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. 2022 Dec;18(6):e2434.
doi: 10.1002/rcs.2434. Epub 2022 Jun 29.

Needle path planning in semiautonomous and teleoperated robot-assisted epidural anaesthesia procedure: A proof of concept

Daniel Haro-Mendoza  1 , Fernando Pérez-Escamirosa  2 , Diego Pineda-Martínez  3 , Victor J Gonzalez-Villela  1
Affiliations

Needle path planning in semiautonomous and teleoperated robot-assisted epidural anaesthesia procedure: A proof of concept

Daniel Haro-Mendoza et al. Int J Med Robot. 2022 Dec.

Abstract

Background: Epidural anaesthesia is a Percutaneous Procedure (PP) which plays a crucial role in surgical procedures, where accurate needle insertion is still challenging. The objective of this work is to present a Tuohy needle path planning, which allows an anaesthesiologist to drive semiautonomously, with the assistance of a teleoperated robot, the tip of the needle during this PP.

Methods: We capture, analysed and modelled the anaesthetist hands' motion during the execution of this procedure, by synthetising, programing and simulating a parametrised and normalised kinematic constrains dependent on an insertion variable in a virtual robot.

Results: Two preoperative path planning models were obtained, which provide a teleoperated robot with kinematic constraints to semiautonomously drive a Tuohy needle in the epidural anaesthesia procedure.

Conclusions: A semiautonomous robot can assist in the execution of this PP using the kinematic constraints obtained from the study of the movement of a specialist's hands.

Keywords: epidural anaesthesia procedure; needle path planning; percutaneous procedure; semiautonomous robot.

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Conflict of interest statement

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Figures

FIGURE 1
FIGURE 1
A simplified schematic of both the lumbar vertebrae anatomy and the Tuohy needle placement in the epidural anaesthesia procedure
FIGURE 2
FIGURE 2
The anaesthetist is observed manipulating a Tuohy needle placed in the pantograph to perform an epidural anaesthesia procedure on a cadaver at the Department of Innovation in Human Biological Material of the Faculty of Medicine, UNAM
FIGURE 3
FIGURE 3
(A) Serial mechanism of 5‐degrees‐of‐freedom (pantograph) with a Tuohy needle attached on its last link. (B) Diagram of the definition of the pantograph's joint rotational axes and the coordinate axes for its direct kinematics calculation
FIGURE 4
FIGURE 4
Graphical results of the data collection on the movements of the base of the Tuohy needle when it was manipulated by an anaesthetist who performed six epidural anaesthesia procedures on the cadaver
FIGURE 5
FIGURE 5
(A) Shows the evolution of the needle base insertion variable ψ i (t) on the x‐axis for each procedure, which is the result of the linear interpolation of the discrete function x i [n]. (B) shows the evolution of the needle base orientation variable y i (t) on the y‐axis for each procedure, which is the result of curve fitting of the discrete function y i [n]. (C) shows the evolution of the needle base orientation variable z i (t) on the z‐axis for each procedure, which is the result of curve fitting of the discrete function z i [n]
FIGURE 6
FIGURE 6
(A) Adjusted, normalised, and parameterised curves of the movements of an anaesthetist in each of the six epidural anaesthesia procedures. (B) First synthesised‐parameterised‐GS of the epidural anaesthesia procedure. (C) Second synthesised‐parameterised‐GS of the epidural anaesthesia procedure
FIGURE 7
FIGURE 7
(A) Lateral view of the workspace of the robot. (B) Top view of the workspace of the robot. (C) Virtual environment for simulating the robot‐assisted epidural anaesthesia procedure, where the placement of the robot with respect to the vertebral column is shown
FIGURE 8
FIGURE 8
(A) Depicts the paths performed by the robot in each test, where y GS1 (ψ) and z GS1 (ψ) are the functions that describe the first path and y GS2 (ψ) and z GS2 (ψ) are the functions that describe the second path. (B) Tissue reaction force at the needle tip caused during the Epidural Anaesthesia Procedure (EAP) execution
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