1,721,212 research outputs found
A novel robotic platform for laser-assisted transurethral surgery of the prostate
No full textBenign prostatic hyperplasia (BPH) is the most common pathology afflicting ageing men. The gold standard for the surgical treatment of BPH is transurethral resection of the prostate. The laser-assisted transurethral surgical treatment of BPH is recently emerging as a valid clinical alternative. Despite this, there are still some issues that hinder the outcome of laser surgery, e.g., distal dexterity is strongly reduced by the current endoscopic instrumentation and contact between laser and prostatic tissue cannot be monitored and optimized. This paper presents a novel robotic platform for laser-assisted transurethral surgery of BPH. The system, designed to be compatible with the traditional endoscopic instrumentation, is composed of a catheter-like robot provided with a fiber optic-based sensing system and a cable-driven actuation mechanism. The sensing system allows contact monitoring between the laser and the hypertrophic tissue. The actuation mechanism allows steering of the laser fiber inside the prostatic urethra of the patient, when contact must be reached. The design of the proposed robotic platform along with its preliminary testing and evaluation is presented in this paper. The actuation mechanism is tested in in vitro experiments to prove laser steering performances according to the clinical requirements. The sensing system is calibrated in experiments aimed to evaluate the capability of discriminating the contact forces, between the laser tip and the prostatic tissue, from the pulling forces exerted on the cables, during laser steering. These results have been validated demonstrating the robot's capability of detecting sub-Newton contact forces even in combination with actuation
A Novel Childbirth Simulator for Real-Time Monitoring of Fetal Head During the Active Phase of the Labor
No full textA correct evaluation of the fetus progress into the birth canal during labor is often a complicated task, but it is of fundamental importance for a proper delivery management. Indeed, incorrect assessment of fetal presentation, position and station could lead to severe complications for both the fetus and the mother. Currently, fetus progress assessment during the delivery phase is still performed in the same way of last centuries, namely with a manual vaginal exploration assessed only using two fingers (index and medium fingers). This evaluation is therefore strongly subjective and dependent on clinical experience of the medical doctor; thus, reproducibility is very limited. In this framework, simulation-based training is a valuable instrument for obstetrics and gynecologists learning process, thus for evaluating and improving their abilities. In this work, we introduce a novel integrated childbirth platform which offers a real-time monitoring of fetal head during the active phase of labor. A real-time evaluation of fetal head presentation, position and station is provided, along with a 3D virtual visualization of the childbirth simulation. This kind of platform was conceived as a valid instrument for gynecological teaching and training. Preliminary results demonstrated its usefulness as an instrument for training in obstetrics and gynecology
Soft robots in surgery
No full textMinimally Invasive Surgery (MIS) represents the gold standard in the majority of abdominal operations, although some fundamental limitations are still present and are far to be really addressed despite emerging robotic solutions. Flexible endoscopes can exploit their high flexibility to reach the surgical target while being inserted remotely or by a natural orifice. However endoscopes may lack stability that rigid tools normally provide. Novel surgical instrumentation is being developed in order to provide higher dexterity and flexibility to the surgeon, but unlike traditional surgical manipulators, here we report the approach followed in the development of the STIFF-FLOP manipulator. The main idea is based on the exploitation of soft materials to be intrinsically flexible and safe while combining different fluidic actuation technologies to enable high dexterity and selective stiffness variability. In this chapter, the functional evolution of the robot is reported highlighting advantages and drawbacks that steered the development of a manipulator which in the end demonstrated to be effective in overcoming mobility limitations experienced with standard rigid tools
Ultrasound Acoustic Phase Analysis Enables Robotic Visual-Servoing of Magnetic Microrobots
Full text linkMicrorobots (MRs) have attracted growing interest for their potentialities in diagnosis and noninvasive intervention in hard-to-reach body areas. The safe operation of biomedical MRs requires fine control capabilities, which strongly depend on precise and robust feedback about their position over time. Ultrasound acoustic phase analysis (US-APA) may allow for a reliable feedback strategy for MR imaging and tracking in tissue. In this article, we combine task-specific magnetic actuation and related US-APA motion tracking to achieve closed-loop navigation of a magnetic MR, rolling on the boundary of a lumen in a tissue-mimicking phantom. A C-arm system attached to a robotic platform is used to precisely position the magnetic actuation source and US-APA detection unit within the workspace, thus enabling MR visual-servoing. In the first place, the proposed approach allows to perform supervised localization of the MR without any a-priori knowledge of its position. After localization, a robust real-time tracking enables closed-loop MR teleoperation in the phantom lumina over a travel distance of 80 mm (145 body lengths), both in static and counter flow, thus achieving an average position tracking error of 368 micron (0.67 body lengths). For the first time, our results validate US-APA as a reliable feedback strategy for visual-servoing control of MRs in simulated in-body environment
Organ Neuroprosthetics: Connecting Transplanted and Artificial Organs with the Nervous System
Full text linkImplantable neural interfaces with the central and peripheral nervous systems are currently used to restore sensory, motor, and cognitive functions in disabled people with very promising results. They have also been used to modulate autonomic activities to treat diseases such as diabetes or hypertension. Here, this study proposes to extend the use of these technologies to (re-)establish the connection between new (transplanted or artificial) organs and the nervous system in order to increase the long-term efficacy and the effective biointegration of these solutions. In this perspective paper, some clinically relevant applications of this approach are briefly described. Then, the choices that neural engineers must implement about the type, implantation location, and closed-loop control algorithms to successfully realize this approach are highlighted. It is believed that these new "organ neuroprostheses" are going to become more and more valuable and very effective solutions in the years to come
AN INNOVATIVE SYSTEM BASED ON BIOIMPEDANCE MEASUREMENTS TO DEFINE THE BLADDER VOLUME
No full textObjectives: Alteration of the bladder sense of fullness due to spinal cord injury or radical cystectomy leads to the inability to plan micturition timing. The development of a system for the fullness detection would be highly desirable and would enable autonomous and spontaneous management of micturition by the patient. Here the design of an innovative system of bladder volume monitoring based on bioimpedance measurements is presented.
Methods: Bioimpedance measurements are performed on ex-vivo bladder tissue using traditional ECG sensors. Two couples of electrodes in different arrangements were applied on the bladder walls to detect degree of filling by 50ml step, from 0ml to 300ml. The bioimpedance values are obtained for frequencies ranging from 1 kHz to 2 MHz. Moreover, different compositions of artificial urine were tested, by varying relevant ions concentration.
Results: The impedance variations were recorded around 20ohm in average from empty to full status. However, the impedance variation was dependent to ion concentration in urine.
Discussion: The experiment shows the feasibility of this approach and the need to find the sensors arrangement able to normalize measurements with respect to urine composition.
Conclusions: A novel system to detect the bladder filling based on bioimpedence measures is reported. This approach could be feasible both in presence of natural or artificial/reconstructed bladder. Future work will target accurate volume estimation independently on urine composition, as well as combination with other sensing strategies.
Acknowledgements: The authors acknowledge INAIL (Istituto Nazionale Assicurazioni Infortuni sul Lavoro) for providing their collaboration within the BioSUP project
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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