NeuRoboScope

Robot-assisted endoscope control that can be manipulated by surgical tools

Information	Details
Funding Agency	THE SCIENTIFIC AND TECHNOLOGICAL RESEARCH COUNCIL OF TURKEY (TÜBİTAK)
Program	1003
ID/Acronym	115E726 / Neuroboscope
Grant Period	2016-2018
Principal Investigator	Prof. Dr. M. İ. Can Dede
Project Partners	Department of Mechanical Engineering, Izmir Institute of Technology Hacettepe University, Brain and Neurosurgery Department
Project Group	Prof. Dr. M. İ. Can Dede Prof. Dr. Gökhan Kiper Prof. Dr. Barbaros Özdemirel Prof. Dr. Enver Tatlıcıoğlu Prof. Dr. Tolga Ayav Omar Maaroof, PhD Student Oğulcan Işıtman, MSc Student Gizem Ateş, MSc Student Abdullah Yaşır, MSc Student Sercan Erat, MSc Student Bengisu Uzun, MSc Student

Aim:

The Pituitary, situated between the visual nerves at the skull base, serves as a crucial gland. The NeuRoboScope project aims to create a specialized robotic system to support endoscopic pituitary surgeries. These surgeries address pathologies originating from the pituitary gland. The proposed system intends to empower surgeons to operate three distinct tools concurrently, including an endoscope. This simultaneous operation is anticipated to enhance surgical productivity and reduce operation duration. The system includes a central control unit that attaches to non-endoscope surgical tools, capturing and processing the surgeon’s hand motions. The processed information is then transmitted to the robot managing the endoscope. This design allows the surgeon to control the endoscope seamlessly while employing other surgical tools with both hands throughout the procedure.

Teleoperatively manipulated robotic endoscope holder

Short Summary of the Topic:

The pituitary, a crucial gland regulating hormonal balance, directly or indirectly influences the functioning of all body organs through its control over essential fluids. Pathologies around the pituitary pose significant health risks due to its vital role. Treatment for such tumors involves either skull-opening procedures or non-invasive methods like endoscopic transnasal transsphenoidal surgery. This modern and effective pituitary surgery employs an endoscope, a tool projecting strong light for illumination and providing a two-dimensional video display of the operative area.

Despite its advantages, the endoscopic procedure presents challenges. Operating the endoscope with one hand, especially given its weight compared to other tools, fatigues the surgeon during the typically lengthy 2-3 hour procedure. This limitation extends operation times and compromises surgical success. Surgeons also need to use multiple tools simultaneously, requiring assistance, yet coordinating with an assistant operating the endoscope poses difficulties, affecting surgical performance.

To address these issues, a system is essential to hold and guide the endoscope effectively. Although various endoscope holders exist, they often fall short of clinical needs and lack widespread adoption. This project endeavors to develop an innovative robotic system to meet these specific clinical requirements and enhance the efficiency of endoscopic pituitary surgeries.

Organizational Approach and the main structure of the Method:

Initially, expert surgeons specialized in endoscopic pituitary surgery will gather anatomical, radiological, and surgical information, along with defining system requirements. Given that the proposed system is a robotics application, it necessitates an interdisciplinary approach, incorporating mechanical, electrical, electronics, and software fields. The focus of this project lies in the field of mechanism science to design a surgery robot mechanism characterized by high precision, back-driveability, and equilibrium against gravitational effects for overall system safety.

The operational mode involves teleoperation, wherein inputs from the surgical tool guide the robot managing the endoscope. System dynamics and control will be the focal point for developing the teleoperation system. Embedded coding studies will be conducted to implement the developed control algorithms on controller cards. This encompasses data acquisition and signal processing efforts to regulate real-time data transfer among subsystems (sensors, actuators, controller cards, etc.).

The surgical team’s involvement is crucial in contributing to the development of 3D anatomical models, simulation environments, and end-user evaluations for designs on anatomical models and cadavers. While preclinical tests, including precision measurements and end-user evaluations on simulated anatomical models and cadavers, are part of the project scope, clinical tests are deferred until after the project’s completion due to the risky and highly critical nature of the operation. Clinical tests will be contingent on the results of preclinical evaluations conducted within the project’s timeframe.

On How to contribute to the goals and targets of the call program with the expected targets and outcomes of the project:

This project aims to guide the optical-camera system in endoscopic pituitary surgery by tracking the surgeon’s tool. The skills learned in mechanics, electronics, and software will be applied to future surgical robotics projects. The goal is to create a robotics system for minimally invasive surgery, aligning with the program’s objectives. The overall system architecture developed in this project will also support robot-assisted surgeries in other similar procedures.

For the most up-to-date information on this project, please check out the Iztech Robotics Lab.

Publications

2019

Viscoelastic modeling of human nasal tissues with a mobile measurement device

Oğulcan Işıtman, Orhan Ayit, Eren Vardarlı, and 4 more authors

In New Trends in Medical and Service Robotics: Advances in Theory and Practice, 2019

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Modeling the dynamic of tool-tissue interaction for the robotic minimally invasive surgeries is one of the main issues for designing appropriate robot controllers. A mobile measurement device is produced in order to model some nasal tissues of a human. This mobile device is a hand-held one which measures the applied moments and relative angular displacements about a fixed pivot point. The ex-vivo measurements are realized by surgeons on a relatively fresh human cadaver head. The tip of the nose and the nasal concha are the two tissues that are investigated. In this study, five different viscoelastic models are considered; Elastic, Kelvin-Voight, Kelvin-Boltzmann, Maxwell and Hunt-Crossley. The results are evaluated and cross-validated on each data set. Hunt-Crossley and Kelvin-Boltzmann models provided the minimum root-mean-square (RMS) error among the other models.
@inproceedings{isitman19, title = {Viscoelastic modeling of human nasal tissues with a mobile measurement device}, author = {I{\c{s}}{\i}tman, O{\u{g}}ulcan and Ayit, Orhan and Vardarl{\i}, Eren and Hanalio{\u{g}}lu, {\c{S}}ahin and I{\c{s}}{\i}kay, {\.I}lkay and Berker, Mustafa and Dede, Mehmet {\.I}smet Can}, booktitle = {New Trends in Medical and Service Robotics: Advances in Theory and Practice}, pages = {216--224}, year = {2019}, organization = {Springer}, doi = {10.1007/978-3-030-00329-6_25}, dimensions = {true} }
Control methods for a teleoperated endoscope robot

Oğulcan Işıtman, and Mehmet İsmet Can Dede

In Advances in Mechanism and Machine Science: Proceedings of the 15th IFToMM World Congress on Mechanism and Machine Science 15, 2019

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In this study, control of a endoscope robot for the pituitary gland surgery is presented. This co-worker robot has non-backdrivable actuation system with external brakes on the actuators. Since it is required to move in a constrained environment, which is the inside the nostrils in this case, modifications are required for the motion controller. In order to provide safe procedure, the maximum force and torque limits are defined for the real surgical case by using human cadaver head. By considering these limits and application specific requirements, a compliance controller is proposed and experimentally tested.
@inproceedings{isitman2019, title = {Control methods for a teleoperated endoscope robot}, author = {I{\c{s}}{\i}tman, O{\u{g}}ulcan and Dede, Mehmet {\.I}smet Can}, booktitle = {Advances in Mechanism and Machine Science: Proceedings of the 15th IFToMM World Congress on Mechanism and Machine Science 15}, pages = {2077--2086}, year = {2019}, organization = {Springer}, doi = {10.1007/978-3-030-20131-9_206}, dimensions = {true}, }

2018

Compliant control of a teleoperated endoscope robot

Oğulcan Işıtman

Izmir Institute of Technology (Turkey), 2018

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With the advancement of technology, robots have begun to be utilized in numerous medical applications, including minimally invasive surgery. This use aims to address the disadvantages of traditional open surgery procedures. This thesis contributes to a research project titled “Robot-assisted endoscope control that can be manipulated by surgical tools (NeuRobo-Scope),” which focuses on minimally invasive endoscopic surgery of the pituitary gland tumor. During this procedure, a robot handles the endoscope as it maneuvers within the human nasal cavity. The movement of the endoscope is restricted by soft tissues. Another operational scenario involves the surgeon manually repositioning the endoscope by directing the robot that holds the endoscope. This thesis addresses two central research challenges: (1) the interaction between the surgeon and the robot, and (2) the interaction between the robot and soft tissue. Firstly, the dynamics of the interaction between the surgeon and the robot are explored. The effects of various compliant controller parameters are examined using a non-backdrivable experimental setup with a single degree of freedom. A specific task is outlined to quantitatively assess the impact of these parameters on energy efficiency and accuracy. The second research challenge centers on modeling human nasal tissue to design a more precise controller. To gather data from human cadavers, a novel hand-held measurement device has been developed. External forces, moments, and soft tissue models are derived from ex-vivo experiments. Once the soft tissue models are identified, a revised interaction control method is proposed for the teleoperated endoscope holder robot. The surgical procedure in focus is tested with this newly proposed interaction controller using a single-degree-of-freedom experimental setup. The experiments conducted with the proposed controllers have proven successful for the outlined operational scenario. The results indicate the feasibility of motion control for surgical robots operating within constrained environments.
The effects of admittance term on back-drivability

Ogulcan Işıtman, Orhan Ayit, and Mehmet İsmet Can Dede

In Mechanisms, Transmissions and Applications: Proceedings of the Fourth MeTrApp Conference 2017 7, 2018

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In the design of kinesthetic haptic devices, there are mainly impedance type and admittance type device. In a customary scenario, the human operator back-drives the haptic device by holding and providing motion to the handle of the haptic device. If the type of transmission system does not allow passive back-drivability, then the back-drivability is satisfied by the use of an admittance controller. This type of a haptic device is said to have admittance structure. The selection of the admittance term in this controller plays a critical part in the task execution performance. Determination of this term is not trivial and the optimal parameters depend on not only the key performance criteria but also on the human operator. An experimental study is carried out in this work to determine the effect of the admittance term parameters on the performance of human operators in terms of the energy efficiency and the best accuracy. In this paper, the experimental set-up and the results of the experiments are presented and discussed.
@inproceedings{isitman2018, title = {The effects of admittance term on back-drivability}, author = {I{\c{s}}{\i}tman, Ogulcan and Ayit, Orhan and Dede, Mehmet {\.I}smet Can}, booktitle = {Mechanisms, Transmissions and Applications: Proceedings of the Fourth MeTrApp Conference 2017 7}, pages = {181--190}, year = {2018}, organization = {Springer}, doi = {10.1007/978-3-319-60702-3_19}, dimensions = {true}, }