Design and Fabrication of a Fiber Bragg Grating Shape Sensor for Shape Reconstruction of a Continuum Manipulator.

Continuum dexterous manipulators (CDMs) are suitable for performing tasks in a constrained environment due to their high dexterity and maneuverability. Despite the inherent advantages of CDMs in minimally invasive surgery, real-time control of CDMs' shape during nonconstant curvature bending is still challenging. This study presents a novel approach for the design and fabrication of a large deflection fiber Bragg grating (FBG) shape sensor embedded within the lumens inside the walls of a CDM with a large instrument channel. The shape sensor consisted of two fibers, each with three FBG nodes. A shape-sensing model was introduced to reconstruct the centerline of the CDM based on FBG wavelengths. Different experiments, including shape sensor tests and CDM shape reconstruction tests, were conducted to assess the overall accuracy of the shape-sensing. The FBG sensor evaluation results revealed the linear curvature-wavelength relationship with the large curvature detection of 0.045 mm and a high wavelength shift of up to 5.50 nm at a 90° bending angle in both the bending directions. The CDM's shape reconstruction experiments in a free environment demonstrated the shape-tracking accuracy of 0.216 ± 0.126 mm for positive/negative deflections. Also, the CDM shape reconstruction error for three cases of bending with obstacles was observed to be 0.436 ± 0.370 mm for the proximal case, 0.485 ± 0.418 mm for the middle case, and 0.312 ± 0.261 mm for the distal case. This study indicates the adequate performance of the FBG sensor and the effectiveness of the model for tracking the shape of the large-deflection CDM with nonconstant-curvature bending for minimally invasive orthopedic applications.

A Dexterous Robotic System for Autonomous Debridement of Osteolytic Bone Lesions in Confined Spaces: Human Cadaver Studies.

This article presents a dexterous robotic system for autonomous debridement of osteolytic bone lesions in confined spaces. The proposed system is distinguished from the state-of-the-art orthopedics systems because it combines a rigid-link robot with a continuum manipulator (CM) that enhances reach in difficult-to-access spaces often encountered in surgery. The CM is equipped with flexible debriding instruments and fiber Bragg grating sensors. The surgeon plans on the patient's preoperative computed tomography and the robotic system performs the task autonomously under the surgeon's supervision. An optimization-based controller generates control commands on the fly to execute the task while satisfying physical and safety constraints. The system design and controller are discussed and extensive simulation, phantom and human cadaver experiments are carried out to evaluate the performance, workspace, and dexterity in confined spaces. Mean and standard deviation of target placement are 0.5 and 0.18 mm, and the robotic system covers 91% of the workspace behind an acetabular implant in treatment of hip osteolysis, compared to the 54% that is achieved by conventional rigid tools.

Data-Driven Shape Sensing of a Surgical Continuum Manipulator Using an Uncalibrated Fiber Bragg Grating Sensor.

This article proposes a data-driven learning-based approach for shape sensing and Distal-end Position Estimation (DPE) of a surgical Continuum Manipulator (CM) in constrained environments using Fiber Bragg Grating (FBG) sensors. The proposed approach uses only the sensory data from an unmodeled uncalibrated sensor embedded in the CM to estimate the shape and DPE. It serves as an alternate to the conventional mechanics-based sensor-model-dependent approach which relies on several sensor and CM geometrical assumptions. Unlike the conventional approach where the shape is reconstructed from proximal to distal end of the device, we propose a reversed approach where the distal-end position is estimated first and given this information, shape is then reconstructed from distal to proximal end. The proposed methodology yields more accurate DPE by avoiding accumulation of integration errors in conventional approaches. We study three data-driven models, namely a linear regression model, a Deep Neural Network (DNN), and a Temporal Neural Network (TNN) and compare DPE and shape reconstruction results. Additionally, we test both approaches (data-driven and model-dependent) against internal and external disturbances to the CM and its environment such as incorporation of flexible medical instruments into the CM and contacts with obstacles in taskspace. Using the data-driven (DNN) and model-dependent approaches, the following max absolute errors are observed for DPE: 0.78 mm and 2.45 mm in free bending motion, 0.11 mm and 3.20 mm with flexible instruments, and 1.22 mm and 3.19 mm with taskspace obstacles, indicating superior performance of the proposed data-driven approach compared to the conventional approaches.

A Surgical Robotic System for Treatment of Pelvic Osteolysis Using an FBG-Equipped Continuum Manipulator and Flexible Instruments.

This paper presents the development and experimental evaluation of a redundant robotic system for the less-invasive treatment of osteolysis (bone degradation) behind the acetabular implant during total hip replacement revision surgery. The system comprises a rigid-link positioning robot and a Continuum Dexterous Manipulator (CDM) equipped with highly flexible debriding tools and a Fiber Bragg Grating (FBG)-based sensor. The robot and the continuum manipulator are controlled concurrently via an optimization-based framework using the Tip Position Estimation (TPE) from the FBG sensor as feedback. Performance of the system is evaluated on a setup that consists of an acetabular cup and saw-bone phantom simulating the bone behind the cup. Experiments consist of performing the surgical procedure on the simulated phantom setup. CDM TPE using FBGs, target location placement, cutting performance, and the concurrent control algorithm capability in achieving the desired tasks are evaluated. Mean and standard deviation of the CDM TPE from the FBG sensor and the robotic system are 0.50 mm, and 0.18 mm, respectively. Using the developed surgical system, accurate positioning and successful cutting of desired straight-line and curvilinear paths on saw-bone phantoms behind the cup with different densities are demonstrated. Compared to the conventional rigid tools, the workspace reach behind the acetabular cup is 2.47 times greater when using the developed robotic system.

Shape Tracking of a Dexterous Continuum Manipulator Utilizing Two Large Deflection Shape Sensors.

Dexterous continuum manipulators (DCMs) can largely increase the reachable region and steerability for minimally and less invasive surgery. Many such procedures require the DCM to be capable of producing large deflections. The real-time control of the DCM shape requires sensors that accurately detect and report large deflections. We propose a novel, large deflection, shape sensor to track the shape of a 35 mm DCM designed for a less invasive treatment of osteolysis. Two shape sensors, each with three fiber Bragg grating sensing nodes is embedded within the DCM, and the sensors' distal ends fixed to the DCM. The DCM centerline is computed using the centerlines of each sensor curve. An experimental platform was built and different groups of experiments were carried out, including free bending and three cases of bending with obstacles. For each experiment, the DCM drive cable was pulled with a precise linear slide stage, the DCM centerline was calculated, and a 2D camera image was captured for verification. The reconstructed shape created with the shape sensors is compared with the ground truth generated by executing a 2D-3D registration between the camera image and 3D DCM model. Results show that the distal tip tracking accuracy is 0.40 ± 0.30 mm for the free bending and 0.61 ± 0.15 mm, 0.93 ± 0.05 mm and 0.23 ± 0.10 mm for three cases of bending with obstacles. The data suggest FBG arrays can accurately characterize the shape of large-deflection DCMs.

Shape Reconstruction of Extensible Continuum Manipulator Based on Soft Sensors.

Continuum manipulators can improve spatial adaptability and operational flexibility in constrained environments by endowing them with contraction and extension capabilities. There are currently desired requirements to quantify the shape of an extensible continuum manipulator for strengthening its obstacle avoidance capability and end-effector position accuracy. To address these issues, this study proposes a methodology of using silicone rubber strain sensors (SRSS) to estimate the shape of an extensible continuum manipulator. The way is to measure the strain at specific locations on the deformable body of the manipulator, and then reconstruct the shape by integrating the information from all sensors. The slender sensors are fabricated by a rolling process that transforms planar silicone rubber sensors into cylindrical structures. The proprioceptive model relationship between the strain of the sensor and the deformation of the manipulator is established with considering the phenomenon of torsion of the manipulator caused by compression. The physically extensible continuum manipulator equipped with three driving tendons and nine SRSS was designed. Comprehensive evaluations of various motion trajectories indicate that this method can accurately reconstruct the shape of the manipulator, especially under end-effector loads. The experimental results demonstrate that the mean (maximum) absolute position error of the endpoint is 1.61% (3.45%) of the manipulator length.

Development of a continuum manipulator with variable bending length and piecewise stiffness for transoral laryngeal surgery.

PURPOSE: Continuum manipulators (CMs) show great potential in transoral laryngeal surgery due to their flexibility. However, CMs for transoral surgery face several issues: large size, which reduces practicality; intersegment coupling, which causes undesired deflection; and a lack of versatility that limits their applicability across different patient groups. METHODS: This work combines a rod-driven proximal segment and a cable-driven distal segment to achieve piecewise stiffness, alleviating the issue of intersegment coupling. A rigid constraint tube is integrated into the proximal segment to diversify its bending behavior. Preliminary experiments are conducted to validate the design concept. RESULTS: The proposed CM has an overall diameter of only 6.5 mm. The proximal segment can achieve a 90° bending with various curvatures. At the working configuration, the coupling error between the proximal segment and the distal segment is less than 1 mm. The effectiveness of the proposed CM is successfully validated using a human model. CONCLUSION: The proposed continuum manipulator possesses the desirable characteristics of small size, low coupling, and high versatility, indicating its great potentialities for the diagnosis and treatment of laryngeal lesion.

Platform for investigating continuum manipulator behavior in orthopedics.

PURPOSE: The use of robotic continuum manipulators has been proposed to facilitate less-invasive orthopedic surgical procedures. While tools and strategies have been developed, critical challenges such as system control and intra-operative guidance are under-addressed. Simulation tools can help solve these challenges, but several gaps limit their utility for orthopedic surgical systems, particularly those with continuum manipulators. Herein, a simulation platform which addresses these gaps is presented as a tool to better understand and solve challenges for minimally invasive orthopedic procedures. METHODS: An open-source surgical simulation software package was developed in which a continuum manipulator can interact with any volume model such as to drill bone volumes segmented from a 3D computed tomography (CT) image. Paired simulated X-ray images of the scene can also be generated. As compared to previous works, tool-anatomy interactions use a physics-based approach which leads to more stable behavior and wider procedure applicability. A new method for representing low-level volumetric drilling behavior is also introduced to capture material variability within bone as well as patient-specific properties from a CT. RESULTS: Similar interaction between a continuum manipulator and phantom bone was also demonstrated between a simulated manipulator and volumetric obstacle models. High-level material- and tool-driven behavior was shown to emerge directly from the improved low-level interactions, rather than by need of manual programming. CONCLUSION: This platform is a promising tool for developing and investigating control algorithms for tasks such as curved drilling. The generation of simulated X-ray images that correspond to the scene is useful for developing and validating image guidance models. The improvements to volumetric drilling offer users the ability to better tune behavior for specific tools and procedures and enable research to improve surgical simulation model fidelity. This platform will be used to develop and test control algorithms for image-guided curved drilling procedures in the femur.

Compound continuum manipulator for surgery: Efficient static-based kinematics.

BACKGROUND: The combination of various continuum manipulators is a potential solution to break the bottleneck of continuum manipulators. However, continuum manipulators dissatisfy the constant curvature assumption due to the influence of joints. METHODS: In this paper, a mechanics-based kinematic model of the compound continuum manipulator is proposed, which indicates that the curvature is non-constant. The static model of the manipulator is established, and the relationship of the bending angles is obtained. An efficient static-based Inverse Kinematic Algorithm using Polynomial Curve (IKAPC) of the manipulator is proposed. The polynomial curve is used to fit the end trajectory of the first manipulator. RESULTS: The simulation results show that the IKAPC is 354 times faster than the Levenberg-Marquardt algorithm. The experimental results show that the mechanics-based model improves the position accuracy by 3.75 times over the constant curvature method. CONCLUSION: This paper is critical for solving the inverse kinematics of the compound continuum manipulator.

Trajectory tracking control of a pneumatically actuated continuum manipulator in the presence of obstacles by using terminal sliding mode control.

This paper proposes an efficient trajectory planning and dynamic tracking controller scheme for a pneumatic continuum manipulator under the effect of material hysteresis. First of all, generalized governing nonlinear dynamic equations in the form of partial differential equations for pneumatic continuum manipulator dynamics are developed by using discrete Cosserat-rod theory, where the manipulator material hysteresis is modeled by using a fractional order Bouc-Wen model. Then, the trajectory planning for the end-effector of a continuum manipulator is proposed, which accounts for the static obstacles in the workspace and the Jacobian singularity. Subsequently, an adaptive terminal sliding mode controller for the joint space control combined with a simple PI controller for task space control is proposed. The proposed controller guarantees exponential convergence of the manipulator tip positional error in finite time, even in the existence of external disturbances and model uncertainties, without any need for prior knowledge of their upper bounds. Finally, the proposed controller is applied to a two-segment continuum manipulator, the trunk of Robotino-XT, through numerical simulations and the performance gain over two controllers proposed in the literature for similar pneumatic continuum manipulators is demonstrated.

Impact of Generic Tendon Routing on Tension Loss of Tendon-Driven Continuum Manipulators with Planar Deformation.

We present a novel physically-intuitive mathematical formulation to investigate the effects of a fully-constrained generic tendon routing (GTR) on the correlation between tension loss and deformation behavior of a variable-curvature tendon-driven continuum manipulator (TD-CM). The proposed model can account for distributed friction forces/moments along a GTR path that have been typically ignored in the previous approaches (e.g., the well-known frictionless Cosserat rod model). For the first time, the internal distributed forces on a GTR are expressed using three physically-intuitive generic functions. Solely relying on the known actuation input(s), the proposed mathematical formulation can also solve the entangled and unknown correlation between GTR, internal distributed forces, tension loss and deformation behavior of TD-CMs. To evaluate the performance of the proposed approach, we performed various simulation studies using eight different GTR paths. Additionally, we fabricated two different types of TD-CMs with different GTRs to experimentally evaluate the efficacy and performance of the proposed mathematical framework. The results demonstrate the proposed model can successfully and accurately (i.e., about <10% error) capture the trends of substantial tension loss (e.g., about <50%) on fully constrained GTRs, which reveals the importance of considering tension loss in modeling these TD-CMs.

Development and experiments of a continuum robotic system for transoral laryngeal surgery.

PURPOSE: Currently, self-retaining laryngoscopic surgery is not suitable for some patients, and there are dead zones relating to surgical field exposure and operation. The quality of the surgery can also be affected by the long periods of time required to complete it. Teleoperated continuum robots with flexible joints are expected to solve these issues. However, at the current stage of developing transoral robotic surgery systems, their large size affects the precision of surgical operative actions and there are high development and treatment costs. METHODS: We fabricated a flexible joint based on selective laser melting technology and designed a shallow neural network-based kinematic modeling approach for a continuum surgical robot. Then, human model and animal experiments were completed by master-slave teleoperation to verify the force capability and dexterity of the robot, respectively. RESULTS: As verified by human model and animal experiments, the designed continuum robot was demonstrated to achieve transoral laryngeal surgical field exposure without laryngoscope assistance, with sufficient load capability to finish the biopsy of vocal fold tissue in living animals. CONCLUSION: The designed continuum robotic system allows the biopsy of vocal fold tissue without laryngoscope assistance. Its stiffness and dexterity indicate the system's potential for applications in the diagnosis and treatment of vocal fold nodules and polyps. The limitations of this robotic system as shown in the experiments were also analyzed.

A variable-stiffness continuum manipulators by an SMA-based sheath in minimally invasive surgery.

BACKGROUND: Due to its unique dexterity and safety, continuum manipulators have been widely used in small constrained environment. However, its flexibility also brings negative effects such as poor stiffness and low strength. This paper presents a novel variable-stiffness sheath for continuum manipulators applied in minimally invasive surgery. METHODS: We present a variable-stiffness sheath based on shape memory alloy (SMA) for each module of the continuum manipulators. The stiffness of the sheath can be continuously adjusted depending on the voltage between both ends of the sheath, along with the phase transformation of SMA between austenite and martensite. RESULTS: The experimental results demonstrate that the stiffness of the sheath and single module are able to increase up to 223.1% and 139.2%, separately, which verify the correctness of the proposed variable stiffness method. CONCLUSION: The robot integrated with the variable-stiffness sheath is demonstrated to possess a fine capacity of variable stiffness.

On the Use of a Continuum Manipulator and a Bendable Medical Screw for Minimally Invasive Interventions in Orthopedic Surgery.

Accurate placement and stable fixation are the main goals of internal fixation of bone fractures using the traditional medical screws. These goals are necessary to expedite and avoid improper fracture healing due to misalignment of the bone fragments. However, the rigidity of the screw, geometry of the fractured anatomy (e.g., femur and pelvis), and osteoporosis may cause an array of complications. To address these challenges, we propose the use of a continuum manipulator and a bendable medical screw (BMS) to drill curved tunnels and fixate the bone fragments. This novel approach provides the clinicians with a degree of freedom in selecting the drilling entry point as well as the navigation of drill in complex anatomical and osteoporotic bones. This technique can also facilitate the treatment of osteonecrosis and augmentation of the hip to prevent osteoporotic fractures. In this paper: 1) we evaluated the performance of the curved drilling technique on human cadaveric specimens by making several curved tunnels with different curvatures and 2) we also demonstrated the feasibility of internal fixation using the BMS versus a rigid straight screw by performing finite element simulation of fracture fixation in an osteoporotic femur.

Elasticity Versus Hyperelasticity Considerations in Quasistatic Modeling of a Soft Finger-Like Robotic Appendage for Real-Time Position and Force Estimation.

Various methods based on hyperelastic assumptions have been developed to address the mathematical complexities of modeling motion and deformation of continuum manipulators. In this study, we propose a quasistatic approach for 3D modeling and real-time simulation of a pneumatically actuated soft continuum robotic appendage to estimate the contact force and overall pose. Our model can incorporate external load at any arbitrary point on the body and deliver positional and force propagation information along the entire backbone. In line with the proposed model, the effectiveness of elasticity versus hyperelasticity assumptions (neo-Hookean and Gent) is investigated and compared. Experiments are carried out with and without external load, and simulations are validated across a range of Young's moduli. Results show best conformity with Hooke's model for limited strains with about 6% average normalized error of position; and a mean absolute error of less than 0.08 N for force applied at the tip and on the body, demonstrating high accuracy in estimating the position and the contact force.

Modeling of Continuum Manipulators Using Pythagorean Hodograph Curves.

Research on continuum manipulators is increasingly developing in the context of bionic robotics because of their many advantages over conventional rigid manipulators. Due to their soft structure, they have inherent flexibility, which makes it a huge challenge to control them with high performances. Before elaborating a control strategy of such robots, it is essential to reconstruct first the behavior of the robot through development of an approximate behavioral model. This can be kinematic or dynamic depending on the conditions of operation of the robot itself. Kinematically, two types of modeling methods exist to describe the robot behavior; quantitative methods describe a model-based method, and qualitative methods describe a learning-based method. In kinematic modeling of continuum manipulator, the assumption of constant curvature is often considered to simplify the model formulation. In this work, a quantitative modeling method is proposed, based on the Pythagorean hodograph (PH) curves. The aim is to obtain a three-dimensional reconstruction of the shape of the continuum manipulator with variable curvature, allowing the calculation of its inverse kinematic model (IKM). It is noticed that the performances of the PH-based kinematic modeling of continuum manipulators are considerable regarding position accuracy, shape reconstruction, and time/cost of the model calculation, than other kinematic modeling methods, for two cases: free load manipulation and variable load manipulation. This modeling method is applied to the compact bionic handling assistant (CBHA) manipulator for validation. The results are compared with other IKMs developed in case of CBHA manipulator.

Steerable catheters for minimally invasive surgery: a review and future directions.

The steerable catheter refers to the catheter that is manipulated by a mechanism which may be driven by operators or by actuators. The steerable catheter for minimally invasive surgery has rapidly become a rich and diverse area of research. Many important achievements in design, application and analysis of the steerable catheter have been made in the past decade. This paper aims to provide an overview of the state of arts of steerable catheters. Steerable catheters are classified into four main groups based on the actuation principle: (1) tendon driven catheters, (2) magnetic navigation catheters, (3) soft material driven catheters (shape memory effect catheters, steerable needles, concentric tubes, conducting polymer driven catheters and hydraulic pressure driven catheters), and (4) hybrid actuation catheters. The advantages and limitations of each of them are commented and discussed in this paper. The future directions of research are summarized.

Modular Continuum Manipulator: Analysis and Characterization of Its Basic Module.

We present the basic module of a modular continuum arm (soft compliant manipulator for broad applications (SIMBA)). SIMBA is a robotic arm with a hybrid structure, namely a combination of rigid and soft components, which makes the arm highly versatile, dexterous, and robust. These key features are due to the design of its basic module, which is characterized by a three-dimensional workspace with a constant radius around its rotation axis, large and highly repeatable bending, complete rotation, and passive stiffness. We present an extensive analysis and characterization of the basic module of the SIMBA arm in terms of design, fabrication, kinematic model, stiffness, and bending behavior. All the theoretical models presented were validated with empirical results. Our findings show a positional typical error of less than ≈6% in module diameter (highly repeatable) with a passive stiffness of 0.8 N/mm (≈1 kg load). Our aim is to demonstrate that this kind of robotic element can be exploited as an elementary module of a more complex structure, which can be used in any application requiring high directional stiffness but without the need for an active stiffness mechanism, as is the case in daily activities (e.g., door opening, water pouring, obstacle avoidance, and manipulation tasks).