몸안에서 자율주행하는 '로봇 카테터' 개발 VIDEO: Robotic catheter brings autonomous navigation into human body
Robotic catheter brings autonomous navigation into human body
By TRR Editor | April 24, 2019
Concentric tube robot. In a recent demo, robotic catheter autonomously found its way to a leaky heart valve. Source: Pediatric Cardiac Bioengineering Lab, Department of Cardiovascular Surgery, Boston Children’s Hospital, Harvard Medical School
Robotic catheter brings autonomous navigation into the human body
몸안에서 자율주행하는 '로봇 카테터' 개발 보스턴 아동병원 '피에르 듀퐁' 교수팀, '사이언스 로보틱스'에 연구 결과 발표 미국 보스턴아동병원 연구진이 동물의 몸안에서 자율적으로 움직이는 로봇 카테터(catheter)를 개발하고 돼지를 대상으로 시연하는 데 성공했다고 밝혔다. 카테터는 체강(흉막강,복막강), 관상 기관(기관, 식도, 위, 장, 방광, 요관, 혈관) 등에 삽입하는 튜브 형태의 외과적 기구를 말한다. 연구팀은 몸안에서 스스로 위치를 파악해 자율적으로 이동하는 의료용 로봇 기술 개발은 처음으로 이뤄진 것이라고 밝혔다. ‘사이언스 데일리’ 등 매체에 따르면 보스턴아동병원 소아과 심장 바이오엔지니어링팀의 피에르 듀퐁(Pierre Dupong) 박사팀은 동물의 몸안에서 스스로 수술 부위를 찾아갈 수 있는 자율주행형 로봇 카테터 기술을 개발하고 관련 연구 성과를 전문 저널인 ‘사이언스 로보틱스’에 게재했다. 기존의 의료 로봇들은 동물의 신체안에 들어가더라도 외부에서 의사들이 마그네틱 등 기술을 이용해 조이스틱으로 로봇의 이동 방향을 제어하는 게 일반적이었다. 이에 비해 이번에 개발된 로봇 카테터는 의사의 개입없이 몸안에서 자신의 위치를 파악하고 원하는 수술 부위로 스스로 이동할 수 있다.  심장내 로봇 카테터 피에르 듀퐁 박사팀은 심장 판막 주변 동맥에 출혈이 있는 돼지를 대상으로 로봇 카테터를 집어넣어 출혈을 막는 플러그를 삽입하는 시연을 성공적으로 마쳤다. 로봇 카테터에는 자체적으로 개발한 광터치 센서 기술을 채택했다. 광터치 센서는 인공지능과 이미지 프로세싱 알고리즘을 이용해 심장의 위치와 수술 부위를 스스로 찾아간다. 로봇 카테터가 수술 부위에 도착하면 수술팀이 통제권을 이어받아 출혈 부위에 플러그를 삽입하는 작업을 완료했다.
  로봇 카테터의 구조 연구팀은 사전에 심장의 해부학적인 구조와 내부 스캔 이미지를 바탕으로 심장에 관한 지도를 제작해 로봇 카테터에 학습시켰다. 또한 곤충이나 설치류들이 더듬이 또는 수염을 이용해 주변 환경에 관한 지도를 만드는 기법을 로봇 카테터에 적용하기도 했다. 이번에 돼지를 대상으로 실험이 성공적으로 이뤄짐에 따라 미래에는 심장병을 앓고 있는 환자를 대상으로 로봇 카테터를 적용하는 길도 열릴 것으로 예측된다. 장길수 ksjang@irobotnews.com 로봇신문사 |
edited by kcontents
BOSTON — Bioengineers at Boston Children’s Hospital said they successfully demonstrated for the first time a robot able to navigate autonomously inside the body. In a live pig, the team programmed a robotic catheter to find its way along the walls of a beating, blood-filled heart to a leaky valve — without a surgeon’s guidance. They reported their work today in Science Robotics.
Surgeons have used robots operated by joysticks for more than a decade, and teams have shown that tiny robots can be steered through the body by external forces such as magnetism. However, senior investigator Pierre Dupont, Ph.D., chief of Pediatric Cardiac Bioengineering at Boston Children’s, said that to his knowledge, this is the first report of the equivalent of a self-driving car navigating to a desired destination inside the body.
Pierre Dupont, chief of Pediatric Cardiac Bioengieering at Boston Children’s Hospital
Dupont said he envisions autonomous robots assisting surgeons in complex operations, reducing fatigue and freeing surgeons to focus on the most difficult maneuvers, improving outcomes.
“The right way to think about this is through the analogy of a fighter pilot and a fighter plane,” he said. “The fighter plane takes on
Dupont said he envisions autonomous robots assisting surgeons in complex operations, reducing fatigue and freeing surgeons to focus on the most difficult maneuvers, improving outcomes.
“The right way to think about this is through the analogy of a fighter pilot and a fighter plane,” he said. “The fighter plane takes on the routine tasks like flying the plane, so the pilot can focus on the higher-level tasks of the mission.”
Touch-guided vision, informed by AI
The team’s robotic catheter navigated using an optical touch sensor developed in Dupont’s lab, informed by a map of the cardiac anatomy and preoperative scans. The touch sensor uses artificial intelligence and image processing algorithms to enable the catheter to figure out where it is in the heart and where it needs to go.
For the demo, the team performed a highly technically demanding procedure known as paravalvular aortic leak closure, which repairs replacement heart valves that have begun leaking around the edges. (The team constructed its own valves for the experiments.) Once the robotic catheter reached the leak location, an experienced cardiac surgeon took control and inserted a plug to close the leak.
In repeated trials, the robotic catheter successfully navigated to heart valve leaks in roughly the same amount of time as the surgeon (using either a hand tool or a joystick-controlled robot).
Biologically inspired navigation
Through a navigational technique called “wall following,” the robotic catheter’s optical touch sensor sampled its environment at regular intervals, in much the way insects’ antennae or the whiskers of rodents sample their surroundings to build mental maps of unfamiliar, dark environments. The sensor told the catheter whether it was touching blood, the heart wall or a valve (through images from a tip-mounted camera) and how hard it was pressing (to keep it from damaging the beating heart).
Data from preoperative imaging and machine learning algorithms helped the catheter interpret visual features. In this way, the robotic catheter advanced by itself from the base of the heart, along the wall of the left ventricle and around the leaky valve until it reached the location of the leak.
“The algorithms help the catheter figure out what type of tissue it’s touching, where it is in the heart, and how it should choose its next motion to get where we want it to go,” Dupont explained.
Though the autonomous robot took a bit longer than the surgeon to reach the leaky valve, its wall-following technique meant that it took the longest path.
“The navigation time was statistically equivalent for all, which we think is pretty impressive given that you’re inside the blood-filled beating heart and trying to reach a millimeter-scale target on a specific valve,” said Dupont.
He added that the robot’s ability to visualize and sense its environment could eliminate the need for fluoroscopic imaging, which is typically used in this operation and exposes patients to ionizing radiation.
Robotic catheter enters internal jugular vein and navigates through the vasculature into the right atrium. Source: Pediatric Cardiac Bioengineering Lab
A vision of the future?
“I remember times when the engineers on our team walked out of the OR completely exhausted, but we managed to pull it off,” said Dupont. “Now that we’ve demonstrated autonomous navigation, much more is possible.”
Some cardiac interventionalists who are aware of Dupont’s work envision using robots for more than navigation, performing routine heart-mapping tasks, for example. Some envision this technology providing guidance during particularly difficult or unusual cases or assisting in operations in parts of the world that lack highly experienced surgeons.
As the U.S. Food and Drug Administration begins to develop a regulatory framework for AI-enabled devices, Dupont said that autonomous surgical robots all over the world could pool their data to continuously improve performance over time — much like self-driving vehicles in the field send their data back to Tesla to refine its algorithms.
“This would not only level the playing field, it would raise it,” said Dupont. “Every clinician in the world would be operating at a level of skill and experience equivalent to the best in their field. This has always been the promise of medical robots. Autonomy may be what gets us there.”
Boston Children’s Hospital in the Longwood Medical Area. Photo by Jenna Lang.
About the paper
Georgios Fagogenis, PhD, of Boston Children’s Hospital was first author on the paper. Coauthors were Margherita Mencattelli, PhD, Zurab Machaidze, MD, Karl Price, MaSC, Viktoria Weixler, MD, Mossab Saeed, MB, BS, and John Mayer, MD of Boston Children’s Hospital; Benoit Rosa, PhD, of ICube, Universite? de Strasbourg (Strasbourg, France); and Fei-Yi Wu, MD, of Taipei Veterans General Hospital, Taipei, Taiwan. For more on the technology, contact TIDO@childrenshospital.org.
The study was funded by the National Institutes of Health (R01HL124020), with partial support from the ANR/Investissement d’avenir program. Dupont and several of his coauthors are inventors on U.S. patent application held by Boston Children’s Hospital that covers the optical imaging technique.
About Boston Children’s Hospital
Boston Children’s Hospital, the primary pediatric teaching affiliate of Harvard Medical School, said it is home to the world’s largest research enterprise based at a pediatric medical center. Its discoveries have benefited both children and adults since 1869. Today, more than 3,000 scientists, including 8 members of the National Academy of Sciences, 18 members of the National Academy of Medicine and 12 Howard Hughes Medical Investigators comprise Boston Children’s research community.
Founded as a 20-bed hospital for children, Boston Children’s is now a 415-bed comprehensive center for pediatric and adolescent health care. For more, visit the Vector and Thriving blogs and follow it on social media @BostonChildrens, @BCH_Innovation, Facebook and YouTube.
https://www.therobotreport.com/robotic-catheter-brings-autonomous-navigation-into-the-human-body/
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