Preoperative Motion Planner for Steerable Needles Using Cost Map Based on Repulsive Field and Empirical Model of Needle Deflection

2021 ◽  
Author(s):  
Shan Jiang ◽  
Bowen Jiang ◽  
Peina Fang ◽  
Zhiyong Yang
Keyword(s):  
Needle Insertion ◽  
Risk Level ◽  
Positioning Error ◽  
Common Procedure ◽  
Straight Line ◽  
Insertion Method ◽  
Steerable Needles ◽  
Needle Trajectory ◽  
The Cost ◽  
Steerable Needle

Abstract Needle insertion is a common procedure in percutaneous puncture. A motion planner for a steerable needle that considers the risk level of the path in anatomical environment and the actual deflection of clinical needle is necessary. A novel preoperative motion planner for a steerable needle controlled by robot is proposed. Our method utilizes sampling-based planner to compute candidate path in the reachable region, the path solutions are optimized by calculating the cost of a path based on a cost map. The cost-map, which is built based on repulsive field theory from CT image, encodes the information of the obstacle locations and the criticality of the anatomical environment. The empirical formula that can predict needle trajectory is obtained by insertion experiments. Experiments shown that positioning error in gelatin phantom under the guidance of our planner is less than 1.1mm. Comparing with the straight-line insertion method, the positioning error was reduced by 80%. The results indicate that the motion planner has the potential to provide effective guidance for robot-assisted puncture surgery while enhancing the position precision and patient safety.

Steerable Needle Trajectory Following in the Lung: Torsional Deadband Compensation and Full Pose Estimation With 5DOF Feedback for Needles Passing Through Flexible Endoscopes

2020 ◽  
Author(s):  
Tayfun Efe Ertop ◽  
Maxwell Emerson ◽  
Margaret Rox ◽  
Josephine Granna ◽  
Robert Webster ◽  
...  
Keyword(s):  
Kalman Filter ◽  
Sliding Mode ◽  
Ex Vivo ◽  
Flexible Bronchoscope ◽  
Complex Interactions ◽  
Trajectory Following ◽  
Steerable Needles ◽  
Needle Trajectory ◽  
Following Error ◽  
Steerable Needle

Abstract Bronchoscopic diagnosis and intervention in the lung is a new frontier for steerable needles, where they have the potential to enable minimally invasive, accurate access to small nodules that cannot be reliably accessed today. However, the curved, flexible bronchoscope requires a much longer needle than prior work has considered, with complex interactions between the needle and bronchoscope channel, introducing new challenges in steerable needle control. In particular, friction between the working channel and needle causes torsional windup along the bronchoscope, the effects of which cannot be directly measured at the tip of thin needles embedded with 5 degree-of-freedom magnetic tracking coils. To compensate for these effects, we propose a new torsional deadband-aware Extended Kalman Filter to estimate the full needle tip pose including the axial angle, which defines its steering direction. We use the Kalman Filter estimates with an established sliding mode controller to steer along desired trajectories in lung tissue. We demonstrate that this simple torsional deadband model is sufficient to account for the complex interactions between the needle and endoscope channel for control purposes. We measure mean final targeting error of 1.36 mm in phantom tissue and 1.84 mm in ex-vivo porcine lung, with mean trajectory following error of 1.28 mm and 1.10 mm, respectively.

THE TECHNICAL CONDITION OF THE SURVEYED HYDRAULIC UNITS IN THE MOSCOW REGION AND THE CLASSIFICATION FEATURES OF THEIR RESERVOIRS

2021 ◽  
pp. 69-79
Author(s):  
V. V. GRITSAN ◽  
Keyword(s):  
Technical Condition ◽  
Moscow Region ◽  
Risk Level ◽  
Ecological Framework ◽  
Safety Level ◽  
Repair Work ◽  
Hydraulic Unit ◽  
Technical Parameters ◽  
Characteristic Features ◽  
The Cost

The article presents the results of surveys of 311 class IV hydraulic structures carried out in 2016-2020 in the Moscow region. All the reservoirs of the surveyed hydraulic units were classified according to their characteristic features, the technical condition of culverts and dams was assessed, there was established the safety level of both separate structures and hydraulic units as a whole. During the surveys, the technical parameters of the surveyed structures were established, the state of each structure and the hydraulic unit as a whole was assessed, a possibility of their accident and a risk level for the downstream areas were considered. At the same time, recommendations were developed for the elimination of serious damage and, with the help of an examination, the amount of the cost of the necessary repair work was determined. The paper also assesses the issues of the ecological state of the areas where the hydraulic units are located and the hydraulic units themselves as blocks of the ecological framework of the territories.

Needle Insertion Control Method for Minimizing Both Deflection and Tissue Damage

2019 ◽  
Vol 04 (01) ◽  
pp. 1842005
Author(s):  
Ryosuke Tsumura ◽  
Yusuke Takishita ◽  
Hiroyasu Iwata
Keyword(s):  
Tissue Damage ◽  
Control Method ◽  
Axial Rotation ◽  
Needle Insertion ◽  
Experimental Results ◽  
Insertion Force ◽  
Tissue Sections ◽  
Needle Deflection ◽  
Hole Area ◽  
Insertion Method

Because fine needles can easily be deflected, accurate needle insertion is often difficult. Lower abdominal insertion is particularly difficult because of less imaging feedback; thus, an approach for allowing a straight insertion path by minimizing deflection is beneficial in cases of lower abdominal insertion. Although insertion with axial rotation can minimize deflection, the rotational insertion may cause tissue damage. Therefore, we established a novel insertion method for minimizing both deflection and tissue damage by combining rotation and vibration. Using layered tissues, we evaluated the effect of a combination of rotation and vibration in terms of deflection and tissue damage, which were measured by the insertion force and torque, and the area of the hole created by the needle using histological tissue sections to measure tissue damage. The experimental results demonstrated that insertion with unidirectional rotation is risky in terms of tissue wind-up, while insertion with bidirectional rotation can decrease deflection and avoid wind-up. We also found that insertion with vibration can decrease the insertion force and torque. Therefore, insertion with a combination of bidirectional rotation and vibration can minimize needle deflection and tissue damage, including the insertion force and torque and the hole area.

scholarly journals Comparison between subcutaneous ketamine with intramuscular pethidine versus intramuscular pethidine for post-operative analgesia after cesarean section

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
B M E Noureldin ◽  
M M Kamal ◽  
A A A Bedewy ◽  
H M M Sultan
Keyword(s):  
Cesarean Section ◽  
Total Dose ◽  
Pain Control ◽  
Well Being ◽  
University Hospitals ◽  
Common Procedure ◽  
Operative Care ◽  
Group A ◽  
Group B ◽  
The Cost

Abstract Background Cesarean section is one of the most common operations. Women undergoing cesarean delivery should achieve adequate postoperative pain relief because of different factors related to the operation complications as well as maternal and neonatal well-being. Immobility due to inadequate pain control could result in thrombo-embolic events, inappropriate neonatal care and delay in discharge which consequently increase the cost of this common procedure both for patients and health care system. Objective to investigate the efficacy of adding subcutaneous ketamine for postoperative analgesia in cesarean section and comparing it to using intramuscular pethidine only regarding opioid requirements and pain level. Patients and Methods The present study was carried out on two groups of women (each group consists of 25) after undergoing cesarean section under spinal anesthesia in Ain Shams University Hospitals and Helwan University Hospitals. Group A patients were given three doses of subcutaneous ketamine (0.9 mg/kg) at post-operative care unit (PACU), 12 and 24 hours after the operation with intramuscular pethidine (50mg) given when patients’ numerical pain score exceeded 5. Group B patients were given three doses of placebo at same intervals as group A and were given intramuscular pethidine (50mg) when NRS score exceeded 5. Results There was significant decrease in pain scores between two groups PACU, 12 and 24 hours postoperative with no significant change in the rest of the study. There was highly significant increase in the time to first pethidine demand in group A than B. There was highly significant decrease in total dose of pethidine given (in group A than in B. Conclusion Subcutaneous ketamine with a dose of (0.9mg/kg) can be used in reducing pain in postoperative period after CS with minimal side effects. The addition of SC ketamine to the pethidine appear to cause more pain control and decrease the total dose of pethidine given in post-operative period.

35 Development of an automatic tapping device: a new needle insertion method for prostate brachytherapy

2005 ◽  
Vol 76 ◽  
pp. S27
Author(s):  
V. Lagerburg ◽  
M. Moerland ◽  
M. Konings ◽  
R. Van de Vosse ◽  
J. Lagendijk ◽  
...  
Keyword(s):  
Needle Insertion ◽  
Prostate Brachytherapy ◽  
Insertion Method

Analysis of Shortest Path Routing for Large Multi-Hop Wireless Networks

2018 ◽  
Vol 7 (3.10) ◽  
pp. 59 ◽  
Author(s):  
Ms S.Girija ◽  
Mrs S.Kayathri ◽  
Ms S.Meena
Keyword(s):  
Wireless Networks ◽  
Shortest Path ◽  
Routing Algorithm ◽  
Concurrent System ◽  
Shortest Path Routing ◽  
Straight Line ◽  
The Cost

In the concurrent system, each node avails as a packet over the network depends on the length of the node. The length of the node generated through straight line routing algorithm. The cost of routing depends on the shortest path routing algorithm. The shortest path is determined by the cost of a distance from one node to another over the network. The capacity of a network is balanced and maintained by the straight routing. The traffic and cost is balanced over the network by using the algorithms.   

Usability Testing of an Interactive Virtual Reality Distraction Intervention to Reduce Procedural Pain in Children and Adolescents With Cancer

2018 ◽  
Vol 35 (6) ◽  
pp. 406-416 ◽  
Author(s):  
Kathryn A. Birnie ◽  
Yalinie Kulandaivelu ◽  
Lindsay Jibb ◽  
Petra Hroch ◽  
Karyn Positano ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Children And Adolescents ◽  
Usability Testing ◽  
Venous Access ◽  
Needle Insertion ◽  
Ease Of Use ◽  
Clinical Implementation ◽  
Insertion Method ◽  
Semistructured Interviews ◽  
Venous Access Device

Purpose: Needle procedures are among the most distressing aspects of pediatric cancer-related treatment. Virtual reality (VR) distraction offers promise for needle-related pain and distress given its highly immersive and interactive virtual environment. This study assessed the usability (ease of use and understanding, acceptability) of a custom VR intervention for children with cancer undergoing implantable venous access device (IVAD) needle insertion. Method: Three iterative cycles of mixed-method usability testing with semistructured interviews were undertaken to refine the VR. Results: Participants included 17 children and adolescents (8-18 years old) with cancer who used the VR intervention prior to or during IVAD access. Most participants reported the VR as easy to use (82%) and understand (94%), and would like to use it during subsequent needle procedures (94%). Based on usability testing, refinements were made to VR hardware, software, and clinical implementation. Refinements focused on increasing responsiveness, interaction, and immersion of the VR program, reducing head movement for VR interaction, and enabling participant alerts to steps of the procedure by clinical staff. No adverse events of nausea or dizziness were reported. Conclusions: The VR intervention was deemed acceptable and safe. Next steps include assessing feasibility and effectiveness of the VR intervention for pain and distress.

scholarly journals Prospective study of percutaneous tracheostomy: Role of bronchoscopy and surgical technique

2016 ◽  
Vol 4 ◽  
pp. 205031211667040 ◽  
Author(s):  
Tanel Laisaar ◽  
Eero Jakobson ◽  
Bruno Sarana ◽  
Silver Sarapuu ◽  
Jüri Vahtramäe ◽  
...  
Keyword(s):  
Intensive Care ◽  
Percutaneous Tracheostomy ◽  
Surgical Techniques ◽  
Needle Insertion ◽  
Common Procedure ◽  
Unified Protocol ◽  
Needle Position ◽  
Tissue Dissection ◽  
Guide Needle

Objective: Percutaneous tracheostomy is a common procedure but varies considerably in approach. The aim of our study was to evaluate the need for intraoperative bronchoscopy and to compare various surgical techniques. Methods: During 1 year all percutaneous tracheostomies in three intensive care units were prospectively documented according to a unified protocol. In one unit, bronchoscopy was used routinely and in others only during the study. Results: A total of 111 subjects (77 males) with median age 64 (range, 18–86) years and body mass index 25.4 (range, 15.9–50.7) were included. In unit A, tracheal wall was directly exposed; in unit B, limited dissection to enable tracheal palpation was made. In both units, bronchoscopy was used to check the location of an already inserted guiding needle; needle position required correction in 8% and 12% of cases, respectively. In unit C, in tracheostomies without pretracheal tissue dissection, bronchoscopy was used to guide needle insertion; needle position required correction in 66% of cases. Median duration of operations performed by thoracic surgeons and residents was 10 (range, 3–37) min and by intensive care doctors and residents was 16.5 (range, 3–63) min (p < 0.001). Time from the beginning of preparations for tracheostomy until the end of the whole procedure was median 32 min for bedside tracheostomies and 64 min for operations in the operating theatre (p < 0.001). Conclusion: Limited pretracheal tissue dissection enabled proper guiding needle insertion and bronchoscopy was rarely needed. Percutaneous tracheostomies performed by thoracic surgeons took less time, and duration of the whole procedure was remarkably shorter when performed at bedside.

scholarly journals The Impact of Market Discipline on Banks’ Capital Adequacy: Evidence From an Emerging Economy

2015 ◽  
Vol 4 (1) ◽  
pp. 61-73 ◽  
Author(s):  
Ayesha Afzal
Keyword(s):  
Perceived Risk ◽  
Banking System ◽  
Empirical Support ◽  
Market Discipline ◽  
Capital Adequacy ◽  
Risk Level ◽  
Bank Capital ◽  
The Cost ◽  
The Impact

This study presents empirical support for the role of market discipline in augmenting bank capital ratios in a competitive banking environment. Using a panel dataset on domestic commercial banks in Pakistan from 2009 to 2014, the study determines if the market penalized banks for any increase in their risk profile through a rise in the cost of raising funds. The results point to a significant relationship between capital adequacy and other risk factors, with the cost of deposits demonstrating how depositors align the required return to the perceived risk level of the bank. These findings have important implications for policymakers as market discipline could complement the role of regulators, which would eventually lower the cost of supervision. Moreover, the focus of international reforms as seen through the implementation of Basel III should continue to be on developing a more competitive and transparent banking system.

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