Bruce L. Tai

Development of a 3D-printed external ventricular drain placement simulator: technical note.

In this paper, the authors present a physical model developed to simulate accurate external ventricular drain (EVD) placement with realistic haptic and visual feedbacks to serve as a platform for complete procedural training. Insertion of an EVD via ventriculostomy is a common neurosurgical procedure used to monitor intracranial pressures and/or drain CSF. Currently, realistic training tools are scarce and mainly limited to virtual reality simulation systems. The use of 3D printing technology enables the development of realistic anatomical structures and customized design for physical simulators. In this study, the authors used the advantages of 3D printing to directly build the model geometry from stealth head CT scans and build a phantom brain mold based on 3D scans of a plastinated human brain. The resultant simulator provides realistic haptic feedback during a procedure, with visualization of catheter trajectory and fluid drainage. A multiinstitutional survey was also used to prove content validity of the simulator. With minor refinement, this simulator is expected to be a cost-effective tool for training neurosurgical residents in EVD placement.

EVALUATION AND COMPARISON OF LUBRICANT PROPERTIES IN MINIMUM QUANTITY LUBRICATION MACHINING

Minimum Quantity Lubrication (MQL) machining involves the application of a minute amount of an oil-based lubricant to the machining process in an attempt to replace the conventional flood coolant system. Understanding the correlations between fluid properties and MQL performance can help in selecting lubricants from a variety of choices without going through extensive machining tests. This study compared nine different MQL fluids in terms of their physical properties, wettability, tribological properties (lubricity and extreme pressure (EP) properties), mist characteristics and machinability to determine the correlation of measured properties and MQL drilling and reaming performance. Results show that low fluid viscosity, high mist concentration, large mist droplet diameter and high wettability were best correlated with good machinability. Although it is difficult to draw strong relationships, the optimal machining in a mild cutting condition was found with the low viscosity fluids, which may also have the highest mist concentration, largest drops and best wettability.

Thermal model to investigate the temperature in bone grinding for skull base neurosurgery

This study develops a thermal model utilizing the inverse heat transfer method (IHTM) to investigate the bone grinding temperature created by a spherical diamond tool used for skull base neurosurgery. Bone grinding is a critical procedure in the expanded endonasal approach to remove the cranial bone and access to the skull base tumor via nasal corridor. The heat is generated during grinding and could damage the nerve or coagulate the blood in the carotid artery adjacent to the bone. The finite element analysis is adopted to investigate the grinding-induced bone temperature rise. The heat source distribution is defined by the thermal model, and the temperature distribution is solved using the IHTM with experimental inputs. Grinding experiments were conducted on a bovine cortical bone with embedded thermocouples. Results show significant temperature rise in bone grinding. Using 50°C as the threshold, the thermal injury can propagate about 3mm in the traverse direction, and 3mm below the ground surface under the dry grinding condition. The presented methodology demonstrated the capability of being a thermal analysis tool for bone grinding study.

A physical simulator for endoscopic endonasal drilling techniques: technical note.

In this paper, the authors present a physical model developed to teach surgeons the requisite drilling techniques when using an endoscopic endonasal approach (EEA) to the skull base. EEA is increasingly used for treating pathologies of the ventral and ventrolateral cranial base. Endonasal drilling is a unique skill in terms of the instruments used, the long reach required, and the restricted angulation, and gaining competency requires much practice. Based on the successful experience in creating custom simulators, the authors used 3D printing to build an EEA training model from post-processed thin-cut head CT scans, formulating the materials to provide realistic haptic feedback and endoscope handling. They performed a preliminary assessment at 2 institutions to evaluate content validity of the simulator as the first step of the validation process. Overall results were positive, particularly in terms of bony landmarks and haptic response, though minor refinements were suggested prior to use as a training device.

Optimal needle design for minimal insertion force and bevel length

This research presents a methodology for optimal design of the needle geometry to minimize the insertion force and bevel length based on mathematical models of cutting edge inclination and rake angles and the insertion force. In brachytherapy, the needle with lower insertion force typically is easier for guidance and has less deflection. In this study, the needle with lancet point (denoted as lancet needle) is applied to demonstrate the model-based optimization for needle design. Mathematical models to calculate the bevel length and inclination and rake angles for lancet needle are presented. A needle insertion force model is developed to predict the insertion force for lancet needle. The genetic algorithm is utilized to optimize the needle geometry for two cases. One is to minimize the needle insertion force. Using the geometry of a commercial lancet needle as the baseline, the optimized needle has 11% lower insertion force with the same bevel length. The other case is to minimize the bevel length under the same needle insertion force. The optimized design can reduce the bevel length by 46%. Both optimized needle designs were validated experimentally in ex vivo porcine liver needle insertion tests and demonstrated the methodology of the model-based optimal needle design.

The Needle With Lancet Point: Geometry for Needle Tip Grinding and Tissue Insertion Force

The grinding procedure and setup, the cutting edge inclination and rake angles of the needle with lancet point (NLP), and the NLP tissue insertion force are investigated in this paper. The NLP is the most commonly used needle tip geometry. However, there is a lack of research on the NLP grinding and cutting edge characteristics. In this study, a four-step grinding procedure and a mathematical model to calculate the inclination and rake angles along the cutting edge of the NLP are developed. Three cases of NLP are defined based on the relative position of the lancets. Prototype NLP for each case was produced and analyzed. Compared to the regular bias bevel needle, grinding two lancets in NLP can increases the inclination angle, particularly at the needle tip. Experiments with needle insertion into the porcine liver were conducted and results showed that NLP could achieve over 40% reduction of the initial peak needle insertion force compared to that of the regular bias bevel needle tip.

Silicone-Based Tissue-Mimicking Phantom for Needle Insertion Simulation

Silicone-based tissue-mimicking phantom is widely used as a surrogate of tissue for clinical simulators, allowing clinicians to practice medical procedures and researchers to study the performance of medical devices. This study investigates using the mineral oil in room-temperature vulcanizing silicone to create the desired mechanical properties and needle insertion characteristics of a tissue-mimicking phantom. Silicone samples mixed with 0, 20, 30, and 40 wt. % mineral oil were fabricated for indentation and needle insertion tests and compared to four types of porcine tissues (liver, muscle with the fiber perpendicular or parallel to the needle, and fat). The results demonstrated that the elastic modulus and needle insertion force of the phantom both decrease with an increasing concentration of mineral oil. Use of the mineral oil in silicone could effectively tailor the elastic modulus and needle insertion force to mimic the soft tissue. The silicone mixed with 40 wt. % mineral oil was found to be the best tissue-mimicking phantom and can be utilized for needle-based medical procedures.

Workpiece Thermal Distortion in Minimum Quantity Lubrication Deep Hole Drilling—Finite Element Modeling and Experimental Validation

This paper presents the three dimensional (3-D) finite element analysis (FEA) to predict the workpiece thermal distortion in drilling multiple deep-holes under minimum quantity lubrication (MQL) condition. Heat sources on the drilling hole bottom surface (HBS) and hole wall surface (HWS) are first determined by the inverse heat transfer method. A 3-D heat carrier consisting of shell elements to carry the HWS heat flux and solid elements to carry the HBS heat flux has been developed to conduct the heat to the workpiece during the drilling simulation. A thermal–elastic coupled FEA was applied to calculate the workpiece thermal distortion based on the temperature distribution. The concept of the heat carrier was validated by comparing the temperature calculation with an existing 2-D advection model. The 3-D thermal distortion was validated experimentally on an aluminum workpiece with four deep-holes drilled sequentially. The measured distortion on the reference point was 61 μm, which matches within uncertainty the FEA predicted distortion of 51 μm.

An Inverse Heat Transfer Method for Determining Workpiece Temperature in Minimum Quantity Lubrication Deep Hole Drilling

This study investigates the workpiece temperature in minimum quantity lubrication (MQL) deep hole drilling. An inverse heat transfer method is developed to estimate the spatial and temporal change of heat flux on the drilled hole wall surfaces based on the workpiece temperature measured using embedded thermocouples and analyzed using the finite element method. The inverse method is validated experimentally in both dry and MQL deep-hole drilling conditions and the results show good agreement with the experimental temperature measurements. This study demonstrates that the heat generated on the hole wall surface is significant in deep hole drilling. In the example of deep hole drilling of ductile iron, the level of thermal power applied on the hole wall surface is about the same as that on the hole bottom surface when a 10 mm drill reached a depth of 120 mm.

Positional accuracy and transmitter orientation of the 3D electromagnetic tracking system

This research investigates the positional accuracy and effects of transmitter orientation of a 3D electromagnetic tracking (EMT) system. EMT systems, capable of real-time position and orientation monitoring, are commonly used in computer-aided surgical navigation and path monitoring. In this study, positional information is evaluated for accuracy by comparing the EMT system against laser interferometer measurements in three orthogonal axes with step sizes between 0.1 and 0.5 mm. The effect of transmitter orientation is evaluated by placing the transmitter with either the front or the side facing the magnetic sensor. Gauge repeatability and reproducibility results demonstrate that the EMT system can accurately measure the motion with a tolerance of 0.2 mm with 0.5 s measurement time. The transmitter oriented with the front facing the sensor has a higher positional accuracy than that of the side transmitter orientation. High accuracy of the EMT system combined with the knowledge of transmitter orientation information presents the potential for accurate navigation and path monitoring in medical procedures.