Talari Hadi F, Monfaredi Reza, Wilson Emmanuel, Blum Emily, Bayne Christopher, Peters Craig, Zhang Anlin, Cleary Kevin
Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, DC, USA.
Children's Health, UT Southwestern, Dallas, Texas, USA.
Proc SPIE Int Soc Opt Eng. 2017 Feb;10135. doi: 10.1117/12.2253862. Epub 2017 Mar 3.
Ureteroscopy is a minimally invasive procedure for diagnosis and treatment of a wide range of urinary tract pathologies. It is most commonly performed in the diagnostic work-up of hematuria and the diagnosis and treatment of upper urinary tract malignancies and calculi. Ergonomic and visualization challenges as well as radiation exposure are limitations to conventional ureteroscopy. For example, for diagnostic tumor inspection, the urologist has to maneuver the ureteroscope through each of the 6 to 12 calyces in the kidney under fluoroscopy to ensure complete surveillance. Therefore, we have been developing a robotic system to "power drive" a flexible fiber-optic ureteroscope with 3D tip tracking and pre-operative image overlay. Our goal is to provide the urologist precise control of the ureteroscope tip with less radiation exposure. Our prototype system allows control of the three degrees of freedom of the ureteroscope via brushless motors and a joystick interface. The robot provides a steady platform for controlling the ureteroscope. Furthermore, the robot design facilitates a quick "snap-in" of the ureteroscope, thus allowing the ureteroscope to be mounted midway through the procedure. We have completed the mechanical system and the controlling software and begun evaluation using a kidney phantom. We put MRI-compatible fiducials on the phantom and obtained MR images. We registered these images with the robot using an electromagnetic tracking system and paired-point registration. The system is described and initial evaluation results are given in this paper.
输尿管镜检查是一种用于诊断和治疗多种尿路疾病的微创手术。它最常用于血尿的诊断性检查以及上尿路恶性肿瘤和结石的诊断与治疗。人体工程学和可视化挑战以及辐射暴露是传统输尿管镜检查的局限性。例如，对于诊断性肿瘤检查，泌尿科医生必须在荧光透视下操纵输尿管镜穿过肾脏中的6至12个肾盏中的每一个，以确保全面监测。因此，我们一直在开发一种机器人系统，以“动力驱动”具有3D尖端跟踪和术前图像叠加功能的柔性光纤输尿管镜。我们的目标是为泌尿科医生提供对输尿管镜尖端的精确控制，同时减少辐射暴露。我们的原型系统允许通过无刷电机和操纵杆接口控制输尿管镜的三个自由度。该机器人为控制输尿管镜提供了一个稳定的平台。此外，机器人的设计便于输尿管镜快速“卡入”，从而允许在手术过程中途安装输尿管镜。我们已经完成了机械系统和控制软件，并开始使用肾脏模型进行评估。我们在模型上放置了与MRI兼容的基准标记，并获得了MR图像。我们使用电磁跟踪系统和配对点配准将这些图像与机器人进行配准。本文描述了该系统并给出了初步评估结果。
