Ex-vivo experiments with a microrobotic surgical system for vitreo-retinal surgery
Citation for published version (APA):
Meenink, H. C. M., Naus, G. J. L., Beelen, M. J., Steinbuch, M., Rosielle, P. C. J. N., & Smet, de, M. D. (2012). Ex-vivo experiments with a microrobotic surgical system for vitreo-retinal surgery. E-Abstract 3789-. Poster session presented at conference; Annual meeting: Association for Research in Vision and Ophthalmology; 2012-05-05; 2012-05-11.
Document status and date: Published: 01/01/2012
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3789
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*Thijs Meenink MSc PhDEx vivo Experiments With A Microrobotic Surgical System For Vitreo retinal Surgery
Department of Mechanical EngineeringjEx‐vivo Experiments With A Microrobotic Surgical System For Vitreo‐retinal Surgery
Department of Mechanical Engineering C t l S t T h lEx vivo Experiments With A Microrobotic Surgical System For Vitreo retinal Surgery
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Control Systems Technology group PO Box 513, Gem‐N ‐1.62* 5600 MB Eindhoven
Thijs MEENINK
1‐*Gerrit NAUS
1Maarten Beelen
1Maarten STEINBUCH
1Nick ROSIELLE
1and Marc DE SMET
2‐3 5600 MB EindhovenThe NetherlandsThijs MEENINK , Gerrit NAUS , Maarten Beelen , Maarten STEINBUCH , Nick ROSIELLE and Marc DE SMET
The Netherlands1 Mechanical Engineering Technische Universiteit Eindhoven Eindhoven The Netherlands; 2 Retina & Inflammation Unit Montchoisi Clinique Lausanne Switzerland; 3 University of Amsterdam The Netherlands Tel. +31 40 247 4789 1. Mechanical Engineering, Technische Universiteit Eindhoven, Eindhoven, The Netherlands; 2. Retina & Inflammation Unit, Montchoisi Clinique, Lausanne, Switzerland; 3. University of Amsterdam, The Netherlands
Fax. +31 40 246 1418 Fax. +31 40 246 1418 h c m meenink@tue nl h.c.m.meenink@tue.nl
Figure 1 Experimental setup of the PRECEYES robotic system
Ab
Figure 1. Experimental setup of the PRECEYES robotic system.Abstract
The
P
REC
EYE
S
robotic system for vitreoretinal surgery
Abstract
The
P
REC
EYE
S
robotic system for vitreoretinal surgery
Purpose
Purpose
p
D l t i it ti l li it d b
Developments in vitreoretinal eye surgery are limited byp y g y y
Introduction
h biliti T i t it ti l i l
Introduction
human capabilities. To improve current vitreoretinal surgicalp p g The PRECEYES robotic system consists of a master console operated by the surgeon that controls
d d t bl d b ti t The PRECEYES robotic system consists of a master console operated by the surgeon that controls
procedures and to enable new procedures, a robotic system two robotic arms (slave) which perform the actual surgery (Meenink 2011; Hendrix 2011 Figure
p p , y
has been developed called PRECEYES extending human two robotic arms (slave) which perform the actual surgery (Meenink, 2011; Hendrix, 2011, Figure
has been developed calledp PRECEYES, extending humang 1) The haptic interfaces of the master console provide the motion reference for the instrument
capabilities 1). The haptic interfaces of the master console provide the motion reference for the instrument
capabilities.p manipulators of the slave system (Figure 3) The slave system performs the actual surgery bymanipulators of the slave system (Figure 3). The slave system performs the actual surgery by
controlling instrument manipulators that directly handle the instruments A comfortable and
M th d
controlling instrument manipulators that directly handle the instruments. A comfortable andMethods
intuitive working environment is created by manipulating the haptic interfaces to simulate theMethods
l h h b l
intuitive working environment is created by manipulating the haptic interfaces to simulate the
A compact, lightweight, easy to setup robotic master‐slave instrument tip inside the eye (figure 2) The PRECEYES robotic system is designed compact
A compact, lightweight, easy to setup robotic master slave
h b li d f i i l
instrument tip inside the eye (figure 2). The PRECEYES robotic system is designed compact,
system has been realized to perform vitreo‐retinal eye surgery lightweight and easy to setup to fit the current OR layout With the PRECEYES robotic system
system has been realized to perform vitreo retinal eye surgery
( Fi 1 3) Th ’ h h j f
lightweight and easy to setup to fit the current OR layout. With the PRECEYES robotic system
(see Figure 1‐3). The system’s reach covers the major part of instruments can be changed automatically hand tremor can be filtered out movements can be
(see Figure 1 3). The system s reach covers the major part of
h i i ( h i h l i ) A
instruments can be changed automatically, hand tremor can be filtered out, movements can be
the vitreous cavity (up to the peripheral region). A scaled, which allows µm precise movements. This could enable procedures as retinal vein
the vitreous cavity (up to the peripheral region). A
bi i f d d h i l d l d i
scaled, which allows µm precise movements. This could enable procedures as retinal vein
combination of advanced mechanical and control designg cannulation for treating CRVO and BRVO
f ilit t hi h ( 10 ) t di h biliti
cannulation for treating CRVO and BRVO.
facilitates high accuracy (<10µm) extending human capabilitiesg y ( µ ) g p
d i ifi t ti i Th d d ibilit f
and significant time saving. The accuracy and reproducibility ofg g y p y
System evaluation
th t lid t d i b h i t i l di
System evaluation
the system are validated via bench experiments, includingy p , g The compact lightweight and easy to setup design contributes to a fast installation The time to
i ti d i k d l t Vit ti l i l The compact, lightweight and easy to setup design contributes to a fast installation. The time to
pointing and pick‐and‐place movements. Vitreo‐retinal surgical prepare a surgical table (Maquet 1120) with the PRECEYES and to activate it takes only a few
p g p p g
d i l t d i d l d i prepare a surgical table (Maquet 1120) with the PRECEYES and to activate it takes only a few
procedures were simulated in an eye model, eggs and porcine minutes Using a laserfibrometer (Polytec OVF 5000 with OVF 552 at 500 µm/V) the
p y , gg p
i i i t Th i t i l d l minutes. Using a laserfibrometer (Polytec OVF‐5000 with OVF‐552, at 500 µm/V), the
eyes via ex‐vivo experiments. The experiments include cannulay p p repeatability and smallest step accuracy was measured at the instrument tip at 25 mm insertion
placement vitrectomy and membrane peeling repeatability and smallest step accuracy was measured at the instrument tip at 25 mm insertion
placement, vitrectomy and membrane peeling. depth The result was an intrinsic accuracy of < 10 µm which corresponds to the requirements
p , y p g depth. The result was an intrinsic accuracy of < 10 µm, which corresponds to the requirements.
φ
R
lt
φ
Results
User tests
Results
f ll f l l b f l
User tests
A fully functional master‐slave robotic system for vitreo‐retinal Θ,Z The first user tests included a training program with simple tasks on paper and more advanced
A fully functional master slave robotic system for vitreo retinal
h b l d f l h φ Ψ The first user tests included a training program with simple tasks on paper and more advanced
eye surgery has been realized. First functional tests show a Ψ i l t k hi k h ig p gll t i b p (L 2004) Th t tp p h
eye surgery has been realized. First functional tests show a
h i i i i i bi i i h d surgical tasks on a chicken egg chorioallantoic membrane (Leng, 2004). The tests show an
short setup time, an intuitive usage in combination with good Ψ intuitive usage combined with good ergonomics and satisfactory instrument reach and accuracyg gg ( g )
short setup time, an intuitive usage in combination with good
i d i f i h d intuitive usage combined with good ergonomics and satisfactory instrument reach and accuracy.
ergonomics and satisfactory instrument reach and accuracy.g y y User tremor is effectively filtered and a motion scaling of 10 to 40 times was consideredg g g
Si l ti f it ti l i l d i di t User tremor is effectively filtered and a motion scaling of 10 to 40 times was considered
Simulation of vitreo‐retinal surgical procedures indicates adequate The intuitive usage resulted in a short learning curve; users adapt in minutes and are
Simulation of vitreo retinal surgical procedures indicates
i d d i ffi i d adequate. The intuitive usage resulted in a short learning curve; users adapt in minutes and are
improved accuracy and time efficient surgery compared top y g y p able to perform surgical tasks successfully within an hour of first usage Pointing tasks on
l able to perform surgical tasks successfully within an hour of first usage. Pointing tasks on
manual surgery. virtual squared mm paper show an accuracy down to 38 µm ±28 µm The accuracy of these tasks is
Θ Z
g y squared mm‐paper show an accuracy down to 38 µm ±28 µm. The accuracy of these tasks is
entry point Θ,Z
limited by the magnification of the currently implemented visualization system (Sony A33 with
entry point
C
l i
limited by the magnification of the currently implemented visualization system (Sony A33 withConclusion
90mm macro lens projected onto a 24”HD monitor)Conclusion
90mm macro lens, projected onto a 24 HD monitor).Figure 3 Realized robotic slave setup with two instrument
Figure 2 Similar movements of the haptic interface
A microrobotic surgical system for vitreo‐retinal surgery is Figure 2. Similar movements of the haptic interfaced h i ib Figure 3. Realized robotic slave setup with two instrument
A microrobotic surgical system for vitreo retinal surgery is and the instrument contribute to an manipulators
realized that meets the requirements and constraints imposed
E
i
i
p intuitive usage
realized that meets the requirements and constraints imposed
Ex‐vivo experiments
intuitive usage.
by this type of specialized surgery First functional tests
Ex vivo experiments
by this type of specialized surgery. First functional tests
The chorioallantoic membrane (CAM) of chicken eggs is used as a model to practice surgical
validate the realization of these requirements and constraints The chorioallantoic membrane (CAM) of chicken eggs is used as a model to practice surgical
validate the realization of these requirements and constraints,
tasks see Figure 4 and 5; the transparent membrane in the right image The CAM of chicken eggs
improving current vitreo‐retinal surgical procedures in time tasks, see Figure 4 and 5; the transparent membrane in the right image. The CAM of chicken eggs
improving current vitreo retinal surgical procedures in time
is commonly used as a model for the retina as the membrane has similar characteristics as the
efficiency and accuracy, and enabling new, high‐precision is commonly used as a model for the retina as the membrane has similar characteristics as the
efficiency and accuracy, and enabling new, high precision
d retina (Leng 2004) The first task involved peeling of the white inner shell membrane from the
procedures. retina (Leng, 2004). The first task involved peeling of the white inner shell membrane from the
procedures.
underlying CAM With a knife and pick the peel was successfully executed on the first attempt It underlying CAM. With a knife and pick, the peel was successfully executed on the first attempt. It was performed within 2 minutes and without any complications such as bleeding. Similar results
R f
was performed within 2 minutes and without any complications such as bleeding. Similar resultsReferences
were realized using forceps to peel the membrane (Figure 4). After removing a piece of the inner
References
H d i R (2011) R b ti i t d A h ti t l PhD th i were realized using forceps to peel the membrane (Figure 4). After removing a piece of the inner
h ll b d h l l l d f ll
Hendrix, R. (2011), Robotic assisted eye surgery. A haptic master console, PhD thesis
shell membrane and exposing the CAM, retinal vein cannulation was simulated successfully to
(supervisors: Nijmeijer, H., Steinbuch, M.), Eindhoven University of Technology, Eindhoven, shell membrane and exposing the CAM, retinal vein cannulation was simulated successfully to
h h h d d ( ) h f h
( p j j , , , ), y gy, , the Netherlands
the veins on the CAM, having a diameter down to 35 µm (Figure 5). The outcome of these
the Netherlands
Meenink H C M (2011) Vitreo retinal eye surgery robot: sustainable precision PhD thesis the veins on the CAM, having a diameter down to 35 µm (Figure 5). The outcome of these
i l k i i b i i h i i
Meenink, H.C.M. (2011), Vitreo‐retinal eye surgery robot: sustainable precision, PhD thesis
surgical tasks were consistent in subsequent experiments with various users. Ex‐vivo
(supervisors: Steinbuch, M., De Smet, M.D.), Eindhoven University of Technology, Eindhoven, g q p
i t i h d t d t ti i t t th t i t th h th
the Netherlands.
experiments on porcine eyes showed a steady rotation point at the entry point through the pars‐
the Netherlands.
Leng T Miller J M Bilbao K V Palanker D V Huie P and Blumenkranz M S (2004) The experiments on porcine eyes showed a steady rotation point at the entry point through the pars
l d i f d
Leng, T., Miller, J.M., Bilbao, K.V., Palanker, D.V., Huie, P. and Blumenkranz, M.S. (2004), The
Figure 5 Vein cannulation at a chicken CAM
Figure 4 Peeling of the inner white shell membrane plana and a vitrectomy was performed.
chick chorioallantoic membrane as a model tissue for surgical retinal research and simulation, Figure 4. Peeling of the inner white shell membrane Figure 5. Vein cannulation at a chicken CAM. plana and a vitrectomy was performed.
24(3): 427‐434 from a chicken CAM.
24(3): 427 434 f