Robotic Percutaneous Intervention Guidance with Respiratory Tracking
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Solution Overview
Problem
Percutaneous interventions face challenges due to variability in target region positions caused by respiratory and pulsating organ movements, leading to a high risk of puncture errors and complications.
Innovation Solution
A combination of a 2D or 3D tomographic imaging system, a registered robot with a mounting unit, and devices capturing external and internal patient movements, using a 4D image dataset to guide the instrument along a predetermined path, accounting for respiratory and other movements to prevent deviations during the intervention.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If percutaneous puncture is performed based on pre-imaging diagnosis and intuitive planning, then the intervention can be performed with minimal invasiveness, but the risk of puncture errors increases due to target region movement from respiratory and organ pulsations
Solution Approach 1:
The system performs pre-imaging diagnosis (CT or MRT) before the percutaneous intervention to capture the target region at multiple respiratory phases. This preliminary action allows the planning of the access path while the target is in a known position, and the recorded movement patterns are later used to compensate for target displacement during the actual puncture procedure.
Solution Approach 2:
The system continuously monitors the patient's respiratory movements and organ pulsations during the intervention using the same imaging system. This real-time feedback is fed back to the control unit, which automatically adjusts the instrument's position and orientation to maintain alignment with the moving target, thereby compensating for respiratory and cardiac movements.
2Reliability
If multiple puncture attempts are performed to account for target movement, then the chance of successful puncture increases, but the intervention time and patient risk increase
Solution Approach 1:
The system transitions from static puncture planning to dynamic adaptation. The access path is not fixed but continuously adjusted in real-time based on monitored respiratory and cardiac movements. The control unit dynamically recalculates and updates the instrument trajectory to track the moving target, enabling single-attempt success despite physiological movements.
Solution Approach 2:
The system replaces manual, intuitive puncture techniques with an automated control system. The control unit processes imaging data and movement patterns computationally to generate precise, real-time guidance for the instrument, substituting human estimation and multiple attempts with algorithmic precision and continuous adaptation.
3Measurement precision
If real-time imaging monitoring is implemented to track target position, then puncture precision improves, but the device complexity and cost increase
Solution Approach 1:
The system uses a single imaging device (CT or MRT scanner) that serves multiple functions: initial diagnostic imaging, pre-intervention planning, real-time movement monitoring, and post-intervention verification. By making the imaging system multi-functional rather than adding separate dedicated monitoring equipment, the overall device complexity is reduced while maintaining continuous tracking capability.
Solution Approach 2:
The imaging system monitors its own operational environment (patient movements) and automatically adjusts the puncture guidance without requiring external intervention. The control unit processes the imaging data and autonomously updates the access path calculation, making the system self-regulating and reducing the need for additional manual monitoring equipment or personnel.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach significantly reduces the risk of puncture errors by automatically adjusting the instrument's path to match instantaneous patient movements, ensuring precise targeting and minimizing complications.
Implementation Method 1
an imaging system for three-dimensional tomographic imaging, in particular a C-arm x-ray system
Data Source
AI summary
The invention relates to an arrangement for assisting a percutaneous intervention, comprising an imaging system for tomographic imaging, a robot registered therewith and devices for capturing movements of the patient. A processing unit registers a 4D image dataset recorded before the intervention with a 2D or 3D image dataset of the patient which was recorded immediately before the intervention by the imaging system at a defined respiratory position. From this image data, the access path is transmitted to the robot as a function of the movements captured during recording the 4D image dataset and registration, said robot in turn, depending on the instantaneous movement data, holding the instrument on a predetermined target path and preventing the instrument from being advanced by the person if and as long as the instantaneous movement data does not match the previously recorded movement data. The arrangement reduces the risk of puncture errors.