Intuitive teleoperation of active catheters for endovascular surgery

摘要

Advances in miniature surgical instrumentation are key to less invasive and safer medical interventions. In cardiovascular procedures interventionalists turn towards catheter-based interventions, treating patients considered unfit for classical more invasive approaches. Improvements in design and steerability of catheters could further reduce the invasiveness of these interventions. For example, by improving controllability and interaction forces with the vessels, tissue damage could be limited. Through improved steerability and coordinated control, operation times and exposure to radiation might also be reduced. Latter argument formed the original motivation for the development of teleoperated robotic catheters. Despite the large kinematic dissimilarity and thus non-trivial mapping between joystick input and catheter output motion, few investigations have been conducted to find intuitive mappings that allow straightforward catheter steering. This paper presents some recent work in this direction. Three promising mappings are proposed. The mappings were implemented and validated upon a robotic catheter moving inside an artificial aorta model. Experimental results show good steerability of the robotic catheter for all the mappings. Although superiority of one mapping with respect to the others was observed, further investigation and validation is planned. In the future, additional visual cues that increase the situational awareness of the user are expected to further simplify the steering.