Surgery enabled by ultrasonics

Lead Research Organisation: University of Glasgow
Department Name: School of Engineering

Abstract

The range of surgical tools for interventional procedures that dissect or fragment tissue has not changed significantly for millennia. There is huge potential for ultrasonic devices to enable new minimal access surgeries, offering higher precision, much lower force, better preservation of delicate structures, low thermal damage and, importantly, enabling more procedures to be carried out on an out-patient or day surgery basis. To realise this potential, and deliver our vision of ultrasonics being the technology of choice for minimal access interventional surgery, a completely new approach to device design is required, to achieve miniaturisation and to incorporate both a cutting and healing capability in the devices. By integrating with innovative flexible, tentacle-like surgical robots, we will bring ultrasonic devices deep into the human body, along tortuous pathways to the surgical site, to deliver unparalleled precision.

Unsurpassed precision in challenging neurological, skull-base and spinal procedures as well as in general surgery is attainable through tailoring the robotic-ultrasonic devices to deliver the exact ultrasonic energy to the exact locations required to optimise the surgery. We will achieve this by quantifying the effects of the ultrasonic excitations typical of surgical devices in tissues, at and surrounding the site of surgery, in terms of precision cutting, tissue damage (mechanical damage, thermal necrosis, cavitation) but also the potential to aid regeneration. We will make world-leading advances in ultra-high speed imaging measurements and biophysical analysis, complementing advances in histology and clinical assessment, to develop a combined approach to the characterisation of both damage and regeneration of tissue. Through this holistic approach to device design, we will create integrated robotic-ultrasonic surgical devices tailored for optimised surgery.

Planned Impact

Societal impact will ultimately be the clinical use of the surgical devices we create. We will propose new complex surgeries (with minimal and difficult access) offering high precision. We will deliver semi-automation of many surgical tasks. The programme will therefore positively benefit patient care for the many millions of surgeries carried out annually world-wide. Resulting increases in out-patient procedures will impact health costs significantly. The clinicians in our team and our NHS partners will ensure patient care is at the heart of our research and will provide direct access to the operating theatre for the research team, to direct the innovations. We will partner with the NHS Medical Devices Unit to co-design the research towards translation to clinical uptake beyond the programme and to work with our clinician investigators and partners on clinical evaluations of our devices.

Our partner companies including Stryker, Dentsply, Intuitive Surgical, Kuka Robotics, Thales, CTS and several SMEs are our basis to ensure economic impact and a route to user engagement by embedding co-creation with their established user community networks. Our industrial partners will ensure we embed the regulatory frameworks into the research directions, and will also host our researchers for extended visits, ensuring a pipeline of highly skilled potential employees.

We plan for annual public engagement events, to include Science Festivals. We will organise a special session and workshop on ultrasonics in surgery during our hosting of the IEEE International Ultrasonics Symposium in Glasgow in 2019, attracting clinicians, engineers and companies, to disseminate our research widely. We will run similar and updated versions of the workshop annually at different venues, particularly to include robot-assisted minimal access ultrasonic surgery.

Academic impact will additionally be through publication of research and presentations at key international conferences and engineering and clinical society events.

Publications

10 25 50

publication icon
Slawinski PR (2019) Sensitivity Ellipsoids for Force Control of Magnetic Robots with Localization Uncertainty. in IEEE transactions on robotics : a publication of the IEEE Robotics and Automation Society

publication icon
Slawinski PR (2019) Sensorless Estimation of the Planar Distal Shape of a Tip-Actuated Endoscope. in IEEE robotics and automation letters

 
Description Ministerial visit
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
URL https://www.leeds.ac.uk/forstaff/news/article/6984/universities_minister_visits_campus
 
Description Collaboration with the Surgical MIC 
Organisation National Institute for Health Research
Department NIHR Surgical MedTech Co-operative
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution We provide the Surgical MIC with our work as a case study to showcase their capabilities and areas of support.
Collaborator Contribution Expert advice and support for the clinical trials aspects of the project, including patient and public involvement. The latter includes access to patient and clinician networks, advice on engagement and other activities.
Impact This collaboration is in the early stages and will come into effect in the later parts of the project.
Start Year 2019
 
Description NHS Medical Devices Unit 
Organisation NHS Greater Glasgow and Clyde (NHSGGC)
Country United Kingdom 
Sector Public 
PI Contribution Co-working on ultrasonic surgical devices and provision of data to meet medical devices requirements.
Collaborator Contribution Training and support to understand and meet requirements for technology development.
Impact We are working towards ultrasonic surgical device demonstrators as part of our pathway to impact.
Start Year 2018
 
Description Partnership with KUKA Robotics 
Organisation KUKA Robotics
Country Germany 
Sector Private 
PI Contribution Contributed feedback on the use of the KUKA LBR Med robotic arm in our application, including any performance issues or general areas for improvement. Helped promote the KUKA LBR Med robotic arm by demonstrating it at the Medica trade show in Dusseldorf (2019) on behalf of KUKA and the University of Leeds.
Collaborator Contribution Extra assistance with the setting-up and maintenance of the KUKA LBR Med robotic arm. General advice and support, above and beyond that received by a typical customer, on the use of their product in our application. Expert feedback on our product and future development.
Impact Output: Public engagement at the Medica trade show in Dusseldorf (2019)
Start Year 2019
 
Description Stryker 
Organisation Stryker
Department Stryker Ireland
Country Ireland 
Sector Private 
PI Contribution We lead a strategic partnership with Stryker for their ultrasonics technical area. We collaborate on a range of ultrasonic interventional surgical devices, especially for bone cutting, and surgical navigation systems.
Collaborator Contribution Stryker have co-funded or fully funded 4 PhD students and an EPSRC IAA award. They are currently partners on our EPSRC Programme Grant (Surgery enabled by ultrasonics) and our EPSRC CDT FUSE (Future ultrasonic engineering). As well as direct funding, supervision and expertise, Stryker manufacture all the test samples and device components for our collaborative research. Stryker are co-funding a PhD studentship on the EPSRC Programme Grant - Surgery enabled by ultrasonics.
Impact Richards, D., Mathieson, A., Lucas, M. and Pretorius, N. (2015) An Ultrasonically Assisted Sagittal Saw for Large Bone Surgeries. In: IEEE International Ultrasonics Symposium (IUS), Taipei, Taiwan, 21-24 Oct 2015, pp. 1-4. ISBN 978147998182315 (doi:10.1109/ULTSYM.2015.0279)
Start Year 2014
 
Description Exhibited at the One Day in Leeds Event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Supporters
Results and Impact The event was to engage with donors and potential donors with the University to celebrate and highlight the research impact of the University. We presented our endoscopic technology to alumni and a guests, representatives from trusts and foundations and non-alumni who are interested in supporting the University.
Year(s) Of Engagement Activity 2019
 
Description Invited speaker at a PPIE group meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact The event was a focused group meeting arranged for patients and patient representatives to communicate the research that is on going in Leeds. We were invited to present our project and its impact for patients. We also had the opportunity to receive feedback from the PPI individuals
Year(s) Of Engagement Activity 2020
 
Description Invited talk at MedX event - Robotics in Healthcare 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Undergraduate students
Results and Impact The MedX society robotics in healthcare invited 'TED-style' talks on robotics and engineering in healthcare with the aim of engaging and inspiring. We presented our work in low-cost and endoscopic robotics and received positive feedback from the attendees.
Year(s) Of Engagement Activity 2019
URL https://surgicalmic.nihr.ac.uk/medtechfoundation/medx/
 
Description Operation Ouch exhibition 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact This was a family event is organised by the Bradford Science and Media Museum's with the CBBC series Operation Ouch during the half-term week. There were hands on exhibits as well as live science shows aimed at all ages. We have exhibited the ultra-low-cost flexible endoscope developed within this project.
Year(s) Of Engagement Activity 2019
URL https://www.scienceandmediamuseum.org.uk/whats-on/operation-ouch-half-term
 
Description Outreach at IEEE IUS 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact We ran a Schools outreach event on ultrasonics at the Glasgow Science Centre during the IEEE International Ultrasonics Symposium that we Co-Chaired in Glasgow in 2019. 600 School pupils from the West of Scotland attended and got hands on experiences, including an image guided ultrasonic surgery device in a 3D printed skull.
Year(s) Of Engagement Activity 2019
 
Description Presentation of Research to the Minister of State for Universities, Science, Research and Innovation (Chris Skidmore) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact In the region as part of a fact-finding visit, the Minister of State for Universities, Science, Research and Innovation, was at our innovation hub, Nexus, to hear about internationally-important research and teaching undertaken at Leeds across these key areas. As part of this visit we presented our Ultra-low-cost endoscope and magnetic colonoscopy platforms which received positive feedback and extensive exposure through social and traditional media.
Year(s) Of Engagement Activity 2020
URL https://www.leeds.ac.uk/news/article/4526/sampling_world-leading_science
 
Description Presentation to the CRUK Trustees 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Third sector organisations
Results and Impact Our ultra-low-cost technologies for gastric cancer screening were presented to CRUK Trustees during their visit to the University of Leeds. This will potentially influence the charity's policy in funding more research in the space of global challenges.
Year(s) Of Engagement Activity 2020
URL https://www.leeds.ac.uk/news/article/4523/cancer_research_uk_delegation_visits_leeds