Peter P. Pott

Abstract

In the study of Activities of Daily Living (ADLs), limb coordination is essential. Specifically, upper extremity bimanual tasks significantly influence human capabilities. Conditions such as nerve injuries or strokes can result in unilateral paralysis. Rehabilitative assistive devices aim to mitigate these functional impairments. This paper demonstrates the importance of bimanual tasks and their significance in developing assistive devices. Six bimanual ADLs were defined, encompassing both standing and seated tasks, various categories of ADLs, and different workspace areas. While a laboratory setting inherently has limitations in replicating realistic scenarios, representative movement patterns of daily living were identified.

Abstract

Automatic recognition of surgical workflows is a complex yet essential task of context-aware systems in the operating room. However, achieving high accuracy in phase recognition remains a challenge due to the complexity of surgical procedures. While recent deep learning models have made significant progress, individual models often exhibit limitations—some may excel at capturing spatial features, while others are better at modeling temporal dependencies or handling class imbalance. This study investigates the use of ensemble learning to combine the complementary strengths of diverse architectures, aiming to mitigate individual model weaknesses and improve performance in surgical phase recognition using the Cholec80 dataset. A variety of advanced deep learning architectures was integrated into a single ensemble. Models were carefully selected and tuned to ensure diversity, resulting in a final set of 15 unique ensembles. Ensemble strategies were explored to determine the most effective method for combining the distinct models. The results demonstrated that ensemble learning significantly improved performance. Among the ensemble strategies tested, majority voting achieved the highest F1-score, followed by the proposed artificial neural network StackingNet. Ensembles with high model diversity showed superior performance compared to those with lower diversity. The optimal ensemble configuration integrated top performing models from different architectures, leading to improvements in accuracy, F1-score, and Jaccard Index by 1.48%, 3.68%, and 5.43%, respectively, compared to the best individual models. This study demonstrates that ensemble learning can substantially enhance surgical phase recognition by leveraging the complementary strengths of diverse deep learning models. Ensemble size, diversity, and meta-model selection were identified as key factors influencing performance. The resulting improvements translate into clinically meaningful benefits by enabling more reliable context-aware guidance, reducing misclassifications during critical phases, and improving surgeons’ trust in artificial intelligence (AI) systems.

Abstract

One of the heavily burdened actors in the operating theatre is the scrub nurse who is responsible for the organized and orderly workflow in the operating theatre. One of the main tasks of the scrub nurse is to perform quick and appropriate instrumentation because fast and proactive instrumentation is crucial for the success of the operation. The actual deficiency of specialist staff in the healthcare sector is motivating the automation of repetitive tasks and simple work steps in order to relieve staff in the future and free up capacity for complex and important activities. A robotic assistance system appears to be a suitable solution for many of these challenges. The vision is to develop advanced assistance systems for the handling of instruments in future surgical procedures. In this work, surgery of the carpal tunnel was chosen as example task. The focus lied on the type and scope of the individual working steps. The analysis was carried out by video analyses and by observing corresponding surgical procedures. Based on the results of the analysis, potentials for improving the workflow were derived and requirements for a robotic assistance system were defined.

Abstract

Despite being among the most common medical procedures, needle insertions suffer from a high error rate. Impedance measurements using electrode-equipped needles offer promise for improved tissue targeting and reduced errors. Impedance visualization usually requires an extensive pre-measured impedance dataset for tissue differentiation and knowledge of the electric fields contributing to the resulting impedances. This work presents two finite element simulation approaches for both problems. The first approach describes the generation of a multitude of impedances with Monte Carlo simulations for both, homogeneous and inhomogeneous tissue to circumvent the need to rely on previously measured data. These datasets could be used for tissue discrimination. The second method describes the simulation of the spatial sensitivity distribution of an electrode layout. Two singularity analysis methods were employed to determine the bulk of the sensitivity within a finite volume, which in turn enables consistent 3D visualization. The modeled electrode layout consists of 12 electrodes radially placed around a hypodermic needle. Electrical excitation was simulated using two neighboring electrodes for current carriage and voltage pickup, which resulted in 12 distinct bipolar excitation states. Both, the impedance simulations and the respective singularity analysis methods were compared with each other. The results show that the statistical spread of impedances is highly dependent on the tissue type and its inhomogeneities. The bounded bulk of sensitivities of both methods are of similar extent and symmetry. Future models should incorporate more detailed tissue properties such as anisotropy or changing material properties due to tissue deformation to gain more accurate predictions.

Abstract

This paper provides a preliminary experimental assessment of a flexible endoscope driven by antagonistic twisted string actuation (TSA). Traditional endoscope designs have relied on manual manipulation or actuation systems lacking force control loops, limiting their versatility and ease of use. The proposed approach leverages the benefits of additive manufacturing to create customizable, deformable endoscope’s tip structures, while TSA provides an efficient and potentially compact actuation mechanism. The experimental evaluation encompasses two key aspects of endoscope performance: tissue interaction and stiffness variation. Through a series of controlled experiments, the endoscope’s ability to interact with mock biological tissues is assessed, demonstrating successful force application using both agonist-only and antagonistic functioning modalities. Furthermore, the endoscope’s resilience to external disturbances is evaluated, with results showing significant improvements in stiffness and response to perturbations when utilizing antagonistic control. These findings highlight the potential of the proposed device to improve flexible endoscopy design and functionality. By integrating advanced manufacturing techniques with innovative actuation mechanisms, robotic flexible endoscopes can offer enhanced maneuverability, diagnostic precision, and patient safety.

Abstract

Needle insertion is a common procedure in modern healthcare practices, such as blood sampling, tissue biopsy, and cancer treatment. Various guidance systems have been developed to reduce the risk of incorrect needle positioning. While ultrasound imaging is considered the gold standard, it has limitations such as a lack of spatial resolution and subjective interpretation of 2D images. As an alternative to conventional imaging techniques, we have developed a needle-based electrical impedance imaging system. The system involves the classification of different tissue types using impedance measurements taken with a modified needle and the visualization in a MATLAB Graphical User Interface (GUI) based on the spatial sensitivity distribution of the needle. The needle was equipped with 12 stainless steel wire electrodes, and the sensitive volumes were determined using Finite Element Method (FEM) simulation. A k-Nearest Neighbors (k-NN) algorithm was used to classify different types of tissue phantoms with an average success rate of 70.56% for individual tissue phantoms. The results showed that the classification of the fat tissue phantom was the most successful (60 out of 60 attempts correct), while the success rate decreased for layered tissue structures. The measurement can be controlled in the GUI, and the identified tissues around the needle are displayed in 3D. The average latency between measurement and visualization was 112.1 ms. This work demonstrates the feasibility of using needle-based electrical impedance imaging as an alternative to conventional imaging techniques. Further improvements to the hardware and the algorithm as well as usability testing are required to evaluate the effectiveness of the needle navigation system.

Abstract

Blood draw procedures are conmon medical interventions, but they can lead to complications if not perfomed accurately. In this paper, we propose an impedance-based approach to enhance feedback to clinicians during needle insertion. Our method involves integrating a thin-film sensor with a hypodemic needle, allowing for multi-local impedance measurements. The needle features a total of 16 electrodes forming four tetrapolar impedance measurement spots. However, challenges related to stability, contact, and calibration were observed. Despite these challenges, our approach shows potential for localized tissue classification during needle insertion. Further refinement and exploration of tissue classification algorithms and visualization techniques are needed. The proposed approach could also find application in spinal and epidural anaesthesia, or nephrostomies.

Abstract

Flexible endoscopes are widely used for diagnostic and therapeutic procedures on internal organs and tissue surfaces. Accurate positioning of the endoscope tip is critical for obtaining clear images and avoiding tissue damage. Proximity sensors can provide information about the distance to the surrounding tissue, which can help align the endoscope tip and navigate along curved paths. This paper presents a method of proximity measurement using capacitive sensors with active shielding to determine the radial distance between an endoscope and surrounding tissue. The capacitive sensor consists of four copper foil electrodes attached to a 9.5 mm diameter ring. Two different active shielding designs were investigated and compared to reduce the sensing angle and minimize lateral effects. Capacitance was measured as a function of distance using a linear stage. A MATLAB script controlled the linear stage and calculated the distance from the measured capacitance. The results showed that advanced active shielding could be useful to reduce the sensing angle (angular space where capacitance sensor detects capacitance changes.). This method provides a cost-effective solution for radial distance measurement in endoscopy, essential for improving diagnostic and therapeutic procedures.

Abstract

This research project investigated the additive manufacturing of pneumatic actuators based on the principle of droplet dosing using an Arburg Freeformer 300-3X 3D printer. The developed structure consists of a porous inner filling and a dense, airtight chamber. By selectively varying the filling densities of the porous inner filling, different membrane deflections of the actuator were achieved. By linking the actuators, a pneumatic network actuator was developed that could be used in endorobotics. To describe the membrane deflection of an additively manufactured pneumatic actuator, a mathematical model was developed that takes into account the influence of additive manufacturing and porous filling. Using a dedicated test rig, the predicted behavior of the pneumatic actuators was shown to be qualitatively consistent. In addition, a pneumatic network actuator (PneuNet) with a diameter of 17 mm and a height of 76 mm, consisting of nine chambers with different filling densities, could be bent through 82° under a pressure of 8 bar. Our study shows that the variation of filling densities during production leads to different membrane deflections. The mathematical model developed provides satisfactory predictions, although the influence of additive manufacturing needs to be determined experimentally. Post-processing is still a necessary step to realize the full bending potential of these actuators, although challenges regarding air-tightness remain. Future research approaches include studying the deflection behavior of the chambers in multiple directions, investigating alternative materials, and optimizing the printing process to improve mechanical properties and reliability.

Abstract

Early detection of tumors and their spread, particularly in lymph node illnesses, is critical for a full recovery. However, it is currently difficult due to a lack of imaging or detection devices that provide the necessary spatial depth and location information. Consequently, it would be beneficial to have a simple and cost-effective sensor device to determine the 3D position of, e.g., a lymph node in the patient's coordinate system.

Abstract

Patients suffering from Wilson’s disease accumulate copper in their body. Copper load may become visible as Kayser-Fleischer (KF) rings - colorful copper-sulfur granules in the base of the cornea. Reoccurrence of KF rings in patients under anti-copper medication may be a sign for ineffective treatment. This work proposes a hand-held sensing system based on infrared reflectivity measurement of the cornea as a potential method for regular at-home progression monitoring. The intensity of the LEDs used is safe for operation on the human eye. As proof of concept, reflectivity was measured when placing the sensor onto samples of white paper that had copper tape of different sizes centered within the sensitive area. Further, reflectivity was determined for different solutions of copper sulfate in saline that were poured into adapter bowels fitting the sensor head, with Cu2+ concentrations of the samples deducted from literature. While the prototype system can be used to differentiate between two copper strips of 6 and 12 mm2 or larger, a different measuring principle would be needed to also determine the concentration of copper sulfate solutions. Since these two in-vitro models cannot fully represent the complex in-vivo molecular conditions of patients’ corneas, additional measurements on patients’ eyes are necessary to evaluate the potential of the proposed sensing system.

Abstract

The demand of automated systems based on artificial intelligence in healthcare has remarkably increased in the last few years. Due to the growing shortage of skilled workers and the associated error potentials, the reduction of the workload is essential for the care of patients. Surgery assisting tasks could be automated in order to overcame these negative effects. This study presents the development and evaluation of a deep learning system for the recognition of surgical instruments. Already implemented algorithms based on Convolutional Neural Networks (CNN) were used. The object detection was carried out with YOLOv5. Altogether 18 models have been trained on a self-generated dataset of around 800 images. A mean average precision (mAP) of 0.978 for the recognition of three classes, and an mAP of 0.874 for the recognition of six classes was achieved.

Abstract

In this paper the model-based assessment of the workspace of a planar Cable-Driven Haptic Device for telemanipulation in the field of Robot-Assisted Surgery is presented. The Cable-Driven Haptic Device is intended to be used for the control of a flexible robot for colonoscopy. It consists of four cables and provides, depending on the endeffector design, two or three Degrees of Freedom. Different endeffector geometries and sizes were investigated and evaluated using three quantitative assessment indices regarding the resulting workspaces. In addition, a set of external wrenches is used to examine the workspace with a haptic feedback force of 5 N which can be displayed to the user at each pose. For the intended application, a point-shaped and a line-shaped endeffector design showed to be a suitable solution based on the assessment indices. This work provides a basis for further research into telemanipulation with haptic user interfaces based on Cable-Driven Parallel Robots, enabling high fidelity haptic feedback.

Abstract

In this paper, the development of a cost-effective assistance system for venipuncture is presented. The system locates forearm veins through near-infrared imaging, depth estimation, deep learning segmentation, and 3D reconstruction. A single-board computer was integrated with two infrared cameras and two 760 nm near-infrared (NIR) LEDs to capture and process stereo images. The depth estimation was achieved through stereo triangulation. A deep learning model based on the U-Net architecture with an attention mechanism and a training dataset of 900 images from 40 participants was used for vein segmentation. Depth information and segmented veins were combined to enable a 3D visualization of the veins. The results show a Jaccard-Score of 92.80 % for vein segmentation and an average reprojection error of 0.48 pixels for the 3D reconstruction.

Abstract

This study explores the potential of using a sensor system and deep learning algorithm for automatic recognition and classification of human movement intentions to enhance the control of active orthopedic aids such as orthoses, prostheses, and exoskeletons. The sensor system consists of four inertial measurement units (IMU) attached to the thighs, lower back, and chest of a person, measuring acceleration and rotational velocity in three axes each. A dataset was generated from 20 healthy individuals performing various movements from a standing position, and preprocessed and segmented into time windows. The data was fed into a convolutional neural network (CNN) capable of classifying the time windows into seven classes. The network achieved a classification accuracy of up to 82 %. The results demonstrate the potential of the proposed system for successful application in the control of assistance systems, which can improve the operability and effectiveness of orthopedic aids.

Abstract

Blood draw procedures are conmon medical interventions, but they can lead to complications if not perfomed accurately. In this paper, we propose an impedance-based approach to enhance feedback to clinicians during needle insertion. Our method involves integrating a thin-film sensor with a hypodemic needle, allowing for multi-local impedance measurements. The needle features a total of 16 electrodes forming four tetrapolar impedance measurement spots. However, challenges related to stability, contact, and calibration were observed. Despite these challenges, our approach shows potential for localized tissue classification during needle insertion. Further refinement and exploration of tissue classification algorithms and visualization techniques are needed. The proposed approach could also find application in spinal and epidural anaesthesia, or nephrostomies.

Abstract

Minimally invasive surgery (MIS) has been an essential tool in the surgical sector for many years due to its crucial advantages compared to open surgery. To overcome remaining limitations, teleoperated MIS experienced a strong emergence. However, the widespread usage of such systems is hindered by the enormous financial hurdle. The use of standard components and conventional tools for teleoperated MIS can facilitate integration into existing hospital workflows and can be a cost-efficient and versatile approach for research purposes. To compensate for the lack of haptic feedback, some teleoperation setups inherit a sensor system allowing them to record interaction forces and display them at the user interface. In research and in commercially available systems, different positions for the sensor can be found. In this paper, mechanical interfaces for the guidance and actuation of non-wristed and wristed standard instruments are presented. Furthermore, a method for the extracorporeal measurement of interaction forces is presented, characterized, and discussed. The overall mean relative error of the magnitude of the interaction force is 9.4%, while the overall mean absolute error of the force vector is 14.4 $^$ , both below the respective human differential perception threshold. The presented measurement method is a simple, yet sufficiently accurate approach to measure interaction forces in surgical telemanipulation.

Abstract

During laparoscopic procedures, the surgeon's view of the situs, and thus her or his performance, is dependent on the skills of the camera assistant. The surgeon lacks control over his own field of view and there is a high potential for reducing mental load and workflow issues. In this paper, a research setup of a 360° laparoscopic imaging system is presented and evaluated. The system consists of a 360° camera and a head-mounted display, through which the surgeon can inspect the situs. In a user test, the system showed advantages over a conventional laparoscope regarding orientation in thesitus, intuitiveness of operation, and faster task completion.

Abstract

We tested the feasibility of ultrasound technology for generating pressurized intraperitoneal aerosol chemotherapy (usPIPAC) and compared its performance vs. comparator (PIPAC).

Abstract

In conventional laparoscopy, the field of view of the surgeon is limited. Angled laparoscopes enable the observation of surrounding structures, however, to change the viewing perspective on a specific object, permanent repositioning and rotation of the shaft is required. In this paper, a demonstrator of a steerable flexible laparoscope is presented, enabling the user to intuitively adjust the perspective onto an object by means of a single control element. The laparoscope provides a viewing angle of ± 50° at 50 mm working distance. In first tests, the presented laparoscope showed advantages regarding intuitiveness of the control, easier handling, and improved depth perception.

Abstract

Accurate measurement of interaction forces during robot-assisted surgery requires compact force sensing modalities in the surgical tools, thus might add considerable cost to the setup. Measuring the motor current to estimate gripping forces, is an advantageous approach since no expensive force sensor is needed. In this paper, a mechanical interface is presented, which allows actuating conventional articulated instruments for robot-assisted surgery. The interface features the estimation of static gripping forces at the instrument’s tip based on the motor current. The evaluation shows reproducible results, and the current-based approach seems to be a cost-efficient way to estimate gripping forces.

Abstract

When manipulating tissue during medical interventions, high-accuracy movements are important to avoid injuries. However, feedback is limited and it is hard to establish control loops to ensure correct movements. We propose the use of a novel highly compact 6-axis force / torque sensor (Ø 10.5 mm x 11.0 mm) within a hand piece to determine low forces and torques during various small-scale procedures including gentle tool-tissue interaction. For a first validation of the system, different venepuncture cannulas were connected to the sensor top and driven into skinned fruits (toma-toes and grapes) as well as into a silicone block. During insertion of the needle tips, maximum forces of 74 – 158 mN (tomato) and 51 - 161 mN (grape) were recorded, and steadily increasing forces in the range of 0 – 250 mN when insert-ing needles 7.5 mm into silicone. For a 0.99 g screw nut (9.73 mN), the measured gravitational force was 10.6 ± 1.5 mN during ten measurement sets. During the insertion, needle torques of up to 9.5 mNm were observed. Different cutting phases were seen similar to the phases during needle penetration testing. We conclude that the compact measurement setup used is suitable to measure the low forces and torques occurring when cutting soft, aqueous human tissues with or without skin-like layers.

Abstract

Localized impedance measurements at the needle tip identifying the present tissue type could aid clinicians in needle procedures. To assess the sensitivity field of a hollow, bipolar needle electrode, a 3D finite element approach using COMSOL Multiphysics was chosen. The simulated bipolar needle electrode consists of two hypodermic needles (17 G and 23 G) with an insulating layer of polytetrafluoro-ethylene (PTFE) in between. Impedance values were recorded while steadily increasing the insertion depth of the needle electrode in a layered tissue structure of skin (dermis), fat, and blood. Simulation results reveal a highly local sensitivity volume around the needle tip that can be approximated by half a tri-axial ellipsoid with elliptic radii of 0.735 mm, 2.886 mm, and 1.774 mm. A comparison with simulated and measured impedance values shows great correspondence.

Abstract

Venipuncture is one of the most often performed invasive clinical procedure. Nevertheless, complications still occur. One opportunity to counteract these complications is to indicate the insertion by electrical impedance measurement, which bases on the various electrical properties of different tissues. This paper presents the evaluation and reproducible fabrication of simple tissue-mimicking phantoms for investigation of impedance sensing techniques. Three different tissue-mimicking phantoms, representing blood, fat, and skin, were made on water-based recipes, including agar and gelatin as gelling agents. For evaluation of the electrical properties an electrode probe, made of hypodermic needles, was fabricated and characterized using six sodium chloride (NaCl) solutions of defined concentrations. For characterization of the phantoms, conductances were measured over a frequency range from 20 Hz up to 1 MHz using the self-fabricated electrodes. The calculated conductivities of the tissue-mimicking phantoms showed sufficient agreement with corresponding electrical literature data of native tissue. Tests with a layered tissue structure proved usability for impedance-based venous entry tests. However, the method proposed was not suitable for investigation of relative permittivity, which would be required for full electrical characterization.

Abstract

Energy harvesting could make it possible to replace batteries of active electronic implants or at least extend the lifespan of the implant, which primarily depends on the capacity of the batteries used. This paper provides an overview of current energy harvesting modalities for medical devices. For each modality, energy harvesting systems are analysed in terms of provided power, size, and location (wearable/implanted). To allow easy comparison the available electrical power was normalized to the largest surface of the devices. During the research 42 energy harvesting systems have been identified. For wearable devices, a power range of 0,43 nW/cm2 up to 1,2 mW/cm2 can be expected. For implanted devices 26,76 nW/cm2 up to 39,5 mW/cm2. The provided power of wearable and implantable systems would usually be sufficient to operate a pacemaker, for example. Most devices are extended in only two dimensions, thus the power-to-surface-ratio is valid. For wide use in medical devices, the systems still need to be adapted, particularly in terms of reliability, size, and biocompatibility.

Abstract

A method for identification of tissue types using a handheld impedance measurement device is proposed. An impedance analyzer chip AD5933, driven by an Arduino Nano, is utilized for measurements of the electrical impedance. The electrodes interfacing the tissue consist of two concentric standard hypodermic needles, separated by an insulating layer of PTFE. The electrical contact is established by two-pole splicing connectors. By a prior determination of the cell constant, the conductivity of the penetrated tissue type can be inferred from impedance values. The cell constant determined for the self-fabricated needle electrode is 3.72 ∙ 10-3 m. For NaCl solutions, percental differences between the conductivities found in this work and literature values are between 0.8 % and 37.7 %. For a test frequency of 100 kHz, only small differences from expected conductivity values (2.1 % for muscle, and 5.8 % for fat) are found in porcine tissue samples, demonstrating the ability to identify unknown tissue types. However, miniaturization of the needle as well as the consideration of the tissue’s permittivity is desired to increase detection quality.

Abstract

Teeth grinding is, due to its various impacts on the human body, a highly discussed issue in dentistry. It can damage the tooth structure or cause pain due to muscle tension. At the moment, there is neither a satisfactory diagnostic nor a comprehensive treatment option. This paper deals with the development of an app-controlled, small, portable sensor unit that can be used by patients to monitor their teeth grinding in everyday life. It also offers a treatment option due to an implemented biofeedback option. To achieve the most cost-effective device possible, only off-theshelf electronics and no proprietary software were used. In initial tests, the measuring device showed high level of measurement accuracy when performing measurements without feedback at rest (f_score=-0.025...0).

Abstract

The treatment of (partially) paralyzed hands continues to reach surgical and therapeutic limits in Germany, marking the supply of patients with mechanical devices becoming increasingly relevant. The aim of the presented work is the realization of a modular orthosis for paralyzed hands. In paresis, an active hand orthosis can be used as a training device to relax spastic paralysis and a support structure to restore flexion and extension. This presented orthosis is intended to functionally support paralyzed fingers regarding the range of motion and achievable force, based on modular mechanical components and drive unit. For the drive unit an actuator principle is required, that permits quiet, lightweight, and inexpensive force generation. The twisted string actuation (TSA) is based on the axial twisting of two polyethylene strings. The twisting reduces the initial length of the string by creating a helix and – given non-elastic behaviour of the material – generates a tensile force against the load. The operating principle requires no additional gears and produces minimal noise. In the first step, the development approach is validated by the movement of two (spastically) paralyzed fingers (index finger, and middle finger) with the orthosis. Two DC-motors of different power are used to move the paralyzed fingers with the required force of 20 N. Two Dyneema® strings are used for the twisted string. Various tests are carried out to characterise the parameters (initial length of the twisted string, pre-twisting of the strings, motor behaviour) for operation. The drive unit works according to an antagonistic principle. The motors for extending the fingers are located on the dorsal side of the forearm, the motor for flexion on the palmar side. The motors and the TSA are attached to an orthotic structure that extends from the forearm to the metacarpophalangeal joint. The basic material of this support structure is ORFIT ECO 2.4 mm, a thermoplastic material which can be deformed at 65°C and adapted to the specific needs of the patient. The TSA is connected to a two-stage mechanical linear guide, which implements the flexion and extension of the fingers. Linear cross roller bearings guide the two carts for movement of the distal and proximal interphalangeal joints in the first step and complete flexion or extension through the metacarpophalangeal joint in the second step. Mechanical pivot joints at the interphalangeal joints and a double joint at the metacarpophalangeal joint allow the flexion and extension of the individual fingers. The joints, the supports for the paralyzed fingers and the two-stage mechanism are printed with polylactide (PLA) using Fused Deposition Modelling (FDM). The constant speed movement of the fingers is triggered by an input from the user. The movement is controlled by limiting the motor current, with feedback from an encoder. If the fingers get in touch with an object, the reaction torque in the motor increases, resulting in the TSA needing to apply more force to bend the fingers. As soon as the motor torque is above a defined maximum, the motor stops and with it a further flexion of the fingers, so that the object is held. A reversal of the direction of rotation causes the fingers to open again. The functionality of the mechanism driven with a TSA and movement over the pivot joints is proven by the first prototype and the movements of the fingers. Currently tests have been performed on a healthy subject and will be extended to subjects with paralysis in the future.

Abstract

Standard microscopes designed for the direct view through oculars have a rather large footprint due to standardised distance between objective and ocular. Most parts in microscopes are made from cast aluminium and brass for reasons of mechanical strength and vibration damping. In the future, microscopes could be designed more compact if solely digital imaging is used as the optical path could be shorter and less optical elements would be needed. One crucial mechanical part of a microscope is the mechanism to adjust the relative position of objective and probe. This work focusses on the deployment of linkages with monolithic joints to provide high-precision linear motion. As a demonstrator, the prototype of a fully automatic compact light sheet microscope is presented. The Lambda-mechanism by Chebyshev has been selected as it allows a complete straight part of the coupler curve. By arranging two such mechanisms in parallel and two of such arrangements in two parallel planes, a three-dimensional linear guide with a vertical axis of motion is created. To allow easy manufacturing and precise motion, monolithic joints with low friction and backlash are used. Using the described mechanism, a prototype of a light-sheet microscope was built using fused-deposition modelling 3D-printing (FDM) of ABS plastics. The device consists of three subgroups: the probe conveyer, the laser adjustment unit, and the actual microscope. The probe conveyor holds 26 specimens in transparent tubes and positions each tube under the lens. This is then moved vertically by the described monolithic mechanism by a stepper motor. Image acquisition is done using a Raspberry V2.1 camera (8 megapixels) with an additional 2.1 mm lens forming a 4f-optics arrangement and a Raspberry Pi3 Model-B computer. The latter is also used to control the mechanics of the microscope. For validation a pappus of dandelion seed was assessed. It was possible to easily visualize the geometrical structure in different horizontal planes. Structures down to ~1.2 µm could be differentiated. It became clear that the vertical stiffness of the monolithic mechanism is sufficient as is the alignment of the axes. The tolerances of the FDM printing process lead to only a very small lateral and angle displacement. However, lateral stiffness of the mechanism is not yet sufficient. Future development will provide higher optical resolution by deploying higher quality lenses and interchangeable fluorescence filters for greater flexibility.

Abstract

A twisted string actuator (TSA) is a small, strong, lightweight, and low-cost gear, transforming rotation into a linear pulling movement. The TSA consists of two or more strings that are twisted along their common longitudinal axis. The helix formed in this process becomes shorter the further the bundle is twisted. A possible application is a tendon-based endoscopic robot. To control the movement of the endoscope, a precise contraction of the tendon is necessary. Since the strings of the TSA show an elastic behaviour, position feedback is needed to determine the exact movement of the TSA. In this paper, a TSA with a closed-loop position control by a low-cost displacement sensor is presented.

Abstract

In robotic telemanipulation for minimally-invasive surgery, lack of haptic sensation and non-congruent movement of input device and manipulator are major drawbacks. Input devices based on cable-driven parallel mechanisms have the potential to be a stiff alternative to input devices based on rigid parallel or serial kinematics by offering low inertia and a scalable workspace. In this paper, the haptic user interface of a cable-driven input device and its technical specifications are presented and assessed. The haptic user interface allows to intuitively control the gripping movement of the manipulator’s end effector by providing a two-finger precision grasp. By design, the interface allows to command input angles between 0° and 45°. Furthermore, interaction forces from the manipulator’s end effector can be displayed to the user’s two-finger grasp in a range from 0 N to 6 N with a frequency bandwidth of 17 Hz.

Abstract

In robotic telemanipulation for minimally-invasive surgery, lack of haptic sensation and non-congruent movement of input device and manipulator are major drawbacks. Input devices based on cable-driven parallel mechanisms have the potential to be a stiff alternative to input devices based on rigid parallel or serial kinematics by offering low inertia and a scalable workspace. In this paper, the haptic user interface of a cable-driven input device and its technical specifications are presented and assessed. The haptic user interface allows to intuitively control the gripping movement of the manipulator’s end effector by providing a two-finger precision grasp. By design, the interface allows to command input angles between 0° and 45°. Furthermore, interaction forces from the manipulator’s end effector can be displayed to the user’s two- finger grasp in a range from 0 N to 6 N with a frequency bandwidth of 17 Hz.

Abstract

To assist the insertion of a robot-aided endoscope during colonoscopy, a measuring system is required so that the endoscope tip can align automatically and thus find the curved pathway of the large intestine. To achieve this, a self-expanding nitinol wire basket is used to sense the contour of the intestine. As the wire basket touches the wall, it is deflected towards the center of the intestine. The relative position of the wire basket within the camera image is captured, which describes the desired direction to follow the organ. To identify the wire basket in the image, the original RGB image stream is converted into the HSV (hue, saturation, value) color space. Thus, a binary image can be created, in which only the neon-green color portion of the wire basket is visible as a cross. The Hough Transformation is used to search for straight lines in the binary image. Once two lines are found, the intersection point can be calculated and thus its position in the image. The evaluation of the execution time of the algorithm on a live stream was 45 ± 31 ms on average. The algorithm robustly recognizes the wire basket even if it was not visible to the human eye in the original RGB image due to deficient lighting.

Abstract

Upper limb absence has an impact on both physical and mental health of a human being. Nowadays, the costs of commercial, externally powered prosthetic hands range between 25.000 € and 70.000 €. A first demonstrator of a lightweight low-cost prosthetic hand is produced with 3D-printing technology (Fused Deposition Modeling). Due to integration of single-axis solid-state joints the five fingers can be printed in one piece. Thermoplastic polyurethane is used for this purpose. The flexion of all fingers is achieved by moving cords which are positioned on the palmar side of each finger. Two twisted string actuators are integrated to allow the movement of the thumb and the remaining four fingers. These actuators consist of two polyethylene strands which are twisted along their main axis by a DC motor, providing a tensile force to bend the fingers. In order to achieve simultaneous but differential actuation of the four fingers (small finger, ring finger, middle finger and index finger), a differential mechanism is used. The thumb is driven by a separate unit. In order to open the hand, the elasticity of the joints’ material is taken advantage of. With the developed mechanics it is possible to perform precision and cylindrical grasps with an opposed thumb. Weights up to 260 g can be held according to the shape and size of an object. To increase the adaption to different sizes and weights of objects, the design should be modified. It can be concluded, that the presented device is a promising basis for a lightweight, lowcost prosthetic hand in the future.

Abstract

Venepuncture is one of the most often performed invasive clinical procedure. Nevertheless, complications still occur. One possibility to counteract these complications is to indicate the insertion by electrical impedance measurement, based on the various electrical properties of different tissues. This paper presents the evaluation and reproducible fabrication of simple tissue-mimicking phantoms for investigation of impedance sensing techniques. Three different tissue-mimicking phantoms, representing blood, fat, and skin, were made on water-based recipes, including agar and gelatin as gelling agents. For evaluation of the electrical properties an electrode probe, made of hypodermic needles, was fabricated and characterized using six sodium chloride (NaCl) solutions of defined concentrations. For characterization of the phantoms, conductances were measured over a frequency range from 20 Hz up to 1 MHz using the self-fabricated electrodes. The calculated conductivities of the tissue-mimicking phantoms show sufficient agreement with corresponding electrical literature data of native tissue. However, the method was not suitable for investigation of relative permittivity, which would be required for full electrical characterization.

Abstract

Venepuncture is one of the most common invasive procedures in medical healthcare worldwide, however failure rates are still relatively high, particularly for paediatric, geriatric, darker skinned, and obese patients. Visualisation of the veins has been shown to decrease failure rates and can be achieved through trans-illumination, near infrared reflectance, or sonography. However, these techniques are either not reliable or very expensive, resulting in them not being commonly used in the clinical workplace. This paper develops a proof of concept low-cost LED vein detection device using photocurrent generated by LEDs in reverse bias. The prototype uses two emitting LEDs and one detecting LED to identify the location of a vein via trans-illuminance and reflectance. Various light intensities and wavelengths of the LEDs are tested in regard to resolution, noise, and signal peaks. A balance between system noise and resolution is identified for each LED in relation to the emitted intensity. No significant difference was observed in relative peak height when different wavelengths were used to identify the same superficial veins. The initial proof of concept proves the LED vein detection method and provides the foundation for further low-cost LED vein detection devices to be developed.

Abstract

Microscopy enables fast and effective diagnostics. However, in resource-limited regions microscopy is not accessible to everyone. Smartphone-based low-cost microscopes could be a powerful tool for diagnostic and educational purposes. In this paper, the imaging quality of a smartphone-based microscope with four different optical parameters is presented and a systematic overview of the resulting diagnostic applications is given. With the chosen configuration, aiming for a reasonable trade-off, an average resolution of 1.23 μm and a field of view of 1.12 mm2 was achieved. This enables a wide range of diagnostic applications such as the diagnosis of Malaria and other parasitic diseases.

Abstract

Access to systems for robot-assisted surgery is limited due to high costs. To enable widespread use, numerous issues have to be addressed to improve and/or simplify their components. Current systems commonly use universal linkage-based input devices, and only a few application-oriented and specialized designs are used. A versatile virtual reality controller is proposed as an alternative input device for the control of a seven degree of freedom articulated robotic arm. The real-time capabilities of the setup, replicating a system for robot-assisted teleoperated surgery, are investigated to assess suitability. Image-based assessment showed a considerable system latency of 81.7 ± 27.7 ms. However, due to its versatility, the virtual reality controller is a promising alternative to current input devices for research around medical telemanipulation systems.

Abstract

Microscopy is an essential tool in research and science. However, it is relatively resource consuming regarding cost, time of usage, and consumable supplies. Current low-cost approaches provide good imaging quality but struggle in terms of versatility or applicability to varying setups. In this paper, a Compact Microscope Module for versatile application in custom-made setups or research projects is presented. As a first application and proof of concept, the use of the module in a High-Throughput Microscope for screening of samples in microtiter plates is shown. The Compact Microscope Module allows for simple and resource-efficient microscopy in various applications while still enabling relatively good imaging qualities.