An Autonomous Guidewire Delivery Method With Distal Position-Based Impedance Control

Leader-follower robotic guidewire delivery system has been a research focus in terms of vascular interventional surgery (VIS) for a few years. However, due to the inconvenient operations and lack of intuition in leader robot manipulation, such systems are not widely used. To get rid of cumbersome operations and promote the safety of guidewire delivery in a VIS, the first autonomous guidewire delivery scheme for VIS which incorporates both human skill and robotic autonomous manipulation is proposed in this article. The delivery criterion of a surgeon remotely manipulating the guidewire is formulated by an impedance model. Then, an autonomous delivery controller based on this model steers the guidewire distal position, not the proximal position which is commonly used in relevant research, towards the desired location. We reduce the effect of uncertainty in flexible guidewire deformation by a real-time estimator. The proposed method exhibits distinct superiorities in both human skill and robotic fast response. Experimental results confirmed the advantages of the proposed autonomous delivery scheme in reducing cumbersome operations and smoothening contact force in a VIS. Note to Practitioners—Many researchers have developed a variety of leader-follower robotic systems for the VIS to reduce harm to surgeons from radiation, because of the occupational use of X-rays in interventional surgeries. However, the insertion manipulation, as a common movement in a VIS, needs a large workspace which is in contradiction to the workspaces of commonly used leader robots. For the sake of less cumbersome movements and smooth operational force, an autonomous guidewire delivery scheme is proposed. This scheme is composed of two phases. In the first phase, the surgeon manipulates the leader robot to remotely complete just one insertion movement. From this movement, manual manipulation skill is extracted by an impedance model, which reveals the relationship between the guidewire tip position and the contact force. Then, in the second phase, an autonomous delivery controller based on the impedance model is devised and adopted to complete the insertion task. By taking the guidewire tip position, not the follower robot position, as a fundamental component of the impedance model, this scheme conforms to sophisticated manual manipulation skill. Such an autonomous scheme takes advantage of both human skills and robotic stability and can be applied in autopilot, assembling, etc.

I. Introduction

In recent decades, the VIS has been surging significantly all over the world [1]. Regarding relevant treatments, surgeons usually suffer from radiation for a long time. For example, in conventional percutaneous coronary interventional therapy, the surgeon steers the guidewire with the help of angiography, which means the surgeon has to be exposed to X-ray radiation during the therapy. The lead-rubber suit is one solution to reduce the hazards. However, the suit cannot protect the surgeon from all the radiation because the eyes and hands are not enclosed. Moreover, the overweight suit can lead to injuries of the spine and muscles [2]. Besides, the heavy suit often makes the surgeon tired easily and hinders flexible operations.