Aiming at developing a safe, intuitive, and collaborative steerable drilling robotic system for pedicle screw fixation procedures, in this paper, we leverage our recently developed steerable drilling robotic framework, and developed a collaborative drilling mode to control this system. In this control mode, first a user positions a concentric tube steerable drilling robot (CT-SDR) in the workspace and aligns it based on a preplanned trajectory. Next, the CT-SDR is directly controlled by the user through an admittance mode to perform a drilling procedure and creating a J-shape tunnel. To evaluate the user comfort and intuitiveness of the drilling procedure using this system and the proposed control interface, we performed a user study with 11 subjects, who had no prior experience in using this system. The results of this study were analyzed using various qualitative and quantitative metrics.

To address the screw loosening and pullout limitations of rigid pedicle screws in spinal fixation procedures, and to leverage our recently developed Concentric Tube Steerable Drilling Robot (CT-SDR) and Flexible Pedicle Screw (FPS), in this paper, we introduce the concept of Augmented Bridge Spinal Fixation (AB-SF). In this concept, two connecting J-shape tunnels are first drilled through pedicles of vertebra using the CT-SDR. Next, two FPSs are passed through this tunnel and bone cement is then injected through the cannulated region of the FPS to form an augmented bridge between two pedicles and reinforce strength of the fixated spine. To experimentally analyze and study the feasibility of AB-SF technique, we first used our robotic system (i.e., a CT-SDR integrated with a robotic arm) to create two different fixation scenarios in which two J-shape tunnels, forming a bridge, were drilled at different depth of a vertebral phantom. Next, we implanted two FPSs within the drilled tunnels and then successfully simulated the bone cement augmentation process.

In this paper, we introduce S3D: A Spatial Steerable Surgical Drilling Framework for Robotic Spinal Fixation Procedures. S3D is designed to enable realistic steerable drilling while accounting for the anatomical constraints associated with vertebral access in spinal fixation (SF) procedures. To achieve this, we first enhanced our previously designed concentric tube Steerable Drilling Robot (CT-SDR) to facilitate steerable drilling across all vertebral levels of the spinal column. Additionally, we propose a four-Phase calibration, registration, and navigation procedure to perform realistic SF procedures on a spine holder phantom by integrating the CT-SDR with a seven-degree-of-freedom robotic manipulator. The functionality of this framework is validated through planar and out-of-plane steerable drilling experiments in vertebral phantoms.

In this study, we introduce a new concept for reconstruction of Volumetric Muscle Loss (VML) injuries and propose the spatial robotic embedded bioprinting technique. As opposed to the traditional layer-by-layer printing, we leverage the support-free nature of embedded bioprinting to print spatial and complex structures of fascicles in a fusiform muscle. To demonstrate feasibility of this concept, we first propose our robotic bioprinting framework including a robotic arm integrated with a custom-designed bioprinting injector. Complementary motion planning algorithms uniquely designed for this printing task are further proposed. Moreover, the effect of embedded bioprinting parameters, as well as the supporting bath and injecting materials compatibility on the uniformity and quality of the printed constructs has been analyzed. Finally, we perform a case study by printing a fusiform muscle-shape construct using the proposed concept and algorithms, and evaluate the quality of the printed structure.

In situbioprinting has been identified as a promising tissue engineering technique for treating volumetric muscle loss (VML) injuries. However, the success of this procedure significantly depends on the uniform and precise deposition of cells contributing to the regeneration of muscles. To address this critical need, in this work, we present design and quantitative evaluation of a novel autonomousin situbioprinting surgical robotic framework that can be used with a generic bioprinting material. The proposed framework consists of three main components: (i) a bioprinting tool integrated with a seven-degree-of-freedom robotic manipulator to perform a precise autonomous bioprinting procedure; (ii) a unique 3D visual measurement framework comprised of a high-accuracy structured light camera with complementary 2D/3D computer vision algorithms-to enable online and accurate measurement and reconstruction of the bioprinted constructs; and (iii) a quantitative evaluation module with novel assessment metrics-to characterize and evaluate the performance of the bioprinting process toward finding optimal bioprinting parameters. To ensure the biological functionality of a printed construct using our robotic system, we performed 90 experiments and identified optimal bioprinting parameters using the proposed novel assessment metrics.Note to Practitioners—This paper was motivated by the problem of volumetric muscle loss treatment using anin situbioprinting procedure but it also can be applied for treatment of skin and cartilage injuries. Existing approaches to performin situbioprinting is limited to either manual handheld bioprinting devices– that suffer from poor manual control and inaccurate printing constructs– or robotic systems– that have been developed without (i) considering a realistic surgical workflow and (ii) quantitatively evaluating the quality of printed constructs. To collectively address these issues, in this paper, we propose a novel autonomousin siturobotic bioprinting framework. We also introduce unique and complementary quantitative assessment metrics to characterize and evaluate the performance of the bioprinting process. Experiments suggest that the proposed framework can robustly identify optimal bioprinting parameters to ensure the biological functionality of a printed construct using our robotic system.