Smart Medical

2012
P. Loschak, K. Xiao, H. Pei, S. B. Kesner, A. J. Thomas, and C. J. Walsh, “Cranial Drilling Tool with Retracting Drill Bit Upon Skull Penetration,” ASME Design of Medical Devices Conference. 2012. PDF
C. J. Walsh, Meskers, A. H. Slocum, and R. Gupta, “CT-Compatible Medical Drilling Stylet for Percutaneous Interventions,” ASME Journal of Medical Devices, vol. 6, no. 4, pp. 041001, 2012. Publisher's Version PDF
2011
C. J. Walsh, A. H. Slocum, and R. Gupta, “Preliminary evaluation of robotic needle distal tip repositioning,” Proc. SPIE, vol. 7901. pp. 790108, 2011. Publisher's VersionAbstract
Advances in medical imaging now provide detailed images of solid tumors inside the body and miniaturized energy delivery systems enable tumor destruction through local heating powered by a thin electrode. We have developed a robot for accurately repositioning the distal tip of a medical instrument such an ablation probe to adjacent points within tissue. The position accuracy in ballistics gelatin was evaluated in a 2D experimental setup with a digital SLR camera that was fixed to a rig that also contained the gelatin. The robot was mounted to the rig in such a way that the stylet was deployed in a plane parallel the camera's lens. A grid paper attached to the back of the box containing the gelatin provided a stationary reference point for each of the pictures taken and also served as a coordinate system for making measurements. The measurement repeatability error was found by taking a stylet tip position measurement five times for two different pictures and found to be 0.26 mm. For a stylet with a radius of curvature of 31.5 mm and a diameter of 0.838 mm, the targeting accuracy was found to be 2.5 ± 1.4 mm at points that were approximately 38 mm lateral from the cannula axis.
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L. J. Brattain, et al., “Design of an Ultrasound Needle Guidance System,” in 33rd Annual International Conference of the IEEE EMBS, Boston, MA, 2011, pp. 8090-8093.Abstract

In this paper, we describe our prototype of an ultrasound guidance system to address the need for an easy-touse, cost-effective, and portable technology to improve ultrasound-guided procedures. The system consists of a lockable, articulating needle guide that attaches to an ultrasound probe and a user-interface that provides real-time visualization of the predicted needle trajectory overlaid on the ultrasound image. Our needle guide ensures proper needle alignment with the ultrasound imaging plane. Moreover, the calculated needle trajectory is superimposed on the real-time ultrasound image, eliminating the need for the practitioner to estimate the target trajectory, and thereby reducing injuries from needle readjustment. Finally, the guide is lockable to prevent needle deviation from the desired trajectory during insertion. This feature will also allow the practitioner to free one hand to complete simple tasks that usually require a second practitioner to perform. Overall, our system eliminates the experience required to develop the fine hand movement and dexterity needed for traditional ultrasound-guided procedures. The system has the potential to increase efficiency, safety, quality, and reduce costs for a wide range of ultrasound-guided procedures. Furthermore, in combination with portable ultrasound machines, this system will enable these procedures to be more easily performed by unskilled practitioners in non-ideal situations such as the battlefield and other disaster relief areas.

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C. J. Walsh, J. C. Franklin, A. H. Slocum, and R. Gupta, “Design of a robotic tool for percutaneous instrument distal tip repositioning,” in 33rd Annual International Conference of the IEEE EMBS, Boston, MA, 2011, pp. 2097-2100. PDF
X. Chen, K. Tuncali, A. H. Slocum, and C. J. Walsh, “Design of an instrument guide for MRI-guided percutaneous interventions,” ASME Design of Medical Devices Conference. 2011. PDF
M. S. Berns, et al., “Single Entry Tunneler [SET] for Hemodialysis Graft Procedures,” ASME Design of Medical Devices Conference. 2011. PDF
2010
C. J. Walsh, J. C. Franklin, A. H. Slocum, and R. Gupta, “Characterization of Pre-curved Needles for use in Distal Tip Manipulation Mechanisms,” Proceedings of the 2010 Design of Medical Devices Conference. 2010. PDF
2009
A. Seitel, et al., “Development and Evaluation of a New Image-Based User Interface for Robot-Assisted Needle Placements with the Robopsy System,” in Proc. SPIE, Lake Buena Vista, FL, 2009, vol. 7261, pp. 72610X-72610X-9. Publisher's VersionAbstract

The main challenges of Computed Tomography (CT)-guided organ puncture are the mental registration of the medical imaging data with the patient anatomy, required when planning a trajectory, and the subsequent precise insertion of a needle along it. An interventional telerobotic system, such as Robopsy, enables precise needle insertion, however, in order to minimize procedure time and number of CT scans, this system should be driven by an interface that is directly integrated with the medical imaging data. In this study we have developed and evaluated such an interface that provides the user with a point-and-click functionality for specifying the desired trajectory, segmenting the needle and automatically calculating the insertion parameters (angles and depth). In order to highlight the advantages of such an interface, we compared robotic-assisted targeting using the old interface (non-image-based) where the path planning was performed on the CT console and transferred manually to the interface with the targeting procedure using the new interface (image-based). We found that the mean procedure time (n=5) was 22±5 min (non-image-based) and 19±1 min (image-based) with a mean number of CT scans of 6±1 (non-image-based) and 5±1 (image-based). Although the targeting experiments were performed in gelatin with homogenous properties our results indicate that an image-based interface can reduce procedure time as well as number of CT scans for percutaneous needle biopsies.

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V. Patil, R. S. J. Estépar, C. J. Walsh, and K. Vosburgh, “Dynamic CT Scanner Environment Effects on a DC Electromagnetic Tracking System,” International Journal of Computer Assisted Radiology & Surgery, vol. 4, no. Suppl 1. pp. S339-S340, 2009. Publisher's Version PDF Poster
L. Maier-Hein, et al., “Human vs. Robot Operator Error in a Needle-Based Navigation System for Percutaneous Liver Interventions,” in Proc. SPIE, Lake Buena Vista, FL, 2009, vol. 7261, pp. 72610Y-72610Y-12. Publisher's VersionAbstract

Computed tomography (CT) guided percutaneous punctures of the liver for cancer diagnosis and therapy (e.g. tumor biopsy, radiofrequency ablation) are well-established procedures in clinical routine. One of the main challenges related to these interventions is the accurate placement of the needle within the lesion. Several navigation concepts have been introduced to compensate for organ shift and deformation in real-time, yet, the operator error remains an important factor influencing the overall accuracy of the developed systems. The aim of this study was to investigate whether the operator error and, thus, the overall insertion error of an existing navigation system could be further reduced by replacing the user with the medical robot Robopsy. For this purpose, we performed navigated needle insertions in a static abdominal phantom as well as in a respiratory liver motion simulator and compared the human operator error with the targeting error performed by the robot. According to the results, the Robopsy driven needle insertion system is able to more accurately align the needle and insert it along its axis compared to a human operator. Integration of the robot into the current navigation system could thus improve targeting accuracy in clinical use.

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2008
C. J. Walsh, N. C. Hanumara, A. H. Slocum, J. - A. Shepard, and R. Gupta, “A Patient-Mounted, Telerobotic Tool for CT-Guided Percutaneous Interventions,” ASME Journal of Medical Devices, vol. 2, no. 1, 2008. PDF
2007
C. J. Walsh, N. C. Hanumara, R. Gupta, J. - A. Shepard, and A. H. Slocum, “Evaluation of a Patient-Mounted, Remote Needle Guidance and Insertion System for CT-Guided, Percutaneous Lung Biopsies,” Proceedings of the 2nd Frontiers in Biomedical Devices Conference. 2007. PDF
M. P. Ottensmeyer, M. Yip, C. J. Walsh, J. B. Kobler, J. T. Heaton, and S. M. Zeitels, “Intra-operative Laryngoscopic Instrument for Characterizing Vocal Fold Visco-elasticity,” Proceedings of the 2nd Frontiers in Biomedical Devices Conference. 2007. PDF
N. C. Hanumara, C. J. Walsh, R. Gupta, J. - A. Shepard, and A. H. Slocum, “Human Factors Design for Intuitive Operation of a Low-cost, Image-Guided, Tele-Robotic Biopsy Assistant,” in Proceedings of the IEEE Engineering in Medicine and Biology Conference, Lyon, France, 2007, pp. 1257-1260. PDF
2005
S. R. H. Barrett, R. Gupta, N. C. Hanumara, A. H. Slocum, and C. J. Walsh, “Remote Needle Guidance System for Percutaneous Image Guided Biopsies,” in Proc. American Society of Mechanical Engineers International Design Engineering and Technical Conferences, Long Beach, California, 2005. PDF

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