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Kovacs L.,Óbuda University | Haidegger T.,Óbuda University | Haidegger T.,Austrian Center for Medical Innovation and Technology | Rudas I.,Óbuda University
SAMI 2013 - IEEE 11th International Symposium on Applied Machine Intelligence and Informatics, Proceedings | Year: 2013

Surgical robotics was only born three decades ago; however it has already spread out worldwide, resulting in systems that can provide less patient trauma and better medical outcome. In the near future, newly developed robotic systems may conquer even the most challenging fields - such as long distance telesurgery. While the master-slave (da Vinci type) robotic surgery practically means teleoperation from within the same room, NASA and other space agencies have long been focusing on its potential for long range applications. In the past decade, we have seen an amazing rise regarding the capability of surgical telepresence systems. Aiming to deploy telepresence technologies on a daily bases in the future, large communication latencies have to be dealt with. Telemedicine technologies offer a real solution to the climaxing problem of maintaining the quality of health care services in Europe. Radically new modeling techniques and algorithmic solutions have to be developed to make telemedicine more effective despite large communication delays. Besides appropriate manufacturing, adequate control strategies are required to ensure maximal effectiveness and safety. Currently leading teleoperated and hands-on systems have to solve major issues with system accuracy, force feedback and communication latency. Automated surgery is a technologically challenging area; it needs fine adaptation to the changing environment of the operating room. Modern control methods, such as model predictive control or soft computing alternatives are to be investigated in this paper, which are applicable to the problem of effective telesurgery. This technology could well find use in many other areas as well, from space exploration to remote mining and nuclear waste control. © 2013 IEEE.


Franz A.M.,German Cancer Research Center | Haidegger T.,Óbuda University | Haidegger T.,Austrian Center for Medical Innovation and Technology | Birkfellner W.,Christian Doppler Laboratory | And 3 more authors.
IEEE Transactions on Medical Imaging | Year: 2014

Object tracking is a key enabling technology in the context of computer-assisted medical interventions. Allowing the continuous localization of medical instruments and patient anatomy, it is a prerequisite for providing instrument guidance to subsurface anatomical structures. The only widely used technique that enables real-time tracking of small objects without line-of-sight restrictions is electromagnetic (EM) tracking. While EM tracking has been the subject of many research efforts, clinical applications have been slow to emerge. The aim of this review paper is therefore to provide insight into the future potential and limitations of EM tracking for medical use. We describe the basic working principles of EM tracking systems, list the main sources of error, and summarize the published studies on tracking accuracy, precision and robustness along with the corresponding validation protocols proposed. State-of-the-art approaches to error compensation are also reviewed in depth. Finally, an overview of the clinical applications addressed with EM tracking is given. Throughout the paper, we report not only on scientific progress, but also provide a review on commercial systems. Given the continuous debate on the applicability of EM tracking in medicine, this paper provides a timely overview of the state-of-the-art in the field. © 1982-2012 IEEE.


Haidegger T.,Óbuda University | Haidegger T.,Austrian Center for Medical Innovation and Technology | Barreto M.,Federal University of Bahia | Goncalves P.,Polytechnic Institute of Castelo Branco | And 6 more authors.
Robotics and Autonomous Systems | Year: 2013

Service robotics is an emerging application area for human-centered technologies. The rise of household and personal assistance robots forecasts a human-robot collaborative society. One of the robotics community's major task is to streamline development trends, work on the harmonization of taxonomies and ontologies, along with the standardization of terms, interfaces and technologies. It is important to keep the scientific progress and public understanding synchronous, through efficient outreach and education. These efforts support the collaboration among research groups, and lead to widely accepted standards, beneficial for both manufacturers and users. This article describes the necessity of developing robotics ontologies and standards focusing on the past and current research efforts. In addition, the paper proposes a roadmap for service robotics ontology development. The IEEE Robotics & Automation Society is sponsoring the working group Ontologies for Robotics and Automation. The efforts of the Working group are presented here, aiming to connect the cutting edge technology with the users of these services - the general public. © 2013 Elsevier B.V. All rights reserved.


Szilagyi L.,Budapest University of Technology and Economics | Szilagyi L.,Sapientia University | Haidegger T.,Budapest University of Technology and Economics | Haidegger T.,Austrian Center for Medical Innovation and Technology | And 7 more authors.
BMC Infectious Diseases | Year: 2013

Background: Hand hygiene compliance is generally assessed by observation of adherence to the " WHO five moments" using numbers of opportunities as the denominator. The quality of the activity is usually not monitored since there is no established methodology for the routine assessment of hand hygiene technique. The aim of this study was to objectively assess hand rub coverage of staff using a novel imaging technology and to look for patterns and trends in missed areas after the use of WHO's 6 Step technique.Methods: A hand hygiene education and assessment program targeted 5200 clinical staff over 7 days at the National University Hospital, Singapore. Participants in small groups were guided by professional trainers through 5 educational stations, which included technique-training and UV light assessment supported by digital photography of hands. Objective criteria for satisfactory hand hygiene quality were defined a priori. The database of images created during the assessment program was analyzed subsequently. Patterns of poor hand hygiene quality were identified and linked to staff demographic.Results: Despite the assessment taking place immediately after the training, only 72% of staff achieved satisfactory coverage. Failure to adequately clean the dorsal and palmar aspects of the hand occurred in 24% and 18% of the instances, respectively. Fingertips were missed by 3.5% of subjects. The analysis based on 4642 records showed that nurses performed best (77% pass), and women performed better than men (75% vs. 62%, p<0.001). Further risk indicators have been identified regarding age and occupation.Conclusion: Ongoing education and training has a vital role in improving hand hygiene compliance and technique of clinical staff. Identification of typical sites of failure can help to develop improved training. © 2013 Szilágyi et al.; licensee BioMed Central Ltd.


Tuijthof G.J.M.,Technical University of Delft | Tuijthof G.J.M.,Orthopedic Research Center Amsterdam | Fruhwirt C.,Austrian Center for Medical Innovation and Technology | Kment C.,Austrian Center for Medical Innovation and Technology
Medical Engineering and Physics | Year: 2013

Minimally invasive surgery poses high demands on tool design. The goal was to measure the influence of drill bit geometry on maximum thrust forces required for drilling, and compare this relative to the known influence of feed rate and bone composition.Blind holes were drilled perpendicular to the iliac crest up to 10. mm depth in cadaveric pelvic bones of 20 pigs (adolescent) and 11 goats (full grown) with eight substantially different drill bits of ∅ 3-3.2. mm. Subsequently, boreholes were drilled perpendicular to the ilium with the same drill bits at three different feed rates (0.58. mm/s, 0.83. mm/s, 1.08. mm/s). The mean maximum thrust force ranges from 10 to 110. N for cortical bone, and from 3 to 65. N for trabecular bone. The results show that both drill bit geometry and feed rate have a significant influence on the maximum thrust forces, with a dominant influence of drill bit geometry in terms of shape of the flutes, sharpness of cutting edges and value of point angle. The differences in thrust forces between cortical and trabecular bone are substantial for all measured conditions. The measured values can be used for drill design. © 2012 IPEM.


Puchberger-Enengl D.,Vienna University of Technology | Krutzler C.,Austrian Center for Medical Innovation and Technology | Vellekoop M.J.,Vienna University of Technology
Proceedings of IEEE Sensors | Year: 2011

In this contribution we present a miniaturized optical reflectance pH sensor based on organically modified silicate for continuous measurements of wound pH. Colorimetric indicators (bromocresol green pH 3.8-5.4 and bromocresol purple pH 5.2-6.8) have been immobilized in tetraethoxysilane (TEOS) thin films. Characteristics of the thin films have been optimized by addition of (3-Glycidyloxypropyl)trimethoxysilane (GLYMO). The pH sensitive layer of the sensor is illuminated through the substrate by a chip-LED. The reflected light at a phototransistor varies in dependence of the color of the thin film. The films have been characterized by visible absorption spectroscopy and the performance of the sensor has been evaluated by measurements on artificial wounds. © 2011 IEEE.


Kettenbach J.,University of Bern | Kara L.,University of Bern | Toporek G.,University of Bern | Fuerst M.,Austrian Center for Medical Innovation and Technology | Kronreif G.,Austrian Center for Medical Innovation and Technology
Minimally Invasive Therapy and Allied Technologies | Year: 2014

Purpose: To test the feasibility of a robotic needle-guidance platform during CT-guided puncture ex vivo. Material and methods: Thin copper wires inserted into a torso phantom served as targets. The phantom was placed on a carbon plate and the robot-positioning unit (RPU) of the guidance platform (iSYS Medizintechnik GmbH, Kitzbuehel, Austria) was attached. Following CT imaging and automatic registration a double oblique trajectory was planned and the RPU was remotely moved into appropriate position and angulation. A 17G-puncture needle was then manually inserted until the preplanned depth, permanently guided by the RPU. The CT scan was repeated and the distance between the actual needle tip and the target was evaluated. Results: Automatic registration was successful in ten experiments and the median duration of an experiment was 9.6 (6.4-46.0) minutes. The angulation of the needle path in x-y and z-axis was within 15.6° to 32.6°, and -32.8° to 3.2°, respectively and the needle insertion depth was 92.8 ± 14.4 mm. The Euclidean distance between the actual needle tip and the target was 2.3 ± 0.8 (range, 0.9-3.7) mm. Conclusion: Automatic registration and accurate needle placement close to small targets was demonstrated. Study settings and torso phantom were very close to the clinical reality. © 2014 Informa Healthcare.


Kettenbach J.,University Institute of Health Sciences | Kronreif G.,Austrian Center for Medical Innovation and Technology
Minimally Invasive Therapy and Allied Technologies | Year: 2015

Several groups have developed robotic systems for invasive medical procedures. In this article we will focus on selected robotic systems for percutaneous needle-guided interventions using CT or MR imaging. We present six interventional robotic systems designed to work with imaging modalities such as CT, Cone-beam CT and MRI. The details of each system are given along with any phantom, animal, or human trials performed with each particular robot. Although each of these systems has specific features, they are all of great clinical value since they provide very stable needle guidance - even for angulated approaches, they may allow access to lesions when the width of the CT- or MR- gantry would limit the access for a biopsy needle or other interventional tools such as thermal ablation probes. Then, such a robot may be able to guide the needle into the most promising region of the lesion without the need for a second contrast injection. Thus, more efficacious characterization and treatment, particularly for lesions that are difficult to target, can be anticipated. Although more research and clinical trials are certainly needed, it is, however, our belief that robotic systems will be an important part of future interventions. © 2014 Informa Healthcare.


Jelinek F.,Austrian Center for Medical Innovation and Technology | Breedveld P.,Technical University of Delft
Journal of Mechanical Design, Transactions of the ASME | Year: 2015

The recently popularized domain of additive manufacturing (AM) has much to offer to medical device development, especially to the growing field of minimally invasive surgery (MIS). With the advancements in AM materials, one could soon envision materializing not only the proofs of concept but also the final clinically approved instruments. DragonFlex-the world's first AM steerable MIS instrument prototype-was recently devised with the aim to follow this vision. Apart from the medical device design restrictions, several limitations of AM materials and processes had to be considered. The aim of this paper is to present these insights to those opting for this means of manufacture, serving as a helpful design and material guide. Over the course of its development, DragonFlex has gone through four design generations so far, each differing in the AM material and process used. Due to being a prototype of a MIS instrument of miniature dimensions, the printing processes were limited to stereolithography (SLA), as to achieve the best possible precision and accuracy. Each SLA process and material brought along specific advantages and disadvantages affecting the final printout quality, which needed to be compensated for either at the design stage, during, or after printing itself. The four DragonFlex generations were printed using the following SLA techniques and materials in this order: polymer jetting from Objet VeroBlue™; SLA Digital Light Processing™ (DLP) method from EnvisionTEC® NanoCure RCP30 and R5; conventional SLA from 3D Systems Accura® 60; and DLP based SLA process from a ceramic composite. The material choice and the printing orientation were found to influence the final printout accuracy and integrity of thin features, as well as material's postproduction behavior. The polymeric VeroBlue™ proved structurally sound, although suffering from undermined accuracy and requiring postprocessing, hence recommended for prototyping of upscaled designs of looser manufacturing tolerances or overdimensioned experimental setups. The NanoCure materials are capable of reaching the best accuracy requiring almost no postprocessing, thus ideal for prototyping small intricate features. Yet their mechanical functionality is undermined due to the high brittleness of RCP30 and high flexibility of R5. The transparent Accura® 60 was found to lose its strength and appeal due to high photosensitivity. Finally, the ceramic composite shows the best potential for medical use due to its biocompatibility and superior mechanical properties, yet one has to compensate for the material shrinkage already at the design stage. © 2015 by ASME.


Kronreif G.,Austrian Center for Medical Innovation and Technology
INES 2016 - 20th Jubilee IEEE International Conference on Intelligent Engineering Systems, Proceedings | Year: 2016

With the first recorded medical application of a robot-a CT-based orientation of a needle guide for biopsy of the brain-occurring in 1985, a number of research groups in Asia, Europe, and the USA began investigating other medical applications of robotics. Beside of a big number of research prototypes and scientific outcome, a relatively small number of commercial ventures were resulting from these efforts. © 2016 IEEE.

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