A Patient-Mounted, Telerobotic Tool for CT-Guided Percutaneous

This paper describes Robopsy, an economical, patient-mounted, telerobotic, needle guidance and insertion system, that enables faster, more accurate targeting during CT-guided biopsies and other percutaneous interventions. The current state of the art imaging technology facilitates precise location of sites within the body; however, there is no mechanical equivalent to then facilitate precise targeting. The lightweight, disposable actuator unit, which affixes directly to the patient, is composed primarily of inexpensive, injection molded, radiolucent, plastic parts that snap together, whereas the four micromotors and control electronics are retained and reused. By attaching to a patient, via an adhesive pad and optional strap points, the device moves passively with patient motion and is thus inherently safe. The device’s mechanism tilts the needle to a two degree-of-freedom compound angle, toward the patient’s head or feet (in and out of the scanner bore) and left or right with respect to the CT slice, via two motor-actuated concentric, crossed, and partially nested hoops. A carriage rides in the hoops and interfaces with the needle via a two degree-of-freedom friction drive that both grips the needle and inserts it. This is accomplished by two rubber rollers, one passive and one driven, that grip the needle via a rack and pinion drive. Gripping is doctor controlled; thus when not actively being manipulated, the needle is released and allowed to oscillate within a defined region so as to minimize tissue laceration due to the patient breathing. Compared to many other small robots intended for medical applications, Robopsy is an order of magnitude less costly and lighter while offering appropriate functionality to improve patient care and procedural efficiency. This demonstrates the feasibility of developing cost-effective disposable medical robots, which could enable their more widespread application.

[1]  Ivan Bricault,et al.  CT and MR Compatible Light Puncture Robot: Architectural Design and First Experiments , 2004, MICCAI.

[2]  Julia F. Barrett,et al.  Artifacts in CT: recognition and avoidance. , 2004, Radiographics : a review publication of the Radiological Society of North America, Inc.

[3]  Dan Stoianovici,et al.  Robotically assisted lung biopsy under CT fluoroscopy: lung cancer screening and phantom study , 2005 .

[4]  Geoffrey Boothroyd,et al.  Product design for manufacture and assembly , 1994, Comput. Aided Des..

[5]  Michael M. Stanisic,et al.  Symmetrically actuated double pointing systems: the basis of singularity-free robot wrists , 1990, IEEE Trans. Robotics Autom..

[6]  Dan Stoianovici,et al.  Automatic Brachytherapy Seed Placement Under MRI Guidance , 2007, IEEE Transactions on Biomedical Engineering.

[7]  Jacques Gangloff,et al.  A robotized positioning platform guided by computed tomography : practical issues and evaluation , 2006, Proceedings 2006 IEEE International Conference on Robotics and Automation, 2006. ICRA 2006..

[8]  D. Stoianovici,et al.  Robotically assisted nerve and facet blocks: a cadaveric study. , 2002, Academic radiology.

[9]  Y. Ohno,et al.  CT-guided transthoracic needle aspiration biopsy of small (< or = 20 mm) solitary pulmonary nodules. , 2003, AJR. American journal of roentgenology.

[10]  O. Miettinen,et al.  Survival of Patients with Stage I Lung Cancer Detected on CT Screening , 2008 .

[11]  D. Stoianovici,et al.  Magnetic resonance imaging compatible robotic system for fully automated brachytherapy seed placement. , 2006, Urology.

[12]  Allison M. Okamura,et al.  Force modeling for needle insertion into soft tissue , 2004, IEEE Transactions on Biomedical Engineering.

[13]  R W Günther,et al.  Multicenter evaluation of a new laser guidance system for computed tomography intervention , 2004, Acta radiologica.

[14]  Dan Stoianovici,et al.  AcuBot: a robot for radiological interventions , 2003, IEEE Trans. Robotics Autom..