Mechatronics in Medicine

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• Journal article
  Hu X, Liu H, Rodriguez y Baena FM, 2021,

  Markerless navigation system for orthopaedic knee surgery: a proof of concept study

  , IEEE Access, Vol: 9, Pages: 64708-64718, ISSN: 2169-3536

  Current computer-assisted surgical navigation systems mainly rely on optical markers screwed into the bone for anatomy tracking. The insertion of these percutaneous markers increases operating complexity and causes additional harm to the patient. A markerless tracking and registration algorithm has recently been proposed to avoid anatomical markers for knee surgery. The femur points were directly segmented from the recorded RGBD scene by a neural network and then registered to a pre-scanned femur model for the real-time pose. However, in a practical setup such a method can produce unreliable registration results, especially in rotation. Furthermore, its potential application in surgical navigation has not been demonstrated. In this paper, we first improved markerless registration accuracy by adopting a bounded-ICP (BICP) technique, where an estimate of the remote hip centre, acquired also in a markerless way, was employed to constrain distal femur alignment. Then, a proof-of-concept markerless navigation system was proposed to assist in typical knee drilling tasks. Two example setups for global anchoring were proposed and tested on a phantom leg. Our BICP-based markerless tracking and registration method has better angular accuracy and stability than the original method, bringing our straightforward, less invasive markerless navigation approach one step closer to clinical application. According to user tests, our proposed optically anchored navigation system achieves comparable accuracy with the state-of-the-art (3.64± 1.49 mm in position and 2.13±0.81° in orientation). Conversely, our visually anchored, optical tracker-free setup has a lower accuracy (5.86± 1.63 mm in position and 4.18±1.44° in orientation), but is more cost-effective and flexible in the operating room.

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• Conference paper
  Franco E, Tang J, Garriga Casanovas A, Rodriguez y Baena F, Astolfi Aet al., 2021,

  Position control of soft manipulators with dynamic and kinematic uncertainties

  , 21st IFAC World Congress, Publisher: Elsevier, Pages: 9847-9852, ISSN: 2405-8963

  This work investigates the position control problem for a soft continuum manipulator in Cartesian space intended for minimally invasive surgery. Soft continuum manipulators have a large number of degrees-of-freedom and are particularly susceptible to external forces because of their compliance. This, in conjunction with the limited number of sensors typically available, results in uncertain kinematics, which further complicates the control problem. We have designed a partial state feedback that compensates the effects of external forces employing a rigid-link model and a port-Hamiltonian approach and we have investigated in detail the use of integral action to achieve position regulation in Cartesian space. Local stability conditions are discussed with a Lyapunov approach. The performance of the controller is compared with that achieved with a radial-basis-functions neural network by means of simulations and experiments on two prototypes.

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• Journal article
  Jamal A, Mongelli M, Vidotto M, Madekurozwa M, Bernardini A, Overby D, De Momi E, Rodriguez y Baena F, Sherwood J, Dini Det al., 2021,

  Infusion mechanisms in brain white matter and its dependence of microstructure: an experimental study of hydraulic permeability

  , IEEE Transactions on Biomedical Engineering, Vol: 68, Pages: 1229-1237, ISSN: 0018-9294

  Objective: Hydraulic permeability is a topic of deep interest in biological materials because of its important role in a range of drug delivery-based therapies. The strong dependence of permeability on the geometry and topology of pore structure and the lack of detailed knowledge of these parameters in the case of brain tissue makes the study more challenging. Although theoretical models have been developed for hydraulic permeability, there is limited consensus on the validity of existing experimental evidence to complement these models. In the present study, we measure the permeability of white matter (WM) of fresh ovine brain tissue considering the localised heterogeneities in the medium using an infusion based experimental set up, iPerfusion. We measure the flow across different parts of the WM in response to applied pressures for a sample of specific dimensions and calculate the permeability from directly measured parameters. Furthermore, we directly probe the effect of anisotropy of the tissue on permeability by considering the directionality of tissue on the obtained values. Additionally, we investigate whether WM hydraulic permeability changes with post-mortem time. To our knowledge, this is the first report of experimental measurements of the localised WM permeability, showing the effect of axon directionality on permeability. This work provides a significant contribution to the successful development of intra-tumoural infusion-based technologies, such as convection-enhanced delivery (CED), which are based on the delivery of drugs directly by injection under positive pressure into the brain.

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• Conference paper
  Favaro A, Secoli R, Rodriguez y Baena F, DeMomi Eet al., 2021,

  Optimal pose estimation method for a multi-segment, programmable bevel-tip steerable needle

  , IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS 2020), Publisher: IEEE, Pages: 3232-3238

  Pose tracking is fundamental to achieve preciseand safe insertion of a surgical tool for minimally invasiveinterventions. In this work, a method for the estimation of thefull pose of steerable needles is presented. Our approach uses aProgrammable Bevel Tip (PBN) needle with four-segment designas a case study. A novel 3D kinematic model of the PBN isdeveloped and used to predict the full needle pose during theinsertion. The pose prediction is estimated through an ExtendedKalman Filter using the position measurements provided byan electromagnetic sensor located at each tip of the needlesegments. The method estimates also the torsion of the needleshaft that can arise over the insertion of the needle becauseof the shear forces exerted between the needle and the insertionmedium. The feasibility of the proposed solution was validated ina number of experiments in gelatin demonstrating a small errorin position reconstruction (RMSE<0.6mm) and good accuracy incomparison to a bespoke geometric pose reconstruction method.

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• Journal article
  Treratanakulchai S, Baena FRY, 2021,

  A Passive Decoupling Mechanism for Misalignment Compensation in Master-Slave Teleoperation

  , IEEE TRANSACTIONS ON MEDICAL ROBOTICS AND BIONICS, Vol: 3, Pages: 285-288
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  • Citations: 1
• Journal article
  Bautista-Salinas D, Kundrat D, Kogkas A, Abdelaziz MEMK, Giannarou S, Baena FRYet al., 2021,

  Integrated Augmented Reality Feedback for Cochlear Implant Surgery Instruments

  , IEEE TRANSACTIONS ON MEDICAL ROBOTICS AND BIONICS, Vol: 3, Pages: 261-264
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  • Citations: 2
• Book chapter
  Virdyawan V, Secoli R, Matheson E, Pinzi M, Watts T, Galvan S, Rodriguez y Baena Fet al., 2021,

  Supervisory-control robots

  , Neuromethods, Pages: 35-47

  The supervisory-control method is used in the majority of neurosurgical robots to date where the surgeon makes the high-level decisions, which are then autonomously performed by the robot. In this chapter the differences in the roles of the robots during preoperative and intraoperative procedures are explained. During intraoperative procedures the robot can have either direct interaction or no direct interaction with the human tissues, called active and passive systems, respectively. The flow of information between the robots, the surgical environment, and the surgeons, to enable these forms of interaction, is also discussed. Examples of currently available robotic systems are provided.

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  • Citations: 1
• Journal article
  Franco E, Brown T, Astolfi A, Rodriguez y Baena Fet al., 2021,

  Adaptive energy shaping control of robotic needle insertion

  , Mechanism and Machine Theory, Vol: 155, ISSN: 0094-114X

  This work studies the control of a pneumatic actuator for needle insertion in soft tissue without using axial rotation or additional needle supports. Employing a simplified rigid-link model description of an axial-symmetric tip needle supported at the base, two energy shaping controllers are proposed. The friction forces of the pneumatic actuator are compensated adaptively and the stability conditions for the closed-loop equilibrium are discussed. The controllers are compared by means of simulations and experiments on two different silicone rubber phantoms. The results indicate that the proposed controllers effectively compensate the actuator's friction, which is comparable to the insertion forces for the chosen pneumatic actuators. The first controller only depends on the actuator's position thus it achieves the prescribed insertion depth but results in a larger tip rotation and corresponding deflection. The second controller also accounts for the rotation of the needle tip on the bending plane, which can consequently be reduced by over 70% for this specific system. This is achieved by modulating the actuator force and, in case of harder phantoms, by automatically limiting the insertion depth.

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• Journal article
  Ng KCG, Bankes M, El Daou H, Rodriguez y Baena F, Jeffers Jet al., 2021,

  Cam osteochondroplasty for femoroacetabular impingement increases microinstability in deep flexion: A cadaveric study

  , Arthroscopy: The Journal of Arthroscopy and Related Surgery, Vol: 37, Pages: 159-170, ISSN: 0749-8063

  Purpose: The purpose of this in vitro cadaveric study was to examine the contributions of each surgical stage during cam femoroacetabular impingement (FAI) surgery (i.e., intact cam hip, T8 capsulotomy, cam resection, capsular repair) towards hip range of motion, translations, and microinstability.Methods: Twelve cadaveric cam hips were denuded to the capsule and mounted onto a robotic tester. Hips were positioned in several flexion positions: Full Extension, Neutral 0°, Flexion 30°, and Flexion 90°; and performed internal-external rotations to 5-Nm torque in each position. Hips underwent a series of surgical stages (T-capsulotomy, cam resection, capsular repair) and was retested after each stage. Changes in range of motion, translation, and microinstability (overall translation normalized by femoral head radius) were measured after each stage.Results: For range of motion, cam resection increased internal rotation at Flexion 90° (ΔIR = +6°, P = .001), but did not affect external rotation. Capsular repairs restrained external rotations compared to the cam resection stage (ΔER = –4 to –8°, P ≤ .04). For translations, the hip translated after cam resection at Flexion 90° in the medial-lateral plane (ΔT = +1.9 mm, P = .04), relative to the intact and capsulotomy stages. For microinstability, capsulotomy increased microinstability in Flexion 30° (ΔM = +0.05; P = .003), but did not further increase after cam resection. At Flexion 90°, microinstability did not increase after capsulotomy (ΔM = +0.03; P = .2, d = .24), but substantially increased after cam resection (ΔM = +0.08; P = .03), accounting for a 31% change with respect to the intact stage.Conclusions: Cam resection increased microinstability by 31% during deep hip flexion relative to the intact hip. This suggests that iatrogenic microinstability may be due to separation of the labral seal and resected contour of the femoral head.

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• Conference paper
  Hu X, Rodriguez y Baena F, Cutolo F, 2021,

  Rotation-constrained optical see-through headset calibration with bare-hand alignment

  , 20th IEEE International Symposium on Mixed and Augmented Reality (ISMAR), Publisher: IEEE COMPUTER SOC, Pages: 256-264, ISSN: 1554-7868
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  • Citations: 4

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