This Bioengineering Research Partnership (BRP) will focus the efforts of highly qualified engineers, scientists and micro-surgeons from Johns Hopkins University and Carnegie-Mellon University to develop technology and systems addressing fundamental limitations in current microsurgical practice, using vitreoretinal surgery as our focus. Vitreoretinal surgery is the most technically demanding ophthalmologic discipline and addresses prevalent sight-threatening conditions in areas of growing need. With the aging of our population, the prevalence of sight-threatening conditions will continue to escalate. Retinal surgery is currently performed under an operating microscope with free-hand instrumentation. Limitations include limited visual resolution, and physiological hand tremor. The surgeon also struggles with a lack of tactile feedback, proximity sensing, and real-time sensing of physiological parameters of the retina. Surgical technique and efficiency would be enhanced by the integration of preoperative images with the intraoperative view. Poor ergonomics for the surgeon in current practice result in surgeon fatigue and potential disability. All of these factors contribute to extended operating times, attendant light toxicity, and higher than needed complication rates. At the center of our planned approach is a """"""""surgical workstation"""""""" system interfaced to a stereo visualization subsystem and a family of novel sensors, instruments, and robotic devices. The capabilities of these components individually address important limitations of current practice;together they provide a modular, synergistic, and extendable system that enables computer-interfaced technology and information processing to work in partnership with surgeons to improve clinical care and enable novel therapeutic approaches.
Our specific aims are 1) Develop enabling technology addressing fundamental limitations in image processing and information fusion, sensing, and manipulation;2) integrate these components into a modular extendable system to significantly enhance surgeons'ability to perform microsurgical tasks;and 3) evaluate our systems'ability to improve surgeon performance of realistic surgical tasks on realistic phantom, cadaver, and animal models associated with three testbed applications. We have chosen surgical treatment of three common sight threatening conditions to provide specific focus for our research: pathology of the retinal surface, pathology of the internal limiting membrane, and retinal vein occlusion. The specific capabilities that we propose to develop both address the specific challenges associated with these procedures and are applicable to other techniques and diseases required of vitreoretinal surgery. Their integration will validate our overall system approach and provide a basis for further development both for ophthalmic applications and other microsurgical disciplines such as neurosurgery or microvascular surgery.
This Bioengineering Research Partnership (BRP) addresses fundamental limitations in current microsurgical practice, focusing on vitreoretinal surgery, which is the most technically demanding ophthalmologic discipline. The capabilities developed directly address challenges associated with surgical treatment of three of the most common causes of vision loss, which are becoming more prevalent with the aging of our population. Further, these capabilities are broadly applicable in other microsurgical problems, and the system will enable further advances both for ophthalmology and for other microsurgical disciplines.
| Gonenc, Berk; Tran, Nhat; Riviere, Cameron N et al. (2015) Force-Based Puncture Detection and Active Position Holding for Assisted Retinal Vein Cannulation. IEEE SICE RSJ Int Conf Multisens Fusion Integr Intell Syst 2015:322-327 |
| Gonenc, Berk; Gehlbach, Peter; Taylor, Russell H et al. (2015) Effects of Micro-Vibratory Modulation during Robot-Assisted Membrane Peeling. Rep U S 2015:3811-3816 |
| He, Xingchi; van Geirt, Vincent; Gehlbach, Peter et al. (2015) IRIS: Integrated Robotic Intraocular Snake. IEEE Int Conf Robot Autom 2015:1764-1769 |
| Horise, Yuki; He, Xingchi; Gehlbach, Peter et al. (2015) FBG-based sensorized light pipe for robotic intraocular illumination facilitates bimanual retinal microsurgery. Conf Proc IEEE Eng Med Biol Soc 2015:13-6 |
| 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 |
| 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) Toward robotically assisted membrane peeling with 3-DOF distal force sensing in retinal microsurgery. Conf Proc IEEE Eng Med Biol Soc 2014:6859-63 |
| He, Xingchi; Handa, James; Gehlbach, Peter et al. (2014) A submillimetric 3-DOF force sensing instrument with integrated fiber Bragg grating for retinal microsurgery. IEEE Trans Biomed Eng 61:522-34 |
| Gonenc, Berk; Gehlbach, Peter; Handa, James et al. (2014) Force-Sensing Microneedle for Assisted Retinal Vein Cannulation* Proc IEEE Sens 2014:698-701 |
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