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International Journal of Computer Assisted Radiology and Surgery

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01-02-2019 | Original Article

Combined OCT distance and FBG force sensing cannulation needle for retinal vein cannulation: in vivo animal validation

Authors: M. Ourak, J. Smits, L. Esteveny, G. Borghesan, A. Gijbels, L. Schoevaerdts, Y. Douven, J. Scholtes, E. Lankenau, T. Eixmann, H. Schulz-Hildebrandt, G. Hüttmann, M. Kozlovszky, G. Kronreif, K. Willekens, P. Stalmans, K. Faridpooya, M. Cereda, A. Giani, G. Staurenghi, D. Reynaerts, E. B. Vander Poorten

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 2/2019

Abstract

Purpose

Retinal vein cannulation is an experimental procedure during which a clot-dissolving drug is injected into an obstructed retinal vein. However, due to the fragility and minute size of retinal veins, such procedure is considered too risky to perform manually. With the aid of surgical robots, key limiting factors such as: unwanted eye rotations, hand tremor and instrument immobilization can be tackled. However, local instrument anatomy distance and force estimation remain unresolved issues. A reliable, real-time local interaction estimation between instrument tip and the retina could be a solution. This paper reports on the development of a combined force and distance sensing cannulation needle, and its experimental validation during in vivo animal trials.

Methods

Two prototypes are reported, relying on force and distance measurements based on FBG and OCT A-scan fibres, respectively. Both instruments provide an 80 \(\upmu \hbox {m}\) needle tip and have outer shaft diameters of 0.6 and 2.3 mm, respectively.

Results

Both prototypes were characterized and experimentally validated ex vivo. Then, paired with a previously developed surgical robot, in vivo experimental validation was performed. The first prototype successfully demonstrated the feasibility of using a combined force and distance sensing instrument in an in vivo setting.

Conclusion

The results demonstrate the feasibility of deploying a combined sensing instrument in an in vivo setting. The performed study provides a foundation for further work on real-time local modelling of the surgical scene. This paper provides initial insights; however, additional processing remains necessary.

Ambastha S, Umesh S, Dabir S, Asokan S (2016) Spinal needle force monitoring during lumbar puncture using fiber Bragg grating force device. J Biomed Opt 21(11):117002PubMed

Asami T, Terasaki H, Ito Y, Sugita T, Kaneko H, Nishiyama J, Namiki H, Kobayashi M, Nishizawa N (2016) Development of a fiber-optic optical coherence tomography probe for intraocular use. Investig Opthalmol Vis Sci 57(9):OCT568–OCT574

Balicki M, Han Jh, Iordachita I, Gehlbach P, Handa J, Taylor R, Kang J (2009) Single fiber optical coherence tomography microsurgical instruments for computer and robot-assisted retinal surgery. In: Medical image computing and computer-assisted intervention, pp 108–115

Borghesan G, Ourak M, Lankenau E, Hüttmann G, Schulz-Hildebrant H, Willekens K, Stalmans P, Reynaerts D, Vander Poorten E (2018) Single scan OCT-based retina detection for robot-assisted retinal vein cannulation. J Med Robot Res 3(02):1840005

Bruyninckx H, Soetens P, Koninckx B (2003) The real-time motion control core of the Orocos project. In: IEEE international conference on robotics and automation, vol 2, pp 2766–2771

Du LT, Wessels IF, Underdahl JP, Auran JD (2001) Stereoacuity and depth perception decrease with increased instrument magnification: comparing a non-magnified system with lens loupes and a surgical microscope. Binocul Vis Strabismus Q 16(1):61–7PubMed

Ehlers JP, Srivastava SK, Feiler D, Noonan AI, Rollins AM, Tao YK (2014) Integrative Advances for OCT-guided ophthalmic surgery and intraoperative OCT: microscope integration, surgical instrumentation, and heads-up display surgeon feedback. PLoS ONE 9(8):e105224PubMedPubMedCentral

Ergeneman O, Pokki J, Počepcovà V, Hall H, Abbott JJ, Nelson BJ (2011) Characterization of puncture forces for retinal vein cannulation. J Med Devices 5(4):044504

Gijbels A, Vander Poorten EB, Stalmans P, Reynaerts D (2015) Development and experimental validation of a force sensing needle for robotically assisted retinal vein cannulations. In: IEEE international conference on robotics and automation, pp 2270–2276

10.

Gijbels A, Willekens K, Esteveny L, Stalmans P, Reynaerts D, Vander Poorten EB (2016) Towards a clinically applicable robotic assistance system for retinal vein cannulation. In: IEEE international conference on biomedical robotics and biomechatronics, pp 284–291

11.

Gonenc B, Chamani A, Handa J, Gehlbach P, Taylor R, Iordachita I (2017) 3-DOF force-sensing motorized micro-forceps for robot-assisted vitreoretinal surgery. IEEE Sens 17(11):3526–3541

12.

Gonenc B, Iordachita I (2016) FBG-based transverse and axial force-sensing micro-forceps for retinal microsurgery. In: IEEE sensors

13.

Gonenc B, Taylor RH, Iordachita I, Gehlbach P, Handa J (2014) Force-sensing microneedle for assisted retinal vein cannulation. In: IEEE sensors proceedings, pp 698–701

14.

Gonenc B, Tran N, Riviere CN, Gehlbach P, Taylor RH, Iordachita I (2015) Force-based puncture detection and active position holding for assisted retinal vein cannulation. In: IEEE/SICE/RSJ international conference on multisensor fusion and integration for intelligent systems, pp 322–327

15.

Hayreh SS, Zimmerman MB, Podhajsky P (1994) Incidence of various types of retinal vein occlusion and their recurrence and demographic characteristics. Am J Ophthalmol 117(4):429–441PubMed

16.

He X, Handa J, Gehlbach P, Taylor RH, Iordachita I (2014) A submillimetric 3-DOF force sensing instrument with integrated fiber bragg grating for retinal microsurgery. IEEE Trans Biomed Eng 61(2):522–534PubMedPubMedCentral

17.

Iordachita I, Sun Z, Balicki M, Kang JU, Phee SJ, Handa J, Gehlbach P, Taylor R (2009) A sub-millimetric, 0.25 mN resolution fully integrated fiber-optic force-sensing tool for retinal microsurgery. Int J Comput Assist Radiol Surg 4(4):383–390PubMedPubMedCentral

18.

Menciassi A, Eisinberg A, Scalari G, Anticoli C, Carrozza M, Dario P (2001) Force feedback-based microinstrument for measuring tissue properties and pulse in microsurgery. In: IEEE international conference on robotics and automation, vol 1, pp 626–631

19.

Molaei A, Abedloo E, de Smet MD, Safi S, Khorshidifar M, Ahmadieh H, Khosravi MA, Daftarian N (2017) Toward the art of robotic-assisted vitreoretinal surgery. J Ophthalmic Vis Res 12:175–182

20.

Noda Y, Ida Y, Tanaka S, Toyama T, Roggia MF, Tamaki Y, Sugita N, Mitsuishi M, Ueta T (2013) Impact of robotic assistance on precision of vitreoretinal surgical procedures. PLoS ONE 8:1–6

21.

Olver J, Cassidy L (2005) Ophthalmology at a glance. Blackwell Science, Hoboken

22.

Peirs J, Clijnen J, Reynaerts D, Brussel HV, Herijgers P, Corteville B, Boone S (2004) A micro optical force sensor for force feedback during minimally invasive robotic surgery. Sens Actuators A 115(2–3):447–455

23.

Riviere C, Ang WT, Khosla P (2003) Toward active tremor canceling in handheld microsurgical instruments. IEEE Trans Robot Autom 19:793–800

24.

Rogers S, Mcintosh RL, Grad B, Journ D, Cheung N, Lim L, Wang JJ, Mitchell P, Kowalski JW, Nguyen H, Wong TY (2011) The prevalence of retinal vein occlusion: pooled data from population studies from the United States, Europe, Asia, and Australia. Popul Stud 117:1–14

25.

Sjaarda RN, Glaser BM, Thompson JT, Murphy RP, Hanham A (1995) Distribution of iatrogenic retinal breaks in macular hole surgery. Ophthalmology 102(9):1387–1392PubMed

26.

Smits J, Mouloud O, Gijbels A, Esteveny L, Borghesan G, Schoevaerdts L, Willekens K, Stalmans P, Lankenau E, Schulz-Hildebrant H, Hüttmann G, Reynaerts D, Vander Poorten, E (2018) Development and experimental validation of a combined FBG force and OCT distance sensing needle for robot-assisted retinal vein cannulation. In: IEEE international conference on robotics and automation

27.

Smits J, Ourak M, Gijbels A, Borghesan G, Esteveny L, Schoevaerdts L, Willekens K, Stalmans P, Lankenau E, Hüttmann G, Reynaerts D, Poorten EBV (2017) Combined force and distance sensing for robot-assisted vitreo-retinal surgery. In: Proceedings of the 7th joint workshop on new technologies for computer/robot assisted surgery

28.

Song C, Gehlbach PL, Kang JU (2012) Active tremor cancellation by a “smart” handheld vitreoretinal microsurgical tool using swept source optical coherence tomography. Opt Express 20(21):23414–23421PubMedPubMedCentral

29.

Tang WM, Han DP (2000) A study of surgical approaches to retinal vascular occlusions. Arch Ophthalmol 118(1):138–43PubMed

30.

Zhang X (2004) Silicon microsurgery-force sensor based on diffractive optical MEMS encoders. Sensor Rev 24(1):37–41

Title: Combined OCT distance and FBG force sensing cannulation needle for retinal vein cannulation: in vivo animal validation
Authors: M. Ourak
J. Smits
L. Esteveny
G. Borghesan
A. Gijbels
L. Schoevaerdts
Y. Douven
J. Scholtes
E. Lankenau
T. Eixmann
H. Schulz-Hildebrandt
G. Hüttmann
M. Kozlovszky
G. Kronreif
K. Willekens
P. Stalmans
K. Faridpooya
M. Cereda
A. Giani
G. Staurenghi
D. Reynaerts
E. B. Vander Poorten
Publication date: 01-02-2019
Publisher: Springer International Publishing
Published in: International Journal of Computer Assisted Radiology and Surgery / Issue 2/2019
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-018-1829-0

At a glance: The STEP trials

Springer Medicine

Combined OCT distance and FBG force sensing cannulation needle for retinal vein cannulation: in vivo animal validation

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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