Abstract:

Newborn children before the age of 9 to 18 months have an anatomical particularity: their skull is composed of several separated bones leaving a zone of soft tissues: fontanelle. These bones are subject to an ossification that progressively closes the skull. The softness of the fontanelle tissues allows the propagation of ultrasonic waves, which makes possible the use of ultrasound for intracranial examination. This specific medical care is called Intracranial Ultrasound (ICU) examination. This task is performed in large number in Taiwan, as a routine exanimation or as critical clinical monitoring where the patients are often place inside neonatal incubator.

The objective of this project is to design the first robotic manipulator being able to perform remote ICU examinations on newborn patients. The specific medical robotic application that allows a doctor to provide ultrasound examination to a distant patient, namely the tele-echography, has been subject to many attentions by medical robotic research since the nineties. However, a tele-operated system dedicated to the examination of newborn’s fontanelle has never been proposed. This project will focus on the mechanical design of the robotic manipulator that holds the ultrasound probe and the haptic control mechanism device that allows the operator to control the system.

The ICU examination through the fontanelle is a delicate procedure as the tissues in contact with probe are fragile. Moreover, the patient is located inside an incubator. This makes the present procedure very challenging to robotize. A new mechanism based on a common pantographic architecture of two Degree of Freedom (DoF) is proposed for the design of the manipulator. Specific architectural improvements are implemented to enhance it into a six-DoF mechanism (three linear and three angular). The definition and the medical-oriented optimization of this mechanism will be based on the result of kinematic and force analysis of the clinical task gesture through experimentations.

In order to complete the robotic system, a haptic control device will be design to allow the pediatric doctor to remotely control the manipulator. An active force feedback system will generate to operator the same kinesthetic sensations of a real examination. It will also allow the operator to accurately control the force to apply on the fontanelle tissues. A series of experimentation are planned to be carried out to test and to validate the motion trajectory and force feedback system of the global “Master-Slave” robotic system. They will respectively rely on motion capture system and external force sensor method. Final clinical simulation experiments using newborn phantom models will be performed with our medical collaborator to validate the robotic system for ICU examination.

This project will bring significant outcomes in terms of innovations: the first medical robotic system dedicated to pediatric patients, the development of a robotic arm able to operate inside an incubator and the definition innovative mechanical architecture. Also, it will generate a demonstrator for further multidisciplinary tele-echography project involving tele-manipulation, communication, control, etc.