Pneumatically Attachable Flexible (PAF) Rails for track-guided imaging and organ manipulation

Brief description of the context of the research including potential impact

Robotic-assisted partial nephrectomy (RAPN) is a surgical operation in which part of a kidney is removed, typically due to the presence of a mass. Pre-operative and intra-operative imaging techniques are used to identify and outline the target mass, and thus the margins of the resection area on the kidney surface. Drop-in ultrasound probes are used to acquire intra-operative images: the probe is inserted through a trocar port, grasped with a robotic-assisted laparoscopic gripper and swiped on the kidney surface. Multiple swipes are performed to define the resection area. This is marked swipe by swipe using an electrocautery tool. During this procedure the probe often requires repositioning because of slippage from the target organ surface. Furthermore, the localization can be inaccurate when the target mass is in particularly hard to reach locations, and thus kidney repositioning could be required. A highly skilled surgeon is typically required to successfully perform this pre-operatory procedure.

In the Wellcome/EPSRC centre for Interventional and Surgical Sciences (WEISS) the UCL Surgical Robot Vision (SRV) research group led by Professor Danail Stoyanov has developed a novel soft robotic solution for the navigation of drop-in ultrasound probes in RAPN: the use of pneumatically attachable flexible rails (PAF rails) to enable swift, effortless, and accurate track-guided scanning of the kidney. The proposed system attaches on the kidney side surface with the use of a series of bio-inspired vacuum suckers. The same system can be customised to be used in similar procedures e.g. partial hepatectomy. The system has also shown significant potential as a safe and versatile soft robotic organ retractor.

Aims and Objectives

The specific objectives are to:

- Design, prototype and test soft robotic systems and sensors, including but not limited to the PAF rails system and derivative systems of it, paving the way for their translation into clinics.

- Investigate soft sensing solution to support multi-imaging modalities.

- Investigate the integration of the proposed system in clinical practice, liaising with clinicians and engineers as well as with industrial partners to conduct testing on phantoms as well as ex vivo and in vivo testing.

Novelty of Research Methodology

The PAF rail system is a novel hardware/software system designed and developed in the SRV research group at UCL WEISS. Given the novelty and the clinical potential of the proposed system, a PCT patent application (PCT/GB2019/051463) has been filed with the support of UCL-Business. The candidate will investigate novel imaging and organ manipulation strategies to optimise the system from the point of view of the hardware and the software.

Alignment to EPSRC's strategies and research areas

The proposed project well aligns with the EPSRC grand challenge of the Frontiers of Physical Intervention by proposing a novel approach to intra-operative organ imaging and manipulation in minimally invasive robotic-assisted surgery. The proposed system will improve the accuracy and the safety of a wide range of laparoscopic procedures providing a safer organ-tool interface, hence, reducing the risks on the patient side, while also significantly deskilling complex procedures. The investigated system has also the potential to open the way to the automation of surgical tasks like organ repositioning and scanning.

In terms of cross-cutting research capabilities this project remits in the research area of Medical Device Design and Innovation in the context of robotics for surgical applications, while also investigating advanced biocompatible silicone materials for active organ manipulation, imaging.

Any companies or collaborators involved

Royal Free Hospital, London, UK

Intuitive Surgical, Sunnyvale, CA, US