Image guided surgery (IGS), which has been developing fast recently, benefits significantly from the superior accuracy of robots and magnetic resonance imaging (MRI) which is a great soft tissue imaging modality. Teleoperation is especially desired in the MRI because of the highly constrained space inside the closed-bore MRI and the lack of haptic feedback with the fully autonomous robotic systems. It also very well maintains the human in the loop that significantly enhances safety. This dissertation describes the development of teleoperation approaches and implementation on an example system for MRI with details of different key components. The dissertation firstly describes the general teleoperation architecture with modular software and hardware components. The MRI-compatible robot controller, driving technology as well as the robot navigation and control software are introduced. As a crucial step to determine the robot location inside the MRI, two methods of registration and tracking are discussed. The first method utilizes the existing Z shaped fiducial frame design but with a newly developed multi-image registration method which has higher accuracy with a smaller fiducial frame. The second method is a new fiducial design with a cylindrical shaped frame which is especially suitable for registration and tracking for needles. Alongside, a single-image based algorithm is developed to not only reach higher accuracy but also run faster. In addition, performance enhanced fiducial frame is also studied by integrating self-resonant coils. A surgical master-slave teleoperation system for the application of percutaneous interventional procedures under continuous MRI guidance is presented. The slave robot is a piezoelectric-actuated needle insertion robot with fiber optic force sensor integrated. The master robot is a pneumatic-driven haptic device which not only controls the position of the slave robot, but also renders the force associated with needle placement interventions to the surgeon. Both of master and slave robots mechanical design, kinematics, force sensing and feedback technologies are discussed. Force and position tracking results of the master-slave robot are demonstrated to validate the tracking performance of the integrated system. MRI compatibility is evaluated extensively. Teleoperated needle steering is also demonstrated under live MR imaging. A control system of a clinical grade MRI-compatible parallel 4-DOF surgical manipulator for minimally invasive in-bore prostate percutaneous interventions through the patient’s perineum is discussed in the end. The proposed manipulator takes advantage of four sliders actuated by piezoelectric motors and incremental rotary encoders, which are compatible with the MRI environment. Two generations of optical limit switches are designed to provide better safety features for real clinical use. The performance of both generations of the limit switch is tested. MRI guided accuracy and MRI-compatibility of whole robotic system is also evaluated. Two clinical prostate biopsy cases have been conducted with this assistive robot.

Wearable assistive robotics have the potential to address an unmet medical need of reducing disability in individuals with chronic hand impairments due to neurological trauma. Despite myriad prior works, few patients have seen the benefits of such devices. Following application experience with tendon-actuated soft robotic gloves and a collaborator's orthosis with novel flat-spring actuators, we identified two common assumptions regarding hand orthosis design. The first was reliance on incomplete studies of grasping forces during activities of daily living as a basis for design criteria, leading to poor optimization. The second was a neglect of increases in muscle tone following neurological trauma, rendering most devices non-applicable to a large subset of the population. To address these gaps, we measured joint torques during activities of daily living with able-bodied subjects using dexterity representative of orthosis-aided motion. Next, we measured assistive torques needed to extend the fingers of individuals with increased flexor tone following TBI. Finally, we applied this knowledge to design a cable actuated orthosis for assisting finger extension, providing a basis for future work focused on an under-represented subgroup of patients.

Cette thèse concerne le développement d'un cadre de contrôle robotique pour l'élastographie ultrasonore quantitative. L'élastographie ultrasonore est une technique qui dévoile les paramètres élastiques du tissu qui sont généralement liés à une pathologie. Cette thèse propose trois nouvelles approches robotiques différentes pour pour assister la procédure d'élastographie. La première approche concerne le contrôle d'un robot actionnant une sonde à ultrasons pour effectuer un mouvement de palpation nécessaire pour l'élastographie par ultrasons. L'élasticité du tissu est utilisée pour concevoir une loi d'asservissement afin de maintenir un tissu d'intérêt rigide dans le champ de vision de la sonde ultrasonore. De plus, l'orientation de la sonde est contrôlée par un utilisateur humain pour explorer différentes vues du tissu pendant que l'élastographie est effectuée. La seconde approche exploite le recalage d'images déformables avec des images ultrasonores pour estimer l'élasticité tissulaire et aider à la compensation automatique par asservissement visuel ultrasonore d'un mouvement introduit dans le tissu. La troisième approche offre une méthodologie pour ressentir l'élasticité du tissu en déplaçant une sonde virtuelle dans l'image ultrasonore avec un dispositif haptique pendant que le robot effectue un mouvement de palpation. Les résultats expérimentaux des trois approches robotiques obtenus sur des fantômes constitués de tissus démontrent l'efficacité des méthodes proposées et ouvre des perspectives intéressantes pour l'élastographie ultrasonore assistée par robot. / This thesis concerns the development of a robotic control framework for quantitative ultrasound elastography. Ultrasound elastography is a technology that unveils elastic parameters of a tissue, which are commonly related with certain pathologies. This thesis proposes three novel robotic approaches to assist examiners with elastography. The first approach deals with the control of a robot actuating an ultrasound probe to perform palpation motion required for ultrasound elastography. The elasticity of the tissue is used to design a servo control law to keep a stiff tissue of interest in the field of view of the ultrasound probe. Additionally, the orientation of the probe is controlled by a human user to explore other tissue while elastography is performed. The second approach exploits deformable image registration of ultrasound images to estimate the tissue elasticity and to help in the automatic compensation by ultrasound visual servoing of a motion introduced into the tissue. The third approach offers a methodology to feel the elasticity of the tissue by moving a virtual probe in the ultrasound image with a haptic device while the robot is performing palpation motion. Experimental results of the three robotic approaches over phantoms with tissue-like offer an excellent perspective for robotic-assistance for ultrasound elastography.

Le geste médical assisté par ordinateur en salle d'opération n'a pas cessé de progresser lors de ladernière décennie. Ce phénomène est lié à l'évolution des techniques de chirurgie et notamment àl'apparition des techniques dites mini-invasives. Cette pratique bien que révolutionnaire car ellepermet de diminuer les risques d'infection a introduit de nombreux problèmes. En effet, lechirurgien est limité dans ses gestes à cause de la restriction de mouvement imposée par les trocarts.De ce fait, la communauté robotique s'est assez rapidement intéressée aux problématiques deschirurgiens afin de développer des dispositifs robotisés adaptés. Un des grands thèmes étudié estcelui de la téléopération. Cette dernière consiste à utiliser deux dispositifs robotisés communémentappelés: maître et esclave. Dans le contexte médical, le robot maître est manoeuvré par le chirurgienet le robot esclave est au contact de l'organe à opérer. La première génération de ces systèmes nepermettait pas au chirurgien de ressentir les efforts qu'il exerçait sur les organes du patient. Unedeuxième génération de dispositifs est apparue en introduisant le retour d'efforts. Au delà desproblèmes de stabilité et de commande rencontrés, de tels systèmes permettent de réduire lesimperfections du geste humain ou d'en augmenter les capacités. Une des gênes constatées par leschirurgiens lors de l'utilisation de tels systèmes est le mouvement physiologique des organes àopérer.Cette thèse s'est principalement focalisée sur le thème de la compensation des mouvementsphysiologiques dans le cadre de la téléopération avec retour d'efforts. L'objectif étant de démontrerqu'il est possible pour le chirurgien de téléopérer un organe soumis à des mouvementsphysiologiques, et notamment le mouvement respiratoire, sans qu'il ne ressente cette perturbation.[...] / Computer aided medical gesture kept increasing during the last decade. This phenomenon is linkedto the evolution of surgical technique and specially the use of minimally invasive surgery. Thisrevolutionary technique allows reducing infection risks but introduces new problems. Indeed, thesurgeon has limited motion capability because the use of trocars. Therefore, robotics communityinterest has kept growing in order to develop specific robotized devices. One of the most currentstudied topics is teleoperation in which two robots are used: the master and the slave. In a medicalcontext, the master robot is manipulated by the surgeon and the slave robot is in contact with theoperated organ. The first generation of those systems did not allow the surgeon to feel how muchforce he applies on the patient. Then with the second generation, force-feedback was introduced.Even if this technique introduces new problems such as control and stability, it also allows medicalgesture improvements. One commonly cited problem is the physiological motion of organs forexample.This thesis mainly focuses on the subject of physiological motion compensation in the context ofmedical force feedback teleoperation. The aim is to prove that the surgeon is able to teleoperate anorgan submitted to a physiological motion, and especially respiratory motion, without feeling thisdisturbance.First of all, the choice of the teleoperation scheme is important. In the literature, many can be found.To simplify this study, a two communication channel scheme has been chosen. This means that onlyone information is sent from the master to the slave and another one from the slave to the master. Inorder to fulfill a task in the free space and in contact with the environment, and to compensate aforce disturbance, the force-position scheme is selected. In this case, the slave sends forceinformation and the master sends back position information.[...]

A partir de la conception d’un robot pour une application médicale particulière de télé-échographie, une démarche de conception générique de robots médicaux est proposée. L’étude se décompose en deux phases : la synthèse topologique et la synthèse dimensionnelle. La première est effectuée pour toutes applications médicales à partir de connaissances capitalisées dans un catalogue de robots médicaux réalisé au préalable. La synthèse dimensionnelle est établie pour un robot de télé-échographie. Une nouvelle structure cinématique de poignet sphérique série permettant de rejeter la singularité aux frontières de l’espace de travail est proposée. Après avoir réalisé une analyse cinématique validant le concept, plusieurs optimisations multi-critères sont effectuées selon des critères de performances cinématiques (manipulabilité, dextérité) et d’encombrement (compacité). Une comparaison de l’influence des indices de performance sur l’optimisation est réalisée. Le concept pour l’application de télé-échographie choisi et dimensionné, une démarche de conception préliminaire à l’aide de l’outil CAO est présentée. Une phase de conception collaborative avec des designers est menée afin d’améliorer l’ergonomie, la compacité et l’esthétique du robot. L’association des étapes de synthèses et de conception préliminaire a conduit à la proposition d’une démarche de conception de robots médicaux. / From the design of a tele-echography robot for a specific medical application, a generic methodology for medical robots design is proposed. The study is presented in two parts: a topological synthesis and a dimensional one. The first is made for all medical applications, from a medical robots catalogue built beforehand. The second synthesis is established for a tele-echography robot. A new spherical kinematic structure permitting to reject singularities to the boundaries of the workspace is proposed. After having validated this concept from a kinematic point of view, several multi-criteria optimisations are realised according to kinematic indices (manipulability, dexterity) and bulkiness (compactness). A comparison of indices influence on optimisations is carried out. The concept for teleechography robot chosen and dimensioned, a process of embodiment design with CAD tool is presented. A collaborative design phase with designers is led to improve ergonomics, compactness and aesthetic of the robot. The association of synthesis steps and embodiment design lead to propose a process of medical robots design.

Orientador: Eleri Cardozo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Elétrica e de Computação / Made available in DSpace on 2018-08-26T06:38:13Z (GMT). No. of bitstreams: 1 Olivi_LeonardoRocha_D.pdf: 17712423 bytes, checksum: a9b0ec521405e93735844f7ce8b3b968 (MD5) Previous issue date: 2014 / Resumo: A mobilidade é uma competência humana extremamente valiosa, e pode ser perdida por diversas razões, tais como traumas na coluna vertebral, acidentes vasculares cerebrais, dentre outras. Algumas tecnologias desenvolvidas para as áreas médicas, como eletroencefalografia e eletromiografia, podem ser empregadas no desenvolvimento de Interfaces Humano-Máquina (Human-Machine Interface, ou, HMI) com o objetivo de permitir que pessoas com capacidades motoras severamente comprometidas possam comunicar e operar os mais diversos equipamentos. Assim, esses usuários podem conduzir robôs móveis por meio de uma HMI adaptada para suas capacidades motoras e cognitivas. Entretanto, essas interfaces apresentam erros na identificação da ação pretendida pelo usuário, os quais comprometem sobremaneira a experiência desse usuário na interação com o mundo exterior. Para o caso dos robôs móveis assistivos, o conceito de controle compartilhado (shared control) foi concebido para compensar as taxas de erros das HMIs, e a responsabilidade pela navegação do robô é dividida entre o usuário e um sistema supervisor automático. As abordagens mais populares na literatura comutam poucos modos de comportamentos específicos para situações individualizadas, como passagens estreitas e desvio de obstáculos. Esta tese propõe uma nova técnica de controle compartilhado, denominada de navegação assistida por campos vetoriais, a qual não possui modos de operação chaveados, evitando quaisquer instabilidades e abrangendo as configurações do ambiente de maneira ilimitada, além de minimizar significativamente os erros gerados pelas HMIs e facilitar a navegação do usuário. Os campos vetoriais oferecem as navegações manual e autônoma, ampliando a interação do usuário com o ambiente. Nessa nova técnica, o sistema de controle embarcado irá executar a ação identificada pela HMI em função dos estados do robô e do ambiente, com o objetivo de maximizar a segurança e capacidade de controle do usuário. Os resultados mostrados neste trabalho evidenciam uma nova forma de tratar o problema, obtendo ganhos significativos com relação ao estado da arte, com baixa complexidade computacional, alta flexibilidade a ambientes e usuários e otimização efetiva de erros, contribuindo para a recuperação da mobilidade dos usuários / Abstract: Human mobility is an extremely valued skill that can be lost due to various reasons, such as spinal cord injuries, strokes, amputations, among others. Technologies developed for the medical areas, such as electroencephalography and electromyography, can be employed in the development of Human-Machine Interfaces (HMI) with the objective of allowing people with severe mobility impairments to communicate and to operate a wide range of equipments. Therefore, these users are allowed to conduct assistive robots allow through a HMI designed according to the user's mobility and cognitive skills. However, these interfaces still present low performance in the correct identification of the intended action by the user, which severely compromise the experience of the user when interacting with external world. In the specific case of assistive mobile robots, a shared control concept was developed in order to compensate the high error rates produced by the HMIs, where the responsibility for the navigation of the mobile robot is shared among the user and an autonomous supervisor system. The mainly approaches shown in literature switch a few modes of specific behavior for individualized situations, such as narrow corridors and obstacle avoidance. This work presents a novel shared control technique, named assistive navigation by vector fields, which does not employ switching modes, avoiding any instabilities and covering the unlimited environment configurations, significantly minimizing the HMI errors, facilitating the user's navigation. The vector fields offer both manual and autonomous navigation, increasing the user's interaction with the environment. In this novel technique, the embedded control system incorporates the HMI command with the robot and environment states, aiming the maximization of user's security and control capabilities. Results shown a novel manner for treating the problem, obtaining substantial gains over the state of art works, with low computational complexity, high flexibility concerning environments and users and effective optimization of errors, contributing for the user's mobility retrieval / Doutorado / Automação / Doutor em Engenharia Elétrica

La vertébroplastie percutanée est une intervention non chirurgicale et peu invasive qui consiste à injecter, sous contrôle radioscopique, un ciment orthopédique dans le corps vertébral. Malgré son efficacité, celle-ci présente quelques inconvénients non négligeables. Le premier est dû au ciment orthopédique qui est injecté pendant sa polymérisation. Au début, sa faible viscosité augmente le risque de fuite hors de la vertèbre traitée, ce qui peut provoquer de lourdes complications. Ensuite, la variation rapide de viscosité limite la durée. Le second désagrément concerne le contrôle par fluoroscopie à rayons X qui expose le praticien de manière prolongée. Ainsi, l’enjeu de ce projet est de proposer aux radiologues un nouveau système d’injection à distance avec retour d’effort sur lequel la viscosité du ciment est régulée pendant l’injection. Le développement de ces aspects permettra la radioprotection des praticiens, une réduction des risques de fuite et une durée d’injection allongée. / Percutaneous vertebroplasty is a minimally invasive intervention that involves injecting bone cement, under fluoroscopic guidance, into the vertebral body. It consolidates the fractured vertebra and reduces pain. However, some inconveniences must be considered. The major difficulties are related to the cement that is injected during its curing phase. It is very liquid at the beginning of the injection, which introduces a high risk of leakage outside the vertebra and, thus, potential dramatic complications. During the injection, the reaction progresses and the cement hardens suddenly, leaving a short working phase. Finally, the operator is permanently exposed to harmful X-rays. This work aims to provide a new teleoperated injection device with haptic feedback that allows a fine supervision of the cement injection by including a viscosity control system. This device will allow the radioprotection of the medical staff, a reduction of the leakage risks and an extended injection phase.

La manipulation robotique d'une sonde échographique a été un important sujet de recherche depuis plusieurs années. Plus particulièrement, des méthodes d'asservissement visuel guidé par échographie ont été développées pour accomplir différentes tâches, telles que la compensation de mouvement, le maintien de la visibilité d'une structure pendant la téléopération, ou le suivi d'un instrument chirurgical. Cependant, en raison de la nature des images échographiques, garantir une bonne qualité d'image durant l'acquisition est un problème difficile, qui a jusqu'ici été très peu abordé. Cette thèse traite du contrôle de la qualité des images échographiques acquises par une sonde robotisée. La qualité du signal acoustique au sein de l'image est représentée par une carte de confiance, qui est ensuite utilisée comme signal d'entrée d'une loi de commande permettant d'optimiser le positionnement de la sonde échographique. Une commande hybride est également proposée pour optimiser la fenêtre acoustique pour une cible anatomique qui est détectée dans l'image. L'approche proposée est illustrée dans le cas d'un scénario de télé-échographie, où le contrôle de la sonde est partagé entre la machine et le téléopérateur. / The robotic guidance of an ultrasound probe has been extensively studied as a way to assist sonographers in performing an exam. In particular, ultrasound-based visual servoing methods have been developed to fulfill various tasks, such as compensating for physiological motion, maintaining the visibility of an anatomic target during teleoperation, or tracking a surgical instrument. However, due to the specific nature of ultrasound images, guaranteeing a good image quality during the procedure remains an unaddressed challenge. This thesis deals with the control of ultrasound image quality for a robot-held ultrasound probe. The ultrasound signal quality within the image is represented by a confidence map, which is used to design a servo control law for optimizing the placement of the ultrasound probe. A control fusion is also proposed to optimize the acoustic window for a specific anatomical target which is tracked in the ultrasound images. The method is illustrated in a teleoperation scenario, where the control is shared between the automatic controller and a human operator.

<p>Minimally Invasive Robotic Surgery (MIRS) has revolutionized the way modern surgery is conducted by allowing for smaller incisions, finer control, reduced pain, and faster recovery. The state-of-the-art end-effector technology used for MIRS are tools based off of the rigid-body instruments used in traditional ‘open’ surgery. The rigid nature of the end-effectors, specifically the grasping jaws, leads to a lack of force feedback when implemented in a robotic system. </p> <p>Without additional feedback from active sensing, the blanching that occurs from restricted blood flow around a grasping site is the only indication a surgeon can use to assess the force applied to a tissue. Ongoing efforts to develop active force sensing solutions are currently faced with two major obstacles: miniaturization and sterilization. The lack of force feedback causes a gap between intention and result during robotic surgery. </p> <p>This work proposes the introduction of Visual Force Feedback (VFF) through the integration of a compliant end-effector design. Visual Force Feedback is an intuition, developed through practice, that allows a surgeon to estimate the reaction force of a compliant mechanism by the deflection of the outer flexures. An understanding of the relationship between opening size, flexure deformation, and pinch force allows for rapid estimation of the force applied to a manipulated object. </p> <p>Force and dimensional data were gathered through finite element simulation and the finite element model was validated with physical experimentation on a custom test bench. Multiple functions relating the flexure deformation to the reactionary force, referred to as pinch force, for specific opening sizes were resolved. Notable observations made through the analysis of these results were: (1) a closely linear relationship between outer flexure deformation and pinch force in both experimental and computational results and (2) a higher rate of pinch force increase due to draw displacement as an effect of wider jaw opening. These findings are intended to help shrink the gap between intention and result in the field of MIRS.</p>

Identification and characterization of a target object included within a surrounding medium is of interest in a variety of fields ranging from medical imaging and diagnostics, to counter-mine operations in military environments. The work described in this document applies a new approach to this problem through the development of Dynamic Interrogation, whereby physical stimuli are combined with imaging techniques to identify physical properties of a target inclusion. Interaction with physical systems in the real world brings with it a number of challenges, namely the stochastic nature of physical systems which adds complexity and uncertainty to any analysis or manipulation performed. In the field of optimal control, stochastic systems are well-studied. However, most approaches from literature seek to minimize the mean cost value of the system. An alternative approach found in literature is to minimize the variance of the cost function while constraining the mean cost to some selected value. This approach is known as Minimal Cost Variance control, and has been demonstrated to regulate finite continuous-time systems while minimizing the cost variance. In this work, we expand this technique to develop a new optimal control methodology suitable for robotic tracking applications. The unknown nature of the interrogation target provides an opportunity to leverage techniques from Model Predictive Control approaches to further improve the performance of the Dynamic Interrogation system. As a result, the developed novel control focuses on utilizing a minimal cost variance approach within the framework of model predictive control to optimize the performance of a Dynamic Interrogation system and facilitate implementation in an online architecture. To do this, we first develop the solution to the continuous-time, full-state feedback tracking MCV control problem which enables stochastic systems track a-priori state trajectories while minimizing the cost variance of the system. Next, we extend the tracking MCV solution to the discrete-time case to facilitate implementation in online architectures and to integrate with architectures from the field of model predictive control, most of which are implemented in discrete time. Finally, we derive the full Model Predictive Minimal Cost Variance (MPMCV) control and provide example implementations to physical systems. In addition to the optimal control work, this dissertation includes the development and structure of Dynamic Interrogation as implemented by robotic systems. The initial application for development of a Dynamic Interrogation approach focuses on tumor detection and characterization within biological tissue by implementation of recently developed imaging techniques to robotic manipulation utilizing novel optimal control approaches. This dissertation presents a nominal architecture for implementation of Dynamic Interrogation on the Baxter research robot, a platform developed specifically for applications in close proximity to humans. Additionally, the development of a Tactile Imagining sensor designed for integration with the robotic platform is presented. The integrated sensor system was then installed and tested on the Baxter robot within a laboratory environment, and experimentation done to verify the abilities and performance of the full system on phantom tissue analogs. The work concludes with experimental results from this implementation and a discussion of future work. / Electrical and Computer Engineering