title: Precision placement of instruments for minimally invasive procedures using a "needle driver" robot.
abstract: Medical practice continues to move toward less invasive procedures. Many of these procedures require the precision placement of a needle in the anatomy. Over the past several years, our research team has been investigating the use of a robotic needle driver to assist the physician in this task. This paper summarizes our work in this area. The robotic system is briefly described, followed by a description of a clinical trial in spinal nerve blockade. The robot was used under joystick control to place a 22 gauge needle in the spines of 10 patients using fluoroscopic imaging. The results were equivalent to the current manual procedure. We next describe our follow-up clinical application in lung biopsy for lung cancer screening under CT fluoroscopy. The system concept is discussed and the results of a phantom study are presented. A start-up company named ImageGuide has recently been formed to commercialize the robot. Their revised robot design is presented, along with plans to install a ceiling-mounted version of the robot in the CT fluoroscopy suite at Georgetown University.
authors.affiliation: Division of Computer Aided Interventions and Medical Robotics (CAIMR), Imaging Science and Information Systems (ISIS) Center, Department of Radiology, Georgetown University Medical Center, Washington, DC, USA. cleary@georgetown.edu
authors.forename: K
authors.initials: K
authors.lastname: Cleary
authors.forename: V
authors.initials: V
authors.lastname: Watson
authors.forename: D
authors.initials: D
authors.lastname: Lindisch
authors.forename: R H
authors.initials: RH
authors.lastname: Taylor
authors.forename: G
authors.initials: G
authors.lastname: Fichtinger
authors.forename: S
authors.initials: S
authors.lastname: Xu
authors.forename: C S
authors.initials: CS
authors.lastname: White
authors.forename: J
authors.initials: J
authors.lastname: Donlon
authors.forename: M
authors.initials: M
authors.lastname: Taylor
authors.forename: A
authors.initials: A
authors.lastname: Patriciu
authors.forename: D
authors.initials: D
authors.lastname: Mazilu
authors.forename: D
authors.initials: D
authors.lastname: Stoianovici
mesh_terms: D001706:Biopsy / Q000379:methods; D002102:Cadaver; D004867:Equipment Design; D005471:Fluoroscopy; D006801:Humans; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009339:Needles; D009407:Nerve Block / Q000295:instrumentation / Q000379:methods; D019047:Phantoms, Imaging; D016032:Randomized Controlled Trials as Topic; D012371:Robotics / Q000295:instrumentation; D013127:Spinal Nerves; D014057:Tomography, X-Ray Computed