Robotic kidney and spine percutaneous procedures using a new laser-based CT registration method

Abstract

We present a simple method for robot registration in computer tomography imaging systems. The method uses the laser markers readily available on any CL scanner and does not require imaging thus eliminating radiation exposure. Its accuracy is inherited from the laser positioning system. This approach does not require additional hardware, laser alignment being performed on the instrument used in the clinical application. Moreover, robotic guidance allows for radiological interventions to be performed on scanners without fluoro-CL capability. Unlike the manual approach, the method allows for performing oblique insertions, for which the skin entry point and the target are located in different slices. The implementation is realized using the latest version of the PAKY-RCM robot developed in our laboratory. This is an increased precision system based on our new Ball-Worm technology. The system was successfully used for five CL-guided biopsy and radio­frequency ablation procedures on the kidney and spine and a nephrostomy tube placement. Further investigation will explore its application to other organs and procedures.