Design and Evaluation of a Puncture Control Method for the Deflection of Ultrafine Needles due to Interfacial Passage-Proposal of Puncture Control Strategy for Increasing.

With the demand for sophisticated techniques to easily prevent the deflection of needles, robotic CT (computed tomography)-guided puncture with an ultrafine needle is being investigated. Quantification of deflection is essential for accurate puncture with ultrafine needles. Research on the quantification of deflection caused by tissue reaction forces to which the beveled surface of the needle tip is in progress, and this method has been applied for deflection reduction and needle steering within the tissue. However, when the needle tip passes through a tissue boundary, the needle deflects regardless of the direction of the beveled surface. Although several methods have been proposed to reduce the deflection caused by the boundary surface, no curve puncture method has been constructed using the deflection. This work aimed to construct a refraction model that can back-calculate the curved path from the body surface to the target. Assumptions of the refraction model were made based on the results of ex vivo examination, and the model was validated through in vivo examination. A refraction model in which the refraction angle is linearly proportional to the needle penetration angle relative to the boundary was hypothesized. Validation test revealed that the correlation coefficient exceeded 0.9, which was similar to that of the model and suggested the biological adaptability of the proposed model. A curve puncture method using this refraction model will be developed in the future.

Development of Needle Guide Unit Considering Buckling Bone-Perforation Control Strategy Based on Computed Tomography-Guided Needle Insertion Robot.

A computed tomography (CT)-guided robotic assistance system is useful for needle insertion into metastatic carcinoma of vertebrae, which has limited pathways. However, the use of conventional needles in this procedure can result in bone fracture in the perforation area caused by the reaction force of the inserted needle. In this study, we developed a multistage retractable needle guide unit that avoids the buckling and crushing of the needle tip that commonly occur in 25-gauge ultrafine needles. First, we clarified a relationship between the shape of the guide and the termination factor when a buckling load is applied to the needle. Next, we revealed the point at which the plastic deformation of the needle occurred when the bone is drilled. Based on these results, we developed a guide unit with the reaction force set to an appropriate value. Finally, an evaluation test of bone needle insertion was conducted on porcine vertebrae with using the developed needle guide unit equipped with a 25-gauge needle. The needle penetrated the vertebra without buckling or crushing of the needle tip, which demonstrates the value of this multistage retractable needle guide unit when ultrafine needles are required. Clinical Relevance- Cancer tumors often metastasize to bones. There is a treatment called percutaneous vertebroplasty which restores the patient's quality of life by injecting poly (methyl methacrylate) (PMMA) into a bone. It helps to reinforce the bone that has become brittle due to cancer metastasis to the vertebral body or osteoporosis. This treatment often involves puncture of the vertebrae but the limited puncture pathway makes it difficult to perform the treatment manually. Therefore it is necessary to construct a system that supports accurate puncture by a robot such as the proposed method.

Robotic Cytology using Extra-Fine Needles : -Proposal of Puncture Control Strategy for Increasing Collection Amount.

Fine needle aspiration cytology requires accurate needle insertion into a tumor and sufficient amount collection of samples, which highly depends on the skill of the physician. The advantage of the diagnosis is to minimize the tissue damage with the fine needle, while, when the amount of the sample sucked from the lesion is not enough for the definite diagnosis, the procedure has to be repeated until satisfying them. Although numerous research reported a robot-assisted insertion method to improve the accuracy of needle placement with fine needles, there was less research to address the efficient tissue collection. Ideally, the amount of the samples can be satisfied for the diagnosis even if an extra-fine needle (e.g. 25-gauge) is used. This paper proposes a novel needle insertion method for increasing the amount of the tissue sample with the extra-fine needle. The proposed insertion method comprises the round-trip insertion motion and trajectory rerouting with the nature of the bevel-tipped needle. The phantom study's result showed the equivalency of the aspiration amount between a physician's manual procedure with a 22-gauge needle and the proposed method with a 25-gauge needle (4.5 ± 1.0 mg vs 5.1 ± 0.7 mg). The results suggested that the proposed robotic aspiration method can increase the sampling amount with the extra-fine needle in the fine needle aspiration cytology.