Fluoroscopy and Ultrasonography Based Passive Robotic Arterial Puncture Mechanism for Reduction of Radiation Exposure and Implementation of Real Time Auditory Feedback Dosimeter

Abstract

Vascular interventional procedures are performed by the physician with the help of image guided techniques. Ultrasonography and fluoroscopy are the most common image In case of ultrasonography the physician has to hold both the needle and the ultrasound probe in his hands. Prolonged holding of probe in the hands create musculoskeletal disorders. Ultrasonography guided arterial puncture approach has also limitation related to the size of the arteries. For small size arteries fluoroscopy guided arterial puncture is a better option. However, use of fluoroscopy creates radiation exposure not only for the physician and medical staff but also for the patient as well. Physician performs arterial puncture more frequently and as a result gets more exposed. Therefore, in this dissertation passive robots for performing arterial puncture procedures using ultrasonography and fluoroscopy are proposed that would not only solve the problem of musculoskeletal disorders but also reduce radiation exposure. Firstly, a new ultrasonography guided arterial puncturing and guidewire insertion mechanism has been developed. The passive robot allows the physician to not only hold the ultrasound probe, but also performs needle and guidewire insertion with precision and accuracy. To test the effectiveness of the device, animal experimentation has been performed. 4 DOF ultrasound probe holder has been designed which is attached to the 7 DOF passive arm. Secondly, a novel passive robotic mechanism for arterial puncturing under fluoroscopy guidance has been designed and developed that has significantly reduced radiation exposure. Radiation dose rate data with and without passive robotic mechanism has been measured and compared. The effectiveness of the passive robotic mechanism has been validated by certain parameters. These parameters include exposure time, success rate and level of complication in arterial puncturing procedures. Three different types needle insertion mechanisms have been designed that helped the physician to perform surgical procedures with precision and accuracy. Finally, real time radiation dosimeters have been used to reduce the radiation exposure and create awareness among the physician and medical staff about the dangers of radiation exposure. Clinical animal experimentation has been done to test the effectiveness of the approach.