Neidhardt Maximilian, Gerlach Stefan, Mieling Robin, Laves Max-Heinrich, Weib Thorben, Gromniak Martin, Fitzek Antonia, Mobius Dustin, Kniep Inga, Ron Alexandra, Schadler Julia, Heinemann Axel, Puschel Klaus, Ondruschka Benjamin, Schlaefer Alexander
Institute of Medical Technology and Intelligent Systems, Hamburg University of Technology 21073 Hamburg Germany.
Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf 20251 Hamburg Germany.
IEEE Trans Med Robot Bionics. 2022 Jan 26;4(1):94-105. doi: 10.1109/TMRB.2022.3146440. eCollection 2022 Feb.
In pathology and legal medicine, the histopathological and microbiological analysis of tissue samples from infected deceased is a valuable information for developing treatment strategies during a pandemic such as COVID-19. However, a conventional autopsy carries the risk of disease transmission and may be rejected by relatives. We propose minimally invasive biopsy with robot assistance under CT guidance to minimize the risk of disease transmission during tissue sampling and to improve accuracy. A flexible robotic system for biopsy sampling is presented, which is applied to human corpses placed inside protective body bags. An automatic planning and decision system estimates optimal insertion point. Heat maps projected onto the segmented skin visualize the distance and angle of insertions and estimate the minimum cost of a puncture while avoiding bone collisions. Further, we test multiple insertion paths concerning feasibility and collisions. A custom end effector is designed for inserting needles and extracting tissue samples under robotic guidance. Our robotic post-mortem biopsy (RPMB) system is evaluated in a study during the COVID-19 pandemic on 20 corpses and 10 tissue targets, 5 of them being infected with SARS-CoV-2. The mean planning time including robot path planning is 5.72±167s. Mean needle placement accuracy is 7.19± 422mm.
在病理学和法医学中，对感染死亡者的组织样本进行组织病理学和微生物学分析，对于制定如COVID-19大流行期间的治疗策略而言是有价值的信息。然而，传统尸检存在疾病传播风险，且可能遭到亲属拒绝。我们提议在CT引导下借助机器人辅助进行微创活检，以将组织采样期间的疾病传播风险降至最低并提高准确性。本文展示了一种用于活检采样的柔性机器人系统，该系统应用于置于防护尸袋内的人体尸体。一个自动规划与决策系统估计最佳插入点。投射到分割后的皮肤上的热图可直观显示插入的距离和角度，并估计穿刺的最低成本，同时避免与骨骼碰撞。此外，我们测试了多条关于可行性和碰撞情况的插入路径。设计了一种定制的末端执行器，用于在机器人引导下插入针并提取组织样本。我们的机器人死后活检（RPMB）系统在COVID-19大流行期间对20具尸体和10个组织靶点进行的一项研究中得到了评估，其中5具尸体感染了SARS-CoV-2。包括机器人路径规划在内的平均规划时间为5.72±167秒。平均针放置精度为7.19±422毫米。
