Highly accurate positioning is fundamental to the performance of microsurgery. Vitreoretinal microsurgery in particular is among the most demanding of specialties in terms of positioning accuracy, and is likely to become more so due to the increasing interest in retinal microvascular interventions. Of similar importance when dealing with delicate tissues is precise control of applied force. The lack of it leads to complications such as iatrogenic retinal breaks during membrane peeling. The original research period under this R01 grant was devoted to the basic development of a fully handheld micromanipulator that performs active tremor compensation by sensing its own movement and deflecting its tool tip to counteract the tremor. A full working prototype has been built and tested, and the tremor compensation has been demonstrated;the ground has now been laid for the realization of the fuller potential of this device for the control of both position and force, which may open the way to numerous significant clinical benefits: reducing complications, improving overall outcomes, and possibly enabling new types of procedures.
This research aims to optimize the parameters of the new tremor compensation filter used within Micron, and validate its improved performance with human users in retinal vein cannulation in vitro in porcine cadaver eyes and in ovo in a chick chorioallantoic membrane (CAM) model, and in cell micromanipulation in the biology laboratory. Improved methods for semi automated micromanipulation with Micron will then be developed and validated with human users in patterned laser photocoagulation in vitro and in chick CAM. Methods for force control of Micron will then be developed and validated with human users in membrane peeling and retinal vessel cannulation tasks in vitro and in chick CAM. The active tremor compensation will be tested primarily in cannulation, the scanning technique in patterned laser photocoagulation, and the force control in membrane peeling and vessel cannulation.

Public Health Relevance

This research aims to develop technology that will improve public health outcomes by enhancing the micromanipulation capabilities of microsurgeons and basic researchers. Vitreoretinal microsurgery is the main surgical focus of the project, but the technologies developed are applicable also to otolaryngology, neurosurgery, and other specialties.

National Institute of Health (NIH)
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Research Project (R01)
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Bioengineering, Technology and Surgical Sciences Study Section (BTSS)
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Krosnick, Steven
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Carnegie-Mellon University
Schools of Arts and Sciences
United States
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Gonenc, Berk; Gehlbach, Peter; Handa, James et al. (2014) Motorized Force-Sensing Micro-Forceps with Tremor Cancelling and Controlled Micro-Vibrations for Easier Membrane Peeling. Proc IEEE RAS EMBS Int Conf Biomed Robot Biomechatron 2014:244-251
He, Xingchi; Gehlbach, Peter; Handa, James et al. (2014) Development of A Miniaturized 3-DOF Force Sensing Instrument for Robotically Assisted Retinal Microsurgery and Preliminary Results. Proc IEEE RAS EMBS Int Conf Biomed Robot Biomechatron 2014:252-258
Gonenc, Berk; Feldman, Ellen; Gehlbach, Peter et al. (2014) Towards Robot-Assisted Vitreoretinal Surgery: Force-Sensing Micro-Forceps Integrated with a Handheld Micromanipulator. IEEE Int Conf Robot Autom 2014:1399-1404
He, Xingchi; Balicki, Marcin; Gehlbach, Peter et al. (2014) A Multi-Function Force Sensing Instrument for Variable Admittance Robot Control in Retinal Microsurgery. IEEE Int Conf Robot Autom 2014:1411-1418
He, Xingchi; Handa, James; Gehlbach, Peter et al. (2013) A Sub-Millimetric 3-DOF Force Sensing Instrument with Integrated Fiber Bragg Grating for Retinal Microsurgery. IEEE Trans Biomed Eng :
Yang, Sungwook; Wells, Trent S; Maclachlan, Robert A et al. (2013) Performance of a 6-degree-of-freedom active microsurgical manipulator in handheld tasks. Conf Proc IEEE Eng Med Biol Soc 2013:5670-3
Yang, Sungwook; Balicki, Marcin; Wells, Trent S et al. (2013) Improvement of optical coherence tomography using active handheld micromanipulator in vitreoretinal surgery. Conf Proc IEEE Eng Med Biol Soc 2013:5674-7
Latt, Win Tun; Tan, U-Xuan; Georgiou, Andreas et al. (2012) A Micro Motion Sensing System for Micromanipulation Tasks. Sens Actuators A Phys 173:254-266
Becker, Brian C; Maclachlan, Robert A; Riviere, Cameron N (2011) State Estimation and Feedforward Tremor Suppression for a Handheld Micromanipulator with a Kalman Filter. Rep U S 2011:5160-5165
Maclachlan, R A; Riviere, C N (2011) Power voltage current convertor using quasi complementary MOSFET current mirrors. Electron Lett 47:1173-1175

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