A Novel Robotic Bronchoscope System for Navigation and Biopsy of Pulmonary Lesions
Abstract
Transbronchial biopsy sampling, as a minimally invasive method with relatively low risk, has been proved to be a promising treatment in the field of respiratory surgery. Although several robotic bronchoscopes have been developed, it remains a great challenge to balance size and flexibility, while integrating multisensors to realize navigation during complex airway networks. This paper proposes a novel robotic bronchoscope system composed by end effector with relatively small size, relevant actuation unit, and navigation system with path planning and surgical guidance capability. The main part of the end effector is machined by bidirectional groove on a nickel–titanium tube, which can realize bending, rotation, and translation 3 degrees of freedom. A prototype of the proposed robotic bronchoscope system is designed and fabricated, and its performance is tested through several experiments to verify the stiffness, flexibility, and navigation performance. The results show that the proposed system is with good environment adaptiveness, and it can become a promising biopsy method through natural cavity of the human body.
References
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021,71(3):209–249.
Blandin Knight S, Crosbie PA, Balata H, Chudziak J, Hussell T, Dive C. Progress and prospects of early detection in lung cancer. Open Biol, 2017,7(9):Article 170070.
Wu CC, Maher MM, Shepard J-AO. Complications of ct-guided percutaneous needle biopsy of the chest: Prevention and management. Am J Roentgenol, 2011,196(6):W678–W682.
Wan IY, Toma TP, Geddes DM, Snell G, Williams T, Venuta F, Yim AP. Bronchoscopic lung volume reduction for end-stage emphysema: Report on the first 98 patients. Chest, 2006,129(3):518–526.
Andolfi M, Potenza R, Capozzi R, Liparulo V, Puma F, Yasufuku K. The role of bronchoscopy in the diagnosis of early lung cancer: A review. J Thorac Dis, 2016,8(11):3329–3337.
Gu Y, Gu C, Yang J, Sun J, Yang G-Z. Vision–kinematics interaction for robotic-assisted bronchoscopy navigation. IEEE Trans Med Imaging, 2022,41(12):3600–3610.
Luo X, Mori K, Peters TM. Advanced endoscopic navigation: Surgical big data, methodology, and applications. Annu Rev Biomed Eng, 2018（20）:221–251.
Mehta AC, Hood KL, Schwarz Y, Solomon SB. The evolutional history of electromagnetic navigation bronchoscopy: State of the art. Chest, 2018,154(4):935–947.
Solomon SB, White P Jr, Acker DE, Strandberg J, Venbrux AC. Real-time bronchoscope tip localization enables three-dimensional ct image guidance for transbronchial needle aspiration in swine. Chest, 1998,114(5):1405–1410.
Lin Z, Gao A, Ai X, Gao H, Fu Y, Chen W, Yang G-Z. Arei: Augmented-reality-assisted touchless teleoperated robot for endoluminal intervention. IEEE/ASME Trans Mechatron, 2021,27(5):3144–3154.
Murgu SD. Robotic assisted-bronchoscopy: Technical tips and lessons learned from the initial experience with sampling peripheral lung lesions. BMC Pulm Med, 2019,19(1):Article 89.
Chen AC, Gillespie CT. Robotic endoscopic airway challenge: Reach assessment. Ann Thorac Surg, 2018,106(1):293–297.
Agrawal A, Hogarth DK, Murgu S. Robotic bronchoscopy for pulmonary lesions: A review of existing technologies and clinical data. J Thorac Dis, 2020,12(6):3279–3286.
Chen Y, Ding M, Guan W-j, Wang W, Luo W-z, Zhong C-h, Jiang M, Jiang J-h, Gu Y-y, Li S-y, et al. Validation of human small airway measurements using endobronchial optical coherence tomography. Respir Med, 2015,109(11):1446–1453.
Li C, Gu X, Xiao X, Lim CM, Ren H. Flexible robot with variable stiffness in transoral surgery. IEEE/ASME Trans Mechatron, 2019,25(1):1–10.
Liu D, Liu X, Chen Z, Zuo Z, Tang X, Huang Q, Arai T. Magnetically driven soft continuum microrobot for intravascular operations in microscale. Cyborg Bionic Syst, 2022:Article 9850832.
Li C, Yan Y, Xiao X, Gu X, Gao H, Duan X, Zuo X, Li Y, Ren H. A miniature manipulator with variable stiffness towards minimally invasive transluminal endoscopic surgery. IEEE Robot Autom Lett, 2021,6(3):5541–5548.
Li C, Gu X, Xiao X, Lim CM, Ren H. Compliant and flexible robotic system with parallel continuum mechanism for transoral surgery: A pilot cadaveric study. Robotics, 2022,11(6):135.
Zhang R, Xie D, Qian C, Duan X, Li C. Design of a flexible robot toward transbronchial lung biopsy. Robotica, 2022,41(3):1055–1065.
Ros-Freixedes L, Gao A, Liu N, Shen M, Yang G-Z. Design optimization of a contact-aided continuum robot for endobronchial interventions based on anatomical constraints. Int J Comput Assist Radiol Surg, 2019,14(7):1137–1146.
Mitros Z, Thamo B, Bergeles C, Da Cruz L, Dhaliwal K, Khadem M. Design and modelling of a continuum robot for distal lung sampling in mechanically ventilated patients in critical care. Front Robot AI, 2021(8):Article 611866.
Qi B, Yu Z, Varnamkhasti ZK, Zhou Y, Sheng J. Toward a telescopic steerable robotic needle for minimally invasive tissue biopsy. IEEE Robot Autom Lett, 2021,6(2):1989–1996.
Chitalia Y, Jeong S, Yamamoto KK, Chern JJ, Desai JP. Modeling and control of a 2-dof meso-scale continuum robotic tool for pediatric neurosurgery. IEEE Trans Robot, 2020,37(2):520–531.
Zhang J, Fang Q, Xiang P, Sun D, Xue Y, Jin R, Qiu K, Xiong R, Wang Y, Lu H. A survey on design, actuation, modeling, and control of continuum robot. Cyborg Bionic Syst, 2022:Article 9754697.
Hu H, Wang P, Sun L, Zhao B, Mantian L. Kinematic analysis and simulation for cable-driven continuum robot. J Mech Eng, 2010,46(19):1–8.
Luó X, Feuerstein M, Deguchi D, Kitasaka T, Takabatake H, Mori K. Development and comparison of new hybrid motion tracking for bronchoscopic navigation. Med Image Anal, 2012,16(3):577–596.
Jaeger HA, Nardelli P, O’shea C, Tugwell J, Khan KA, Power T, O’shea M, Kennedy MP, Cantillon-Murphy P. Automated catheter navigation with electromagnetic image guidance. IEEE Trans Biomed Eng, 2017,64(8):1972–1979.
Izzo R, Steinman D, Manini S, Antiga L. The vascular modeling toolkit: A python library for the analysis of tubular structures in medical images. J Open Source Softw, 2018,3(25):745.
Deschamps T, Cohen LD. Fast extraction of minimal paths in 3d images and applications to virtual endoscopy. Med Image Anal, 2001,5(4):281–299.
Li C, Gu X, Xiao X, Lim CM, Ren H. A robotic system with multichannel flexible parallel manipulators for single port access surgery. IEEE Trans Industr Inform, 2018,15(3):1678–1687.
Bakr S, Gevaert O, Echegaray S, Ayers K, Zhou M, Shafiq M, Zheng H, Benson JA, Zhang W, Leung AN, et al. A radiogenomic dataset of non-small cell lung cancer. Sci Data, 2018,5(1):Article 180202.
Tanner C, Boye D, Samei G, Szekely G. Review on 4d models for organ motion compensation. Crit Rev Biomed Eng, 2012,40(2):135–154.
Wagshul ME, Sin S, Lipton ML, Shifteh K, Arens R. Novel retrospective, respiratory-gating method enables 3D, high resolution, dynamic imaging of the upper airway during tidal breathing. Magn Reson Med, 2013,70(6):1580–1590.
京公网安备11010802044758号