal of anaesthesia.

[16]  Makoto Hashizume,et al.  Development of a needle insertion manipulator for central venous catheterization , 2012, The international journal of medical robotics + computer assisted surgery : MRCAS.

[17]  Daniel Schnobrich,et al.  Ultrasound guidance for lumbar puncture , 2016, Neurology Clinical Practice.

[18]  E. M. Pedersen,et al.  Ultrasound-guided lumbar plexus block in volunteers; a randomized controlled trial , 2017, British journal of anaesthesia.

[19]  Navid Shahriari,et al.  Flexible Needle Steering in Moving Biological Tissue With Motion Compensation Using Ultrasound and Force Feedback , 2018, IEEE Robotics and Automation Letters.

[20]  Martin L. Yarmush,et al.  Adaptive Kinematic Control of a Robotic Venipuncture Device Based on Stereo Vision, Ultrasound, and Force Guidance , 2017, IEEE Transactions on Industrial Electronics.

[21]  P. Marhofer,et al.  Fifteen years of ultrasound guidance in regional anaesthesia: part 1. , 2010, British journal of anaesthesia.

[22]  Ken Chen,et al.  Three‐dimensional ultrasound image‐guided robotic system for accurate microwave coagulation of malignant liver tumours , 2010, The international journal of medical robotics + computer assisted surgery : MRCAS.

[23]  Thomas M. Hemmerling,et al.  First Robotic Ultrasound-Guided Nerve Blocks in Humans Using the Magellan System , 2013, Anesthesia and analgesia.

[24]  Dan Stoianovici,et al.  Multi-Imager Compatible, MR Safe, Remote Center of Motion Needle-Guide Robot , 2018, IEEE Transactions on Biomedical Engineering.

[25]  Nassir Navab,et al.  3D ultrasound registration-based visual servoing for neurosurgical navigation , 2017, International Journal of Computer Assisted Radiology and Surgery.

[26]  Yo-An Lim,et al.  Surgical Robot for Single-Incision Laparoscopic Surgery , 2014, IEEE Transactions on Biomedical Engineering.

[27]  T. Hemmerling,et al.  Comparison of success rates, learning curves, and inter-subject performance variability of robot-assisted and manual ultrasound-guided nerve block needle guidance in simulation. , 2014, British journal of anaesthesia.