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Mojtaba Esfandiari

Publications and source records attributed to Mojtaba Esfandiari.

14 recordsLinked to original sources

A Deep Learning-Driven Autonomous System for Retinal Vein Cannulation: Validation Using a Chicken Embryo Model

Retinal vein cannulation (RVC) is a minimally invasive microsurgical procedure for treating retinal vein occlusion (RVO), a leading cause of vision impairment. However, the small size and fragility of retinal veins, coupled with the need for high-precision, tremor-free needle manipulation, create significant technical challenges. These limitations highlight the need for robotic assistance to improve accuracy and stability. This study presents an automated robotic system with a top-down microscope and B-scan optical coherence tomography (OCT) imaging for precise depth sensing. Deep learning-based models enable real-time needle navigation, contact detection, and vein puncture recognition, using a chicken embryo model as a surrogate for human retinal veins. The system autonomously detects needle position and puncture events with 85% accuracy. The experiments demonstrate notable reductions in navigation and puncture times compared to manual methods. Our results demonstrate the potential of integrating advanced imaging and deep learning to automate microsurgical tasks, providing a pathway for safer and more reliable RVC procedures with enhanced precision and reproducibility.

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An Extended Generalized Prandtl-Ishlinskii Hysteresis Model for I2RIS Robot

Retinal surgery requires extreme precision due to constrained anatomical spaces in the human retina. To assist surgeons achieve this level of accuracy, the Improved Integrated Robotic Intraocular Snake (I2RIS) with dexterous capability has been developed. However, such flexible tendon-driven robots often suffer from hysteresis problems, which significantly challenges precise control and positioning. In particular, we observed multi-stage hysteresis phenomena in the small-scale I2RIS. In this paper, we propose an Extended Generalized Prandtl-Ishlinskii (EGPI) model to increase the fitting accuracy of the hysteresis. The model incorporates a novel switching mechanism that enables it to describe multi-stage hysteresis in the regions of monotonic input. Experimental validation on I2RIS data demonstrates that the EGPI model outperforms the conventional Generalized Prandtl-Ishlinskii (GPI) model in terms of RMSE, NRMSE, and MAE across multiple motor input directions. The EGPI model in our study highlights the potential in modeling multi-stage hysteresis in minimally invasive flexible robots.

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Deep Learning-Enhanced Robotic Subretinal Injection with Real-Time Retinal Motion Compensation

Subretinal injection is a critical procedure for delivering therapeutic agents to treat retinal diseases such as age-related macular degeneration (AMD). However, retinal motion caused by physiological factors such as respiration and heartbeat significantly impacts precise needle positioning, increasing the risk of retinal pigment epithelium (RPE) damage. This paper presents a fully autonomous robotic subretinal injection system that integrates intraoperative optical coherence tomography (iOCT) imaging and deep learning-based motion prediction to synchronize needle motion with retinal displacement. A Long Short-Term Memory (LSTM) neural network is used to predict internal limiting membrane (ILM) motion, outperforming a Fast Fourier Transform (FFT)-based baseline model. Additionally, a real-time registration framework aligns the needle tip position with the robot's coordinate frame. Then, a dynamic proportional speed control strategy ensures smooth and adaptive needle insertion. Experimental validation in both simulation and ex vivo open-sky porcine eyes demonstrates precise motion synchronization and successful subretinal injections. The experiment achieves a mean tracking error below 16.4 {\mu}m in pre-insertion phases. These results show the potential of AI-driven robotic assistance to improve the safety and accuracy of retinal microsurgery.

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Model Predictive Path Integral Control of I2RIS Robot Using RBF Identifier and Extended Kalman Filter

Modeling and controlling cable-driven snake robots is a challenging problem due to nonlinear mechanical properties such as hysteresis, variable stiffness, and unknown friction between the actuation cables and the robot body. This challenge is more significant for snake robots in ophthalmic surgery applications, such as the Improved Integrated Robotic Intraocular Snake (I$^2$RIS), given its small size and lack of embedded sensory feedback. Data-driven models take advantage of global function approximations, reducing complicated analytical models' challenge and computational costs. However, their performance might deteriorate in case of new data unseen in the training phase. Therefore, adding an adaptation mechanism might improve these models' performance during snake robots' interactions with unknown environments. In this work, we applied a model predictive path integral (MPPI) controller on a data-driven model of the I$^2$RIS based on the Gaussian mixture model (GMM) and Gaussian mixture regression (GMR). To analyze the performance of the MPPI in unseen robot-tissue interaction situations, unknown external disturbances and environmental loads are simulated and added to the GMM-GMR model. These uncertainties of the robot model are then identified online using a radial basis function (RBF) whose weights are updated using an extended Kalman filter (EKF). Simulation results demonstrated the robustness of the optimal control solutions of the MPPI algorithm and its computational superiority over a conventional model predictive control (MPC) algorithm.

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Towards Motion Compensation in Autonomous Robotic Subretinal Injections

Exudative (wet) age-related macular degeneration (AMD) is a leading cause of vision loss in older adults, typically treated with intravitreal injections. Emerging therapies, such as subretinal injections of stem cells, gene therapy, small molecules and RPE cells require precise delivery to avoid damaging delicate retinal structures. Robotic systems can potentially offer the necessary precision for these procedures. This paper presents a novel approach for motion compensation in robotic subretinal injections, utilizing real time Optical Coherence Tomography (OCT). The proposed method leverages B$^5$-scans, a rapid acquisition of small-volume OCT data, for dynamic tracking of retinal motion along the Z-axis, compensating for physiological movements such as breathing and heartbeat. Validation experiments on ex vivo porcine eyes revealed challenges in maintaining a consistent tool-to-retina distance, with deviations of up to 200 $\mu m$ for 100 $\mu m$ amplitude motions and over 80 $\mu m$ for 25 $\mu m$ amplitude motions over one minute. Subretinal injections faced additional difficulties, with phase shifts causing the needle to move off-target and inject into the vitreous. These results highlight the need for improved motion prediction and horizontal stability to enhance the accuracy and safety of robotic subretinal procedures.

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Real-time Deformation-aware Control for Autonomous Robotic Subretinal Injection under iOCT Guidance

Robotic platforms provide consistent and precise tool positioning that significantly enhances retinal microsurgery. Integrating such systems with intraoperative optical coherence tomography (iOCT) enables image-guided robotic interventions, allowing autonomous performance of advanced treatments, such as injecting therapeutic agents into the subretinal space. However, tissue deformations due to tool-tissue interactions constitute a significant challenge in autonomous iOCT-guided robotic subretinal injections. Such interactions impact correct needle positioning and procedure outcomes. This paper presents a novel method for autonomous subretinal injection under iOCT guidance that considers tissue deformations during the insertion procedure. The technique is achieved through real-time segmentation and 3D reconstruction of the surgical scene from densely sampled iOCT B-scans, which we refer to as B${^5}$-scans. Using B${^5}$-scans we monitor the position of the instrument relative to a virtual target layer between the ILM and RPE. Our experiments on ex vivo porcine eyes demonstrate dynamic adjustment of the insertion depth and overall improved accuracy in needle positioning compared to prior autonomous insertion approaches. Compared to a 35% success rate in subretinal bleb generation with previous approaches, our method reliably created subretinal blebs in 90% our experiments.

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Bimanual Manipulation of Steady Hand Eye Robots with Adaptive Sclera Force Control: Cooperative vs. Teleoperation Strategies

Performing retinal vein cannulation (RVC) as a potential treatment for retinal vein occlusion (RVO) without the assistance of a surgical robotic system is very challenging to do safely. The main limitation is the physiological hand tremor of surgeons. Robot-assisted eye surgery technology may resolve the problems of hand tremors and fatigue and improve the safety and precision of RVC. The Steady-Hand Eye Robot (SHER) is an admittance-based robotic system that can filter out hand tremors and enables ophthalmologists to manipulate a surgical instrument inside the eye cooperatively. However, the admittance-based cooperative control mode does not safely minimize the contact force between the surgical instrument and the sclera to prevent tissue damage. Additionally, features like haptic feedback or hand motion scaling, which can improve the safety and precision of surgery, require a teleoperation control framework. This work presents a bimanual adaptive teleoperation (BMAT) control framework using SHER 2.0 and SHER 2.1 robotic systems. We integrate them with an adaptive force control (AFC) algorithm to automatically minimize the tool-sclera interaction force. The scleral forces are measured using two fiber Bragg grating (FBG)-based force-sensing tools. We compare the performance of the BMAT mode with a bimanual adaptive cooperative (BMAC) mode in a vessel-following experiment under a surgical microscope. Experimental results demonstrate the effectiveness of the proposed BMAT control framework in performing a safe bimanual telemanipulation of the eye without over-stretching it, even in the absence of registration between the two robots.

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Cooperative vs. Teleoperation Control of the Steady Hand Eye Robot with Adaptive Sclera Force Control: A Comparative Study

A surgeon's physiological hand tremor can significantly impact the outcome of delicate and precise retinal surgery, such as retinal vein cannulation (RVC) and epiretinal membrane peeling. Robot-assisted eye surgery technology provides ophthalmologists with advanced capabilities such as hand tremor cancellation, hand motion scaling, and safety constraints that enable them to perform these otherwise challenging and high-risk surgeries with high precision and safety. Steady-Hand Eye Robot (SHER) with cooperative control mode can filter out surgeon's hand tremor, yet another important safety feature, that is, minimizing the contact force between the surgical instrument and sclera surface for avoiding tissue damage cannot be met in this control mode. Also, other capabilities, such as hand motion scaling and haptic feedback, require a teleoperation control framework. In this work, for the first time, we implemented a teleoperation control mode incorporated with an adaptive sclera force control algorithm using a PHANTOM Omni haptic device and a force-sensing surgical instrument equipped with Fiber Bragg Grating (FBG) sensors attached to the SHER 2.1 end-effector. This adaptive sclera force control algorithm allows the robot to dynamically minimize the tool-sclera contact force. Moreover, for the first time, we compared the performance of the proposed adaptive teleoperation mode with the cooperative mode by conducting a vessel-following experiment inside an eye phantom under a microscope.

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An Improved Approach for Output Feedback Model Predictive Control of Hybrid Systems

In this paper, a modified robust model predictive control scheme is proposed for linear parametric variable (LPV) and hybrid systems based on a quasi-min-max algorithm. Using a new cost function resulted in reduced unwanted disturbances during switching. In addition, the effects of uncertainties are reduced in the prediction dynamics, and robust stability of piecewise switching LPV systems subjected to linear matrix inequality (LMI) input constraints are guaranteed. Simulation results demonstrate the performance of the proposed controller compared to prior research.

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Human-Robot Interaction in Retinal Surgery: A Comparative Study of Serial and Parallel Cooperative Robots

Cooperative robots for intraocular surgery allow surgeons to perform vitreoretinal surgery with high precision and stability. Several robot structural designs have shown capabilities to perform these surgeries. This research investigates the comparative performance of a serial and parallel cooperative-controlled robot in completing a retinal vessel-following task, with a focus on human-robot interaction performance and user experience. Our results indicate that despite differences in robot structure and interaction forces and torques, the two robots exhibited similar levels of performance in terms of general robot-to-patient interaction and average operating time. These findings have implications for the development and implementation of surgical robotics, suggesting that both serial and parallel cooperative-controlled robots can be effective for vitreoretinal surgery tasks.

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Using an Improved Output Feedback MPC Approach for Developing a Haptic Virtual Training System

Haptic training simulators generally consist of three major components, namely a human operator, a haptic interface, and a virtual environment. Appropriate dynamic modeling of each of these components can have far-reaching implications for the whole system's performance improvement in terms of transparency, the analogy to the real environment, and stability. In this paper, we developed a virtual-based haptic training simulator for Endoscopic Sinus Surgery (ESS) by doing a dynamic characterization of the phenomenological sinus tissue fracture in the virtual environment, using an input-constrained linear parametric variable model. A parallel robot manipulator equipped with a calibrated force sensor is employed as a haptic interface. A lumped five-parameter single-degree-of-freedom mass-stiffness-damping impedance model is assigned to the operator's arm dynamic. A robust online output feedback quasi-min-max model predictive control (MPC) framework is proposed to stabilize the system during the switching between the piecewise linear dynamics of the virtual environment. The simulations and the experimental results demonstrate the effectiveness of the proposed control algorithm in terms of robustness and convergence to the desired impedance quantities.

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A Virtual-Based Haptic Endoscopic Sinus Surgery (ESS) Training System: from Development to Validation

Simulated training platforms offer a suitable avenue for surgical students and professionals to build and improve upon their skills, without the hassle of traditional training methods. To enhance the degree of realistic interaction paradigms of training simulators, great work has been done to both model simulated anatomy in more realistic fashion, as well as providing appropriate haptic feedback to the trainee. As such, this chapter seeks to discuss the ongoing research being conducted on haptic feedback-incorporated simulators specifically for Endoscopic Sinus Surgery (ESS). This chapter offers a brief comparative analysis of some EES simulators, in addition to a deeper quantitative and qualitative look into our approach to designing and prototyping a complete virtual-based haptic EES training platform.

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A Data-Driven Model with Hysteresis Compensation for I2RIS Robot

Retinal microsurgery is a high-precision surgery performed on an exceedingly delicate tissue. It now requires extensively trained and highly skilled surgeons. Given the restricted range of instrument motion in the confined intraocular space, and also potentially restricting instrument contact with the sclera, snake-like robots may prove to be a promising technology to provide surgeons with greater flexibility, dexterity, space access, and positioning accuracy during retinal procedures requiring high precision and advantageous tooltip approach angles, such as retinal vein cannulation and epiretinal membrane peeling. Kinematics modeling of these robots is an essential step toward accurate position control, however, as opposed to conventional manipulators, modeling of these robots does not follow a straightforward method due to their complex mechanical structure and actuation mechanisms. Especially, in wire-driven snake-like robots, the hysteresis problem due to the wire tension condition can have a significant impact on the positioning accuracy of these robots. In this paper, we proposed an experimental kinematics model with a hysteresis compensation algorithm using the probabilistic Gaussian mixture models (GMM) Gaussian mixture regression (GMR) approach. Experimental results on the two-degree-of-freedom (DOF) integrated robotic intraocular snake (I2RIS) show that the proposed model provides 0.4 deg accuracy, which is an overall 60% and 70% of improvement for yaw and pitch degrees of freedom, respectively, compared to a previous model of this robot.

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Design and Fabrication of a Fiber Bragg Grating Shape Sensor for Shape Reconstruction of a Continuum Manipulator

Continuum dexterous manipulators (CDMs) are suitable for performing tasks in a constrained environment due to their high dexterity and maneuverability. Despite the inherent advantages of CDMs in minimally invasive surgery, real-time control of CDMs' shape during non-constant curvature bending is still challenging. This study presents a novel approach for the design and fabrication of a large deflection fiber Bragg grating (FBG) shape sensor embedded within the lumens inside the walls of a CDM with a large instrument channel. The shape sensor consisted of two fibers, each with three FBG nodes. A shape-sensing model was introduced to reconstruct the centerline of the CDM based on FBG wavelengths. Different experiments, including shape sensor tests and CDM shape reconstruction tests, were conducted to assess the overall accuracy of the shape sensing. The FBG sensor evaluation results revealed the linear curvature-wavelength relationship with the large curvature detection of 0.045 mm at a 90 degrees bending angle and a sensitivity of up to 5.50 nm/mm in each bending direction. The CDM's shape reconstruction experiments in a free environment demonstrated the shape tracking accuracy of 0.216+-0.126 mm for positive/negative deflections. Also, the CDM shape reconstruction error for three cases of bending with obstacles were observed to be 0.436+-0.370 mm for the proximal case, 0.485+-0.418 mm for the middle case, and 0.312+-0.261 mm for the distal case. This study indicates the adequate performance of the FBG sensor and the effectiveness of the model for tracking the shape of the large-deflection CDM with nonconstant-curvature bending for minimally-invasive orthopaedic applications.

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