Transurethral resection of the prostate (TURP) is a minimally invasive endoscopic procedure that requires experience and skill of the surgeon. To permit surgical training under realistic conditions we report a novel phantom of the human prostate that can be resected with TURP. The phantom mirrors the anatomy and haptic properties of the gland and permits quantitative evaluation of important surgical performance indicators. Mixtures of soft materials are engineered to mimic the physical properties of the human tissue, including the mechanical strength, the electrical and thermal conductivity, and the appearance under an endoscope. Electrocautery resection of the phantom closely resembles the procedure on human tissue. Ultrasound contrast agent was applied to the central zone, which was not detectable by the surgeon during the surgery but showed high contrast when imaged after the surgery, to serve as a label for the quantitative evaluation of the surgery. Quantitative criteria for performance assessment are established and evaluated by automated image analysis. We present the workflow of a surgical simulation on a prostate phantom followed by quantitative evaluation of the surgical performance. Surgery on the phantom is useful for medical training, and enables the development and testing of endoscopic and minimally invasive surgical instruments.
Endoscopy enables minimally invasive procedures in many medical fields, such as urology. However, current endoscopes are normally cable-driven, which limits their dexterity and makes them hard to miniaturize. Indeed current urological endoscopes have an outer diameter of about 3 mm and still only possess one bending degree of freedom. In this paper, we report a novel wireless actuation mechanism that increases the dexterity and that permits the miniaturization of a urological endoscope. The novel actuator consists of thin active surfaces that can be readily attached to any device and are wirelessly powered by ultrasound. The surfaces consist of two-dimensional arrays of micro-bubbles, which oscillate under ultrasound excitation and thereby generate an acoustic streaming force. Bubbles of different sizes are addressed by their unique resonance frequency, thus multiple degrees of freedom can readily be incorporated. Two active miniaturized devices (with a side length of around 1 mm) are demonstrated: a miniaturized mechanical arm that realizes two degrees of freedom, and a flexible endoscope prototype equipped with a camera at the tip. With the flexible endoscope, an active endoscopic examination is successfully performed in a rabbit bladder. This results show the potential medical applicability of surface actuators wirelessly powered by ultrasound penetrating through biological tissues.
Advanced Materials Interfaces, 4(21):1700933, September 2017 (article)
A major challenge that prevents the miniaturization of mechanically actuated systems is the lack of suitable methods that permit the efficient transfer of power to small scales. Acoustic energy holds great potential, as it is wireless, penetrates deep into biological tissues, and the mechanical vibrations can be directly converted into directional forces. Recently, active acoustic surfaces are developed that consist of 2D arrays of microcavities holding microbubbles that can be excited with an external acoustic field. At resonance, the surfaces give rise to acoustic streaming and thus provide a highly directional propulsive force. Here, this study advances these wireless surface actuators by studying their force output as the size of the bubble-array is increased. In particular, a general method is reported to dramatically improve the propulsive force, demonstrating that the surface actuators are actually able to propel centimeter-scale devices. To prove the flexibility of the functional surfaces as wireless ready-to-attach actuator, a mobile mini-robot capable of propulsion in water along multiple directions is presented. This work paves the way toward effectively exploiting acoustic surfaces as a novel wireless actuation scheme at small scales.
Ann. of Biomed. Eng., 45(4):963-972, April 2017 (article)
Organ models are used for planning and simulation of operations, developing new surgical instruments, and training purposes. There is a substantial demand for in vitro organ phantoms, especially in urological surgery. Animal models and existing simulator systems poorly mimic the detailed morphology and the physical properties of human organs. In this paper, we report a novel fabrication process to make a human kidney phantom with realistic anatomical structures and physical properties. The detailed anatomical structure was directly acquired from high resolution CT data sets of human cadaveric kidneys. The soft phantoms were constructed using a novel technique that combines 3D wax printing and polymer molding. Anatomical details and material properties of the phantoms were validated in detail by CT scan, ultrasound, and endoscopy. CT reconstruction, ultrasound examination, and endoscopy showed that the designed phantom mimics a real kidney's detailed anatomy and correctly corresponds to the targeted human cadaver's upper urinary tract. Soft materials with a tensile modulus of 0.8-1.5 MPa as well as biocompatible hydrogels were used to mimic human kidney tissues. We developed a method of constructing 3D organ models from medical imaging data using a 3D wax printing and molding process. This method is cost-effective means for obtaining a reproducible and robust model suitable for surgical simulation and training purposes.
In Eur Urol Suppl, 16(3):e1914, March 2017 (inproceedings)
Endoscopy is an essential and common method for both diagnostics and therapy in Urology. Current flexible endoscope is normally cable-driven, thus it is hard to be miniaturized and its reachability is restricted as only one bending section near the tip with one degree of freedom (DoF) is allowed. Recent progresses in micro-robotics offer a unique opportunity for medical inspections in minimally invasive surgery. Micro-robots are active devices that has a feature size smaller than one millimeter and can normally be actuated and controlled wirelessly. Magnetically actuated micro-robots have been demonstrated to propel through biological fluids.Here, we report a novel micro robotic arm, which is actuated wirelessly by ultrasound. It works as a miniaturized endoscope with a side length of ~1 mm, which fits through the 3 Fr. tool channel of a cystoscope, and successfully performs an active cystoscopy in a rabbit bladder.
Miniaturization calls for micro-actuators that can be powered wirelessly and addressed individually. Here, we develop functional surfaces consisting of arrays of acoustically resonant microcavities, and we demonstrate their application as two-dimensional wireless actuators. When remotely powered by an acoustic field, the surfaces provide highly directional propulsive forces in fluids through acoustic streaming. A maximal force of similar to 0.45mN is measured on a 4 x 4 mm(2) functional surface. The response of the surfaces with bubbles of different sizes is characterized experimentally. This shows a marked peak around the micro-bubbles' resonance frequency, as estimated by both an analytical model and numerical simulations. The strong frequency dependence can be exploited to address different surfaces with different acoustic frequencies, thus achieving wireless actuation with multiple degrees of freedom. The use of the functional surfaces as wireless ready-to-attach actuators is demonstrated by implementing a wireless and bidirectional miniaturized rotary motor, which is 2.6 x 2.6 x 5 mm(3) in size and generates a stall torque of similar to 0.5 mN.mm. The adoption of micro-structured surfaces as wireless actuators opens new possibilities in the development of miniaturized devices and tools for fluidic environments that are accessible by low intensity ultrasound fields.
Our goal is to understand the principles of Perception, Action and Learning in autonomous systems that successfully interact with complex environments and to use this understanding to design future systems