Marco Beccani

Real-Time Pose Detection for Magnetic Medical Devices

Magnetic coupling is one of the few physical phenomena capable of transmitting motion across a physical barrier. In gastrointestinal endoscopy, remote magnetic manipulation has the potential to make screening less invasive and more acceptable, thus saving lives by early diagnoses and treatment. Closed-loop control of the magnetic device position is crucial for a safe and reliable operation. In order to implement closed-loop control, the pose (position and orientation) of the device must be available in real-time. This becomes challenging if magnetic coupling is achieved by permanent magnets, since the strong magnetic field required for manipulation interferes with current localization techniques. In this work, we present a novel real-time pose detection strategy that is compatible with magnetic manipulation based on permanent magnets. The localization algorithm combines multiple sensor readings with a pre-calculated magnetic field map. The proposed approach is able to provide an average error below 5 mm in position detection, and below 19° for angular motion within a spherical workspace of 15 cm in radius.

Wireless Tissue Palpation for Intraoperative Detection of Lumps in the Soft Tissue

In an open surgery, identification of precise margins for curative tissue resection is performed by manual palpation. This is not the case for minimally invasive and robotic procedures, where tactile feedback is either distorted or not available. In this paper, we introduce the concept of intraoperative wireless tissue palpation. The wireless palpation probe (WPP) is a cylindrical device (15 mm in diameter, 60 mm in length) that can be deployed through a trocar incision and directly controlled by the surgeon to create a volumetric stiffness distribution map of the region of interest. This map can then be used to guide the tissue resection to minimize healthy tissue loss. The wireless operation prevents the need for a dedicated port and reduces the chance of instrument clashing in the operating field. The WPP is able to measure in real time the indentation pressure with a sensitivity of 34 Pa, the indentation depth with an accuracy of 0.68 mm, and the probe position with a maximum error of 11.3 mm in a tridimensional workspace. The WPP was assessed on the benchtop in detecting the local stiffness of two different silicone tissue simulators (elastic modulus ranging from 45 to 220 kPa), showing a maximum relative error below 5%. Then, in vivo trials were aimed to identify an agar-gel lump injected into a porcine liver and to assess the device usability within the frame of a laparoscopic procedure. The stiffness map created intraoperatively by the WPP was compared with a map generated ex vivo by a standard uniaxial material tester, showing less than 8% local stiffness error at the site of the lump.

Wireless tissue palpation: Proof of concept for a single degree of freedom

Palpating tissues and organs to identify hidden tumors or to detect buried vessels is not a viable option in laparoscopic surgery due to lack of force feedback. So far, research toward restoring tactile and kinesthetic sensations in minimally invasive surgery has focused on the distal sensing element or on the proximal rendering of haptic cues. In this work we present a pilot study to assess the feasibility of wireless tissue palpation, where a magnetic device is deployed through a standard surgical trocar and operated to perform tissue palpation without requiring a dedicated entry port. The setup consists of a wireless intra-body device and an external robotic manipulator holding a load cell and a permanent magnet. Embedded in the wireless cylindrical device (12.7 mm in diameter and 27.5 mm in height) is a sensing module, a wireless microcontroller, a battery and a permanent magnet. This preliminary study assessed the precision in reconstructing the indentation depth based on magnetic field measurements at the wireless device (i.e., 0.1 mm accuracy). Experimental trials demonstrated the effectiveness of wireless vertical indentation in detecting the elastic modulus of three different silicone tissue simulators (elastic modulus ranging from 50 kPa to 93 kPa), showing a maximum relative error below 3%. Finally, wireless palpation was used to identify differences in tissue stiffness from a lump embedded into a porcine liver. The reported results have the potential to open a new paradigm in the field of palpation devices, where direct physical connection across the abdominal wall is no longer required.

Jacobian-Based Iterative Method for Magnetic Localization in Robotic Capsule Endoscopy

The purpose of this study is to validate a Jacobian-based iterative method for real-time localization of magnetically controlled endoscopic capsules. The proposed approach applies finite-element solutions to the magnetic field problem and least-squares interpolations to obtain closed-form and fast estimates of the magnetic field. By defining a closed-form expression for the Jacobian of the magnetic field relative to changes in the capsule pose, we are able to obtain an iterative localization at a faster computational time when compared with prior works, without suffering from the inaccuracies stemming from dipole assumptions. This new algorithm can be used in conjunction with an absolute localization technique that provides initialization values at a slower refresh rate. The proposed approach was assessed via simulation and experimental trials, adopting a wireless capsule equipped with a permanent magnet, six magnetic field sensors, and an inertial measurement unit. The overall refresh rate, including sensor data acquisition and wireless communication was 7 ms, thus enabling closed-loop control strategies for magnetic manipulation running faster than 100 Hz. The average localization error, expressed in cylindrical coordinates was below 7 mm in both the radial and axial components and 5

Closed-Loop Control of Local Magnetic Actuation for Robotic Surgical Instruments

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A Platform for Gastric Cancer Screening in Low- and Middle-Income Countries

in the azimuthal component. The average error for the capsule orientation angles, obtained by fusing gyroscope and inclinometer measurements, was below 5

Systematic Design of Medical Capsule Robots

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Design and implementation of an instrumented cane for gait recognition

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Toward rapid prototyping of miniature Capsule Robots

We propose local magnetic actuation (LMA) as an approach to robotic actuation for surgical instruments. An LMA actuation unit consists of a pair of diametrically magnetized single-dipole cylindrical magnets, working as magnetic gears across the abdominal wall. In this study, we developed a dynamic model for an LMA actuation unit by extending the theory proposed for coaxial magnetic gears. The dynamic model was used for closed-loop control, and two alternative strategies-using either the angular velocity at the motor or at the load as feedback parameter-were compared. The amount of mechanical power that can be transferred across the abdominal wall at different intermagnetic distances was also investigated. The proposed dynamic model presented a relative error below 7.5% in estimating the load torque from the system parameters. Both the strategies proposed for closed-loop control were effective in regulating the load speed with a relative error below 2% of the desired steady-state value. However, the load-side closed-loop control approach was more precise and allowed the system to transmit larger values of torque, showing, at the same time, less dependence from the angular velocity. In particular, an average value of 1.5 mN·m can be transferred at 7 cm, increasing up to 13.5 mN·m as the separation distance is reduced down to 2 cm. Given the constraints in diameter and volume for a surgical instrument, the proposed approach allows for transferring a larger amount of mechanical power than what would be possible to achieve by embedding commercial dc motors.

Uniaxial Wireless Tissue Palpation Device for Minimally Invasive Surgery

Gastric cancer is the second leading cause of cancer death worldwide and screening programs have had a significant impact on reducing mortality. The majority of cases occur in low- and middle-income countries (LMIC), where endoscopy resources are traditionally limited. In this paper, we introduce a platform designed to enable inexpensive gastric screening to take place in remote areas of LMIC. The system consists of a swallowable endoscopic capsule connected to an external water distribution system by a multichannel soft tether. Pressurized water is ejected from the capsule to orient the view of the endoscopic camera. After completion of a cancer screening procedure, the outer shell of the capsule and the soft tether can be disposed, while the endoscopic camera is reclaimed without needing further reprocessing. The capsule, measuring 12 mm in diameter and 28 mm in length, is able to visualize the inside of the gastric cavity by combining waterjet actuation and the adjustment of the tether length. Experimental assessment was accomplished through a set of bench trials, ex vivo analysis, and in vivo feasibility validation. During the ex vivo trials, the platform was able to visualize the main landmarks that are typically observed during a gastric cancer screening procedure in less than 8 min. Given the compact footprint, the minimal cost of the disposable parts, and the possibility of running on relatively available and inexpensive resources, the proposed platform can potentially widen gastric cancer screening programs in LMIC.