1. Robotic Needle End Arm Effector for Integration With CT Scan
Team Members:
David Sun
Chris Willingham
Advisor:
Dr. Bradford Wood

2. Problem Definition and Background
CT assisted fluoroscopy allows surgical procedures such as tissue biopsy and ablation to be performed with several advantages over traditional techniques (Solomon 2002):
The method allows visualization for interventional procedures
Procedures are performed in real time
The process is faster and more accurate than traditional methods
Cases show greater success rates (improved patient outcomes)
The primary disadvantage to this method is the radiation exposure received by the physician during the procedure:
2mGy per procedure
500mSv annual limit
Each physician is thus limited to 4 procedures per year

3. Project Statement
A robotic system which reduces radiation exposure during CT assisted fluoroscopy while providing greater accuracy and precision is feasible (Cleary and Nguyen, 2001).
One of the primary limitations to this system is its ability to place instruments with the “touch” that a skilled physician provides (Stoianovici and Cleary 2002).

4. Project Goal
A successful resolution to this problem will remove the physician from the operating suite, and provide a robotic arm end effector that addresses these factors:
It will allow for respiratory motion in the craniocaudal axis.
It will allow 6+ degrees of freedom during instrument placement, and free range of motion after placement.
It will provide an interface for various instruments at a common joint.
Should be easily adaptable to other systems

5. Current System

6. Ideal System

7. Proposed System

8. Procedural Benefits
Increasing the speed and accuracy and decreasing the cost of procedures such as tissue biopsy will allow several profitable benefits:
An increased number of routine procedures such as the staging of tumors and hepatitis C can be performed (increased revenue and improved patient outcomes)
An expanded schedule in the operating room will allow more cutting edge procedures such as proteomic and genomic analysis of tissue to allow targeting of smart drugs
Combination of robotic systems with image guided surgery techniques will one day help to completely automate mundane surgical procedures

9. Johns Hopkins Robotic System

10. Current Robotic Arm System
Georgetown Robotic Arm
Medtronic Robotic Arm

11. Arm Modification

12. Proposed End-Effector

13. Status Analyzed and assembled frame and mounting arm from NIH
Analyzing biopsy needle from NIH and redesigning needle interface based on findings
Consulted with Physic’s machine shop regarding mechanical arm modification ($200)
Patent search for similar devices (micropat.com)
Acquiring FLEXBAR device from NIH
Searched products that matches our crude solution: Parallel MiniGripper
Beginning production of mechanical drawing for the flexible arm and gripper (CAD)

14. Future Work
Appointment with Dr. Lee Gordon and Dr. Ron Price to observe biopsy for operational constraints
Continue modification of FLEXBAR to interface with the robotic arm—possible cable attachments, electronic locking
Consult with machine shop for possible gripper solution
Produce a liver phantom via silicon gel polyurethane
Consult with Dr. Bob Galloway for modifications to proposed solution
Use SolidEdge™ 2002 to model end-effector for prototype purposes
Prototype, testing, and early FDA requirements

15. Conclusion Current Situation? Problems? Chances of Success?
Finished research and brainstorm phase
Continuing design and modifications
Continue consultation with surgeons and engineers for feedback
Refine possible solutions
Problems?
Respiratory motion in the craniocaudal axis
Needle interface
Electrical interface necessary for performance
Chances of Success?
Design idea is progressing well
Limiting design to a mechanical prototype to obtain testable results

16. References
Solomon, Stephen, et. al. Robotically Drive Intervention: A method of Using CT Fluoroscopy without Radiation Exposure to the Physician. Radiology Volume 225-Number 1.
Stoianovici, Dan, et. al. AcuBot: A Robot for Radiological Interventions. IEEE-TR&A.
Cleary, Kevin, et. al. State of the Art in Surgical Robotics:Clinical Applications and Technology Challenges. Computer Aided Surgery, August 2001.
Saadeh, Sherif, et. al. The Role of Liver Biopsy in Chronic Hepatitis C. Hepatology, Volume 33, 2001.

17. Contacts david.d.sun@vanderbilt.edu jc.willin@vanderbilt.edu David Sun
Chris Willingham