title: Robot-assisted retinal vein cannulation with force-based puncture detection: Micron vs. the steady-hand eye robot.
abstract: Retinal vein cannulation is a demanding procedure where therapeutic agents are injected into occluded retina veins. The feasibility of this treatment is limited due to challenges in identifying the moment of venous puncture, achieving cannulation and maintaining it throughout the drug delivery period. In this study, we integrate a force-sensing microneedle with two distinct robotic systems: the handheld micromanipulator Micron, and the cooperatively controlled Steady-Hand Eye Robot (SHER). The sensed tool-to-tissue interaction forces are used to detect venous puncture and extend the robots' standard control schemes with a new position holding mode (PHM) that assists the operator hold the needle position fixed and maintain cannulation for a longer time with less trauma on the vasculature. We evaluate the resulting systems comparatively in a dry phantom, stretched vinyl membranes. Results have shown that modulating the admittance control gain of SHER alone is not a very effective solution for preventing the undesired tool motion after puncture. However, after using puncture detection and PHM the deviation from the puncture point is significantly reduced, by 65% with Micron, and by 95% with SHER representing a potential advantage over freehand for both.
authors.forename: Berk
authors.initials: B
authors.lastname: Gonenc
authors.forename: Nhat
authors.initials: N
authors.lastname: Tran
authors.forename: Peter
authors.initials: P
authors.lastname: Gehlbach
authors.forename: Russell H
authors.initials: RH
authors.lastname: Taylor
authors.forename: Iulian
authors.initials: I
authors.lastname: Iordachita
mesh_terms: D001696:Biomechanical Phenomena; D002404:Catheterization; D004867:Equipment Design; D005123:Eye; D006801:Humans; D008846:Micromanipulation / Q000295:instrumentation*; D009339:Needles; D019047:Phantoms, Imaging; D011677:Punctures; D012169:Retinal Vein / Q000601:surgery*; D012170:Retinal Vein Occlusion; D012371:Robotics / Q000379:methods*