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1

Duffy, B. L. "“Don't Turn the Needle!”." Anaesthesia and Intensive Care 21, no. 3 (June 1993): 328–30. http://dx.doi.org/10.1177/0310057x9302100312.

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Accidental dural puncture is a well-recognised complication of epidural anaesthesia. The technique of inserting the epidural needle with the bevel parallel to the spinal ligaments is still taught in some centres. Evidence is presented that the subsequent turning of the needle to allow passage of the epidural catheter may increase the likelihood of dural puncture. There would also appear to be a greater chance of subdural catheterisation. The epidural needle should be introduced with the bevel in the direction in which the catheter is to go and not moved once the epidural space is located.
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2

Zhao, Yan-Jiang, Ze-Hua Liu, Yong-De Zhang, and Zhi-Qing Liu. "Kinematic model and its parameter identification for cannula flexible needle insertion into soft tissue." Advances in Mechanical Engineering 11, no. 6 (June 2019): 168781401985218. http://dx.doi.org/10.1177/1687814019852185.

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In minimally invasive surgery, flexible needle insertion is a popular application which has been extensively researched. However, needle steering is challenging for a bevel tip cannula flexible needle due to the nonholonomic constraints and the rebounds of the needle shaft when the needle tip is reoriented. We proposed a novel kinematic model for the bevel tip cannula flexible needle based on bicycle and unicycle models, taking consideration of the deflection of the bevel tip and the rebounds of the needle shaft. Aiming at different types of paths, forward kinematics of the model was analyzed and calculated. Each parameter of the kinematic models was identified based on the experimental data using the least square method. Furthermore, the changing rules of parameters were explored under different angles of the bevel tip. The experimental results show that the errors of the proposed kinematic models are within 2 mm, which is greatly reduced compared to the traditional bicycle or unicycle model, and fulfill a general clinical surgery.
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3

Wang, Yi Zhong, Qi Long Yin, Cheng Jie Liu, and Yong Hua Chen. "Towards an Articulated Needle." Applied Mechanics and Materials 152-154 (January 2012): 946–51. http://dx.doi.org/10.4028/www.scientific.net/amm.152-154.946.

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Needle is a kind of basic medical instruments in minimally invasive surgery. A thin and long needle is inserted into a human body through the skin to perform diagnosis and treatment tasks. In order to improve the steerability of a needle, articulated needle is proposed in this paper. An articulated needle consists of a head with a bevel-tip, several articulations and several sections. Articulations are much easier to be bent, which allows proposed articulated needle to be more easily controlled to achieve a complex curved trajectory. The structure of the articulated needle is investigated for improving its bending performance. The influences of the angle of bevel-tip, the sectional dimension of sections, the number of articulations, the maximum bending angle of articulations, and the distribution of articulations on the bending performance of the needle are studied, which provide the basis for path planning and navigation of an articulated needle.
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4

DOONER, JOHN J. "Needle Bevel Direction and Postlumbar Puncture Headache." Anesthesiology 71, no. 4 (October 1, 1989): 623. http://dx.doi.org/10.1097/00000542-198910000-00031.

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5

NORRIS, MARK C. "Needle Bevel Direction and Postlumbar Puncture Headache." Anesthesiology 71, no. 4 (October 1, 1989): 624. http://dx.doi.org/10.1097/00000542-198910000-00032.

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6

Angle, Pamela J., Jean E. Kronberg, Dorothy E. Thompson, Cameron Ackerley, John Paul Szalai, James Duffin, and Peter Faure. "Dural Tissue Trauma and Cerebrospinal Fluid Leak after Epidural Needle Puncture." Anesthesiology 99, no. 6 (December 1, 2003): 1376–82. http://dx.doi.org/10.1097/00000542-200312000-00021.

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Background The effects of epidural needle design, angle, and bevel orientation on cerebrospinal fluid leak after puncture have not been reported. The impact of these factors on leak rate was examined using a dural sac model. Dural trauma was examined using scanning electron microscopy. Methods Human cadaveric dura, mounted on a cylindrical model, was punctured with epidural needles using a micromanipulator. Tissue was punctured at 15 cm H2O (left lateral decubitus) system pressure, and leak was measured at 25 cm H2O (semisitting) pressure. Leak rates and trauma were compared for the following: (1) six different epidural needles at 90 degrees, bevel parallel to the dural long axis; (2) 18-gauge Tuohy and 18-gauge Special Sprotte epidural needles, 30 degrees versus 90 degrees; (3) 18-gauge Tuohy, bevel perpendicular versus parallel to the dural long axis. Results With the 90 degrees puncture, bevel parallel, the greatest leak occurred with a 17-gauge Hustead (516 +/- 319 ml/15 min), and the smallest leak occurred with a 20-gauge Tuohy (100 +/- 112 ml/15 min; P = 0.0018). A 20-gauge Tuohy puncture led to statistically significant reductions in leak (P value range, 0.0001-0.0024) compared with all needles except the Special Sprotte. With the 30 degrees versus 90 degrees angle, 30 degrees punctures with an 18-gauge Tuohy produced nonstatistically significant leak reductions compared with the 18-gauge Tuohy at 90 degrees. The puncture angle made no difference for the Special Sprotte. Nonsignificant reductions were found for the Special Sprotte compared with the Tuohy. With the 18-gauge Tuohy bevel orientation, perpendicular orientation produced nonstatistically significant reductions in leak compared with parallel orientation. Conclusions Cerebrospinal fluid leak after puncture was influenced most by epidural needle gauge. Leak rate was significantly less for the 20-gauge Tuohy needle.
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7

Roeder, Blayne A., Charles F. Babbs, William E. Schoenlein, Klod Kokini, and Farshid Sadeghi. "Self-sealing, Large Bore Arterial Punctures: A Counterintuitive New Phenomenon." Journal of Biomechanical Engineering 124, no. 4 (July 30, 2002): 342–46. http://dx.doi.org/10.1115/1.1488935.

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The human femoral artery can bleed dangerously following the removal of a catheter during cardiac catheterization. In this study, a modified technique of needle insertion, simply inserting the needle bevel-down instead of the standard bevel-up approach, was tested as a means to reduce bleeding after catheter removal. Large bore needle punctures were made in surgically exposed arteries of anesthetized pigs using either a standard technique (45 degree approach, bevel up) or a modified technique (25 degree approach, bevel down). For half the punctures, topical phenylephrine solution (1 mg/ml) was applied to the adventitia of the artery to cause constriction. Median bleeding rates were reduced from 81 to less than 1 ml/min/100 mmHg intraluminal pressure by the modified technique with application of phenylephrine. In most cases zero bleeding, that is self-sealing, of the arteries occurred. It is postulated that a flap-valve of tissue created by the modified technique produced this self-sealing behavior. Sophisticated modeling studies are needed to fully understand this new phenomenon.
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Murray, Timothy E., Damien C. O'Neill, and Michael J. Lee. "Accessing Implantable Ports: An Opportunistic Computed Tomography-Based Audit." Journal of the Association for Vascular Access 22, no. 4 (December 1, 2017): 193–98. http://dx.doi.org/10.1016/j.java.2017.09.002.

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Abstract Aim: Implantable ports are typically inserted by interventional radiologists or surgeons; however, daily maintenance, access, and de-access are often performed by members of nursing staff in accordance with manufacturers' guidelines and local policy. An audit of port access using retrospective computed tomography (CT) scanning was proposed. Methodology: Across a 4-year period, all CT scans performed for any reason while a port was accessed were reviewed. Results: Fifty-four CT scans of accessed ports were included. Mean depth of tissue between skin and port was 3.74 mm, and between port and pectoralis major was 5.91 mm. Port tilt in side-to-side and up-down axes measured 6.9° and 10.6°, respectively. Mean distance from needle to center of the septum was 1.96 mm. Mean distance from center of the chamber to the needle tip was 2.73 mm. In 2 cases (3.7%), the needle bevel was malpositioned, with the bevel still within the silicone-rubber septum. Mean angulation of the access needle from perpendicular was 11.5°. Angulation of the needle correlated with port tilt (r = 0.37; P = .006). Angle of the needle bevel relative to the port exit channel was 140.8°. No significant correlation between needle bevel directionality and needle angle, depth of port, or tilt of port was detected (all P values > .21). Conclusions: Variability in accessing of implantable ports is described relative to research- and manufacturer-recommended needle bevel angle, needle puncture angle, and central puncture position. The extent to which such deviation influences port function deserves focused clinical research.
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9

Xu, Yingqiang, Xuemei Qin, Guowei Liu, Lei Tan, Hongjian Dong, Pengpeng Wei, Qinhe Zhang, and Hongcai Zhang. "A new method for evaluating the normal rake angle and inclination angle on medical needles." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 232, no. 1 (November 22, 2017): 24–32. http://dx.doi.org/10.1177/0954411917742942.

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Hollow needles are the most frequently used medical equipment. The design of a hollow needle that best enables medical procedures requires a better understanding of needle tip geometry. Calculating the cutting angles of a needle for a complex surface topology is difficult. This article proposes a new method based on non-Euclidean geometry for the analysis of biopsy needle tip. The method can be used to calculate the cutting angles on any pipe needle. To verify the validity of this method, the normal rake angle and inclination angle on four types of needles (bias bevel needle, cylinder surface needle, curved surface needle and Cournand-type needle) were investigated. It was found that calculation of the cutting angles was simple and convenient using this method, especially for the curved surface needles. Images of the cutting angles from the Cournand-type needles revealed that the smaller bevel angle [Formula: see text] resulted in a higher normal rake angle [Formula: see text] and inclination angle [Formula: see text]. As [Formula: see text] increased, the range of the normal rake angle [Formula: see text] became larger at first and then became smaller.
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10

Kwon, Won Kyoung, Ah Na Kim, Pil Moo Lee, Cheol Hwan Park, and Jae Hun Kim. "Needle Tip Position and Bevel Direction Have No Effect in the Fluoroscopic Epidural Spreading Pattern in Caudal Epidural Injections: A Randomized Trial." Pain Research and Management 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/4158291.

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Background.Caudal epidural steroid injections (CESIs) are an effective treatment for pain. If the injection spreads in a specific pattern depending on the needle position or bevel direction, it would be possible to inject the agent into a specific and desired area.Objectives.We conducted a prospective randomized trial to determine if the needle position and bevel direction have any effect on the epidural spreading pattern in CESI.Methods.Demographic data of the patient were collected. During CESI, the needle position (middle or lateral) and direction (ventral or dorsal) were randomly allocated. Following fluoroscope-guided injection of 4 mL contrast media and 10 mL of injectates, the epidural spreading patterns (ventral or dorsal, bilateral or lateral) were imaged.Results.In the 210 CESIs performed, the needle tip position and bevel direction did not influence the epidural spreading patterns at L4-5 and L5-S1 disc levels. A history of Lumbar spine surgery was associated with a significantly limited spread to each disc level. A midline needle tip position was more effective than the lateral position in spreading to the distant disc levels.Conclusions.Neither the needle tip position nor the bevel direction affected the epidural drug spreading pattern during CESI.
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11

Qi, Yingchun, Jingfu Jin, Tingkun Chen, and Qian Cong. "Modeling of geometry and insertion force of a new lancet medical needle." Science Progress 103, no. 1 (December 10, 2019): 003685041989107. http://dx.doi.org/10.1177/0036850419891074.

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Lancet needle is a typical medical treatment device. Its tip consists of two lancet planes and one bevel plane. When the lancet needle is inserted into soft organ tissue, the insertion force may influence the needle cutting direction and treatment effect and increase the pain. One of the main factors affecting this insertion force is the geometry of the needle tip. Based on the research on the shape and processing method of the conventional lancet needle, a new lancet needle tip geometry was obtained by adjusting the relative position of the grinding wheel to the needle. A mathematical model of this new lancet needle was established. The relationship between processing parameters and needle shape was analyzed, and the needle insertion force was predicted. Compared with the conventional lancet needle, the new lancet needle is sharper, and the insertion force on the cutting edge is smaller. However, this change in the grinding position of the needle lancet plane has a great influence on the shape of needle tip near the intersection of the bevel plane and the lancet plane. Some special second bevel angle and rotated angle will cause a large change in the specific force at the intersection place, which is not conducive to reducing the insertion force.
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12

Prakash, Smita, and Parul Mullick. "Spinal anesthesia and direction of spinal needle bevel." Journal of Anaesthesiology Clinical Pharmacology 32, no. 2 (2016): 268. http://dx.doi.org/10.4103/0970-9185.173360.

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13

Lee, Young Joo, Joung Ja Kim, Hae Keum Kil, Duck Mi Yoon, Jae Sun Shim, Myung Sook Chun, and Chung Hyun Cho. "Effects of Needle Size and Needle Bevel Direction on the Postspinal Headache." Korean Journal of Anesthesiology 24, no. 3 (1991): 594. http://dx.doi.org/10.4097/kjae.1991.24.3.594.

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14

Rominger, Marga, Katharina Martini, Evelyn Dappa, Gilbert Puippe, Volker Klingmüller, Thomas Frauenfelder, and Sergio Sanabria. "Ultrasound Needle Visibility in Contrast Mode Imaging: An In Vitro and Ex Vivo Study." Ultrasound International Open 03, no. 02 (April 2017): E82—E88. http://dx.doi.org/10.1055/s-0043-101511.

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Abstract Purpose To evaluate needle visibility in ultrasound under contrast mode conditions. Materials and Methods Needle visibility was evaluated for bevel, EchoTip® and shaft of 18G Chiba biopsy needle with a 9 MHz linear probe (GE Logiq E9). Insertion angles varied between 30°(steep) and 90°(parallel to the probe surface). The acoustic output varied from 5–28%. 2 different contrast mode presets with either 'Amplitude Modulation' (Penetration) or 'Phase Inversion Harmonics' (High Resolution) were assessed. All other imaging parameters were kept constant. The visibility of bevel, EchoTip® and shaft was assessed for grayscale and color-coded images with a 3-point Likert-like scale (not, poorly, well visible) by 2 independent readers. The echogenicity of the needle bevel, EchoTip® and shaft was assessed in deciBel (dB) on the color-coded images. Results With the parallel insertion angle, all needle areas were well visible. With steep insertion the EchoTip® was the only visible area. High Resolution was superior to Penetration (p<0.001). The visibility and echogenicity of the needle bevel (r grayscale=0.109, pgrayscale=0.178; r color-coded=0.236, pcolor-coded=0.266; r dB=0.956, pdB=0.001), EchoTip® (r grayscale+= 0.477, pgrayscale+= 0.018; r color-coded=0.540, pcolor-coded+= 0.006; r dB=0.911, pdB=0.001) and shaft (r grayscale=0.124, pgrayscale=0.563; r color-coded=0.061, pcolor-coded+= 0.775; r dB+= 0.926, pdB=0.001) increased with increasing acoustic output. Grayscale images were superior to color-coded images for needle visibility (p=0.004). Conclusion Parallel needle insertion, use of an echogenic tip, adequate choice of presets, increased acoustic output, and dual view of grayscale and color-coded images improve needle visibility in ultrasound under contrast mode conditions.
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JIANG, SHAN, XINGJI WANG, and ZHILIANG SU. "MECHANICS-BASED BEVEL-TIP NEEDLE DEFLECTION MODEL DURING NEEDLE–SOFT TISSUE INTERACTION PROCESS." Journal of Mechanics in Medicine and Biology 14, no. 05 (August 2014): 1450076. http://dx.doi.org/10.1142/s0219519414500766.

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Flexible needle insertion is performed in many clinical and brachytherapy procedures. Needle bending which results from needle–tissue interaction and needle flexibility plays a pivotal role in implantation accuracy. In this paper, a needle insertion force model and a mechanics-based needle deflection model are applied in simulating the real needle insertion process. Using tissue-equivalent materials, the needle force model is acquired from needle insertion experiments. Based on the principle of minimum potential energy, a mechanics-based model is developed to calculate needle deflection. The needle deflection model incorporates needle insertion forces model, needle–tissue interaction model, needle geometric, and tissue properties. The bending–stretching coupling and geometric non-linearity of the flexible needle are both taken into consideration in the needle deflection model. A modified p–y curves method is first introduced in depicting the lateral needle–tissue interaction. The comparison between experimental and simulation results of needle deflection shows that our mechanics-based model can simulate the deflection of the flexible needle with reasonable accuracy. Parametric studies on different geometry properties of needles show that our mechanics-based model can precisely predict the needle deflection when more than one parameter is changed. In addition, as the needle deflection results are obtained numerically by Rayleigh–Ritz approach, further study on the form of deflection formulation leads to the conclusion that choosing a higher order polynomial can improve the overall simulation accuracy.
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Jeffrey, Hubers, Eric M. Nelsen, Thomas J. Holobyn, Deepak V. Gopal, Patrick R. Pfau, and Mark E. Benson. "Performance of a Fork Tipped Needle versus Reverse Bevel Needle in EUS-Guided Fine Needle Biopsy." American Journal of Gastroenterology 112 (October 2017): S461—S462. http://dx.doi.org/10.14309/00000434-201710001-00825.

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17

Norris, Mark C., Barbara L. Leighton, and Cheryl A. DeSimone. "Needle Bevel Direction and Headache after Inadvertent Dural Puncture." Anesthesiology 70, no. 5 (May 1, 1989): 729–31. http://dx.doi.org/10.1097/00000542-198905000-00002.

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Norris, M. C., B. L. Leighton, C. A. Desimone, Theodore G. Cheek, and Brett B. Gutsche. "Needle Bevel Direction and Headache After Inadvertent Durai Puncture." Obstetric Anesthesia Digest 9, no. 4 (January 1990): 202. http://dx.doi.org/10.1097/00132582-199001000-00021.

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19

Zhang, Yong-De, Kai-Ming Shi, Yan-Jiang Zhao, Ji-Chao Yang, and Jia Liu. "Path optimization algorithm and its robustness for bevel tip flexible needle." International Journal of Advanced Robotic Systems 15, no. 5 (September 1, 2018): 172988141880116. http://dx.doi.org/10.1177/1729881418801166.

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Bevel tip flexible needle is a novel application in minimally invasive surgery, for it can avoid obstacles by performing a curved trajectory to reach the target. In clinical surgeries, path optimization is a basis for a robot-assisted surgery, and robustness is a crucial issue for an algorithm. However, to the best of our knowledge, none of the researches has an intensive study on the robustness of an algorithm for a bevel tip needle’s path optimization. In this article, a path optimization algorithm for a bevel tip flexible needle is proposed based on a mathematical calculation method by establishing an optimization objective function, and the robustness of the algorithm is analyzed regarding to each weighting coefficient of the objective function. Simulation results show that on the one hand, the algorithm can obtain the optimal path effectively in the presence of obstacles; and on the other hand, the optimization function has little sensitivity to any of the weighting coefficients, verifying strong robustness of the algorithm. Experiments for three typical paths are performed, and the accuracy is within 2 mm which fulfills the surgical requirements. The experimental results not only prove the feasibility of the paths obtained by the algorithm but also verify the validity of the proposed path optimization algorithm.
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20

Sanromán-Junquera, Margarita, Andre Boezaart, Yury Zasimovich, Olga C. Nin, Xavier Sala-Blanch, Jose De Andres, and Miguel A. Reina. "Vulnerability of different nerves to intrafascicular injection by different needle types and at different approach angles: a mathematical model." Regional Anesthesia & Pain Medicine 45, no. 4 (January 27, 2020): 306–10. http://dx.doi.org/10.1136/rapm-2019-100784.

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Background and objectivesWe assume that intrafascicular spread of a solution can only occur if a large enough portion of the distal needle orifice is placed inside the fascicle. Our aim is to present and evaluate a mathematical model that can calculate the theoretical vulnerability of fascicles, analyzing the degree of occupancy of the needle orifice in fascicular tissue by performing simulations of multiple positions that a needle orifice can take inside a cross-sectional nerve area.MethodsWe superimposed microscopic images of two routinely used nerve block needles (22-gauge, 15° needle and 22-gauge, 30° needle) over the microscopic images of cross-sections of four nerve types photographed at the same magnification. Fascicular tissue that was overlapped between 80% and 100% by a needle orifice was considered at risk to possible intrafascicular injection. The effect of three angular approaches was evaluated.ResultsThere were statistical differences between the vulnerability of fascicular tissue depending on nerve type, the bevel angle of the needle and the angle approach. Fascicular vulnerability was greater in nerve roots of the brachial plexus after using a 22-gauge 30° needle, as was choosing a 45° angle approach to the longitudinal axis of the nerve.ConclusionsOur results suggest that clinicians may want to consider needle insertion angle and bevel type as they perform peripheral nerve blocks. Furthermore, researchers may want to consider this mathematical model when estimating vulnerabilities of various nerves, needle types and angles of approach of needles to nerves.
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Fandino, Jonatan, Jaime Orejas, Jorge Pisonero, Philippe Guillot, Nerea Bordel, and Alfredo Sanz-Medel. "Plasma regime transition in a needle-FAPA desorption/ionization source." Journal of Analytical Atomic Spectrometry 31, no. 11 (2016): 2213–22. http://dx.doi.org/10.1039/c6ja00257a.

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The needle-Flowing Atmospheric Pressure Afterglow (n-FAPA) is a miniaturized plasma device with Ambient Desorption/Ionization capabilities. It is generated in flowing He using two concentric electrodes: a stainless steel capillary tube (outer electrode), and a hypodermic needle with a bevel-cut edge (inner electrode).
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Matheson, Eloise, and Ferdinando Rodriguez y Baena. "Biologically Inspired Surgical Needle Steering: Technology and Application of the Programmable Bevel-Tip Needle." Biomimetics 5, no. 4 (December 16, 2020): 68. http://dx.doi.org/10.3390/biomimetics5040068.

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Percutaneous interventions via minimally invasive surgical systems can provide patients with better outcomes and faster recovery times than open surgeries. Accurate needle insertions are vital for successful procedures, and actively steered needles can increase system precision. Here, we describe how biology inspired the design of a novel Programmable Bevel-Tip Needle (PBN), mimicking the mechanics and control methods of certain insects ovipositors. Following an overview of our unique research and development journey, this paper explores our latest, biomimetic control of PBNs and its application to neurosurgery, which we validate within a simulated environment. Three modalities are presented, namely a Direct Push Controller, a Cyclic Actuation Controller, and a newly developed Hybrid Controller, which have been integrated into a surgical visual interface. The results of open loop, expert human-in-the-loop and a non-expert user study show that the Hybrid Controller is the best choice when considering system performance and the ability to lesson strain on the surrounding tissue which we hypothesis will result in less damage along the insertion tract. Over representative trajectories for neurosurgery using a Hybrid Controller, an expert user could reach a target along a 3D path with an accuracy of 0.70±0.69 mm, and non-expert users 0.97±0.72 mm, both clinically viable results and equivalent or better than the state-of-the-art actively steered needles over 3D paths. This paper showcases a successful example of a biologically inspired, actively steered needle, which has been integrated within a clinical interface and designed for seamless integration into the neurosurgical workflow.
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Matheson, Eloise, Riccardo Secoli, Christopher Burrows, Alexander Leibinger, and Ferdinando Rodriguez y Baena. "Cyclic Motion Control for Programmable Bevel-Tip Needles to Reduce Tissue Deformation." Journal of Medical Robotics Research 04, no. 01 (March 2019): 1842001. http://dx.doi.org/10.1142/s2424905x18420011.

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Robotic-assisted steered needles aim to accurately control the deflection of the flexible needle’s tip to achieve accurate path following. In doing so, they can decrease trauma to the patient, by avoiding sensitive regions while increasing placement accuracy. This class of needle presents more complicated kinematics compared to straight needles, which can be exploited to produce specific motion profiles via careful controller design and tuning. Motion profiles can be optimized to minimize certain conditions such as maximum tissue deformation and target migration, which was the goal of the formalized cyclic, low-level controller for a Programmable Bevel-tip Needle (PBN) presented in this work. PBNs are composed of a number of interlocked segments that are able to slide with respect to one another. Producing a controlled, desired offset of the tip geometry leads to the corresponding desired curvature of the PBN, and hence desired path trajectory of the system. Here, we propose a cyclical actuation strategy, where the tip configuration is achieved over a number of reciprocal motion cycles, which we hypothesize will reduce tissue deformation during the insertion process. A series of in vitro, planar needle insertion experiments are performed in order to compare the cyclic controller performance with the previously used direct push controller, in terms of targeting accuracy and tissue deformation. It is found that there is no significant difference between the target tracking performance of the controllers, but a significant decrease in axial tissue deformation when using the cyclic controller.
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Wang, Yancheng, Roland K. Chen, Bruce L. Tai, Patrick W. McLaughlin, and Albert J. Shih. "Optimal needle design for minimal insertion force and bevel length." Medical Engineering & Physics 36, no. 9 (September 2014): 1093–100. http://dx.doi.org/10.1016/j.medengphy.2014.05.013.

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Jushiddi, Mohamed Gouse, John J. E. Mulvihill, Drahomir Chovan, Aladin Mani, Camelia Shanahan, Christophe Silien, Syed Ansar Md Tofail, and Peter Tiernan. "Simulation of biopsy bevel-tipped needle insertion into soft-gel." Computers in Biology and Medicine 111 (August 2019): 103337. http://dx.doi.org/10.1016/j.compbiomed.2019.103337.

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Reusz, Geza, Csilla Langer, Lajos Jakab, and Zita Morvay. "Ultrasound-guided vascular access: the importance of the needle bevel." Canadian Journal of Anesthesia/Journal canadien d'anesthésie 59, no. 5 (March 7, 2012): 499–500. http://dx.doi.org/10.1007/s12630-012-9683-y.

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27

Smuck, Matthew, Andrew J. Yu, Chi-Tsai Tang, and Eric Zemper. "Influence of needle type on the incidence of intravascular injection during transforaminal epidural injections: a comparison of short-bevel and long-bevel needles." Spine Journal 10, no. 5 (May 2010): 367–71. http://dx.doi.org/10.1016/j.spinee.2009.12.018.

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28

Engh, Johnathan A., Davneet S. Minhas, Douglas Kondziolka, and Cameron N. Riviere. "Percutaneous Intracerebral Navigation by Duty-Cycled Spinning of Flexible Bevel-Tipped Needles." Neurosurgery 67, no. 4 (October 1, 2010): 1117–23. http://dx.doi.org/10.1227/neu.0b013e3181ec1551.

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Abstract BACKGROUND: Intracerebral drug delivery using surgically placed microcatheters is a growing area of interest for potential treatment of a wide variety of neurological diseases, including tumors, neurodegenerative disorders, trauma, epilepsy, and stroke. Current catheter placement techniques are limited to straight trajectories. The development of an inexpensive system for flexible percutaneous intracranial navigation may be of significant clinical benefit. OBJECTIVE: Utilizing duty-cycled spinning of a flexible bevel-tipped needle, the authors devised and tested a means of achieving nonlinear trajectories for the navigation of catheters in the brain, which may be applicable to a wide variety of neurological diseases. METHODS: Exploiting the bending tendency of bevel-tipped needles due to their asymmetry, the authors devised and tested a means of generating curvilinear trajectories by spinning a needle with a variable duty cycle (ie, in on-off fashion). The technique can be performed using image guidance, and trajectories can be adjusted intraoperatively via joystick. Fifty-eight navigation trials were performed during cadaver testing to demonstrate the efficacy of the needle-steering system and to test its precision. RESULTS: The needle-steering system achieved a target acquisition error of 2 ± 1 mm, while demonstrating the ability to reach multiple targets from one burr hole using trajectories of varying curvature. CONCLUSION: The accuracy of the needle-steering system was demonstrated in a cadaveric model. Future studies will determine the safety of the device in vivo.
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ASSAAD, WISSAM, ALEX JAHYA, PEDRO MOREIRA, and SARTHAK MISRA. "FINITE-ELEMENT MODELING OF A BEVEL-TIPPED NEEDLE INTERACTING WITH GEL." Journal of Mechanics in Medicine and Biology 15, no. 05 (October 2015): 1550079. http://dx.doi.org/10.1142/s0219519415500797.

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Deviation of a needle from its intended path can be minimized by using a robotic device to steer the needle towards its target. Such a device requires information about the interactions between the needle and soft tissue, and this information can be obtained using finite element (FE) analysis. In this study, we present an FE analysis that integrates the Johnson–Cook damage model for a linear elastic material with an element deletion-based method. The FE analysis is used to model a bevel-tipped needle interacting with gel. The constants for the damage model are obtained using a compression test. We compare simulation results with experimental data that include tip–gel interaction forces and torques, and three-dimensional (3D) in situ images of the gel rupture obtained using a laser scanning confocal microscope. We quantitatively show that the percentage errors between simulation and experimental results for force along the insertion axis and torque about the bevel edge are 3% and 5%, respectively. Furthermore, it is also shown qualitatively that tip compression is observed at the same locations in both experimental and simulation results. This study demonstrates the potential of using an FE analysis with a damage model and an element deletion-based method to accurately simulate 3D gel rupture, and tip–gel interaction forces and torques.
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30

Huo, Benyan, Xingang Zhao, Jianda Han, and Weiliang Xu. "Closed-loop control of bevel-tip needles based on path planning." Robotica 36, no. 12 (August 24, 2018): 1857–73. http://dx.doi.org/10.1017/s0263574718000772.

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SUMMARYBevel-tip needles have the potential to improve paracentetic precision and decrease paracentetic traumas. In order to drive bevel-tip needles precisely with the constrains of path length and path dangerousness, we propose a closed-loop control method that only requires the position of the needle tip and can be easily applied in a clinical setting. The control method is based on the path planning method proposed in this paper. To establish the closed-loop control method, a kinematic model of bevel-tip needles is first presented, and the relationship between the puncture path and controlled variables is established. Second, we transform the path planning method into a multi-objective optimization problem, which takes the path error, path length and path dangerousness into account. Multi-objective particle swarm optimization is employed to solve the optimization problem. Then, a control method based on path planning is presented. The current needle tip attitude is essential to plan an insertion path. We analyze two methods to obtain the tip attitude and compare their effects using both simulations and experiments. In the end, simulations and experiments in phantom tissue are executed and analyzed, the results show that our methods have high accuracy and have the ability to deal with the model parameter uncertainty.
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31

Kim, Jeong Ho, Young Hyeun Kim, Hoon Soo Kang, and Tae In Park. "Relatins of needle gauge & bevel direction for postdural puncture headache." Korean Journal of Anesthesiology 26, no. 5 (1993): 961. http://dx.doi.org/10.4097/kjae.1993.26.5.961.

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32

Mihic, D. N. "Postspinal Headache and Relationship of Needle Bevel to Longitudinal Dural Fibers." Obstetric Anesthesia Digest 6, no. 2 (June 1986): 222. http://dx.doi.org/10.1097/00132582-198606000-00014.

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33

Hans, Surender, and Felix Orlando Maria Joseph. "Robust control of a bevel-tip needle for medical interventional procedures." IEEE/CAA Journal of Automatica Sinica 7, no. 1 (January 2020): 244–56. http://dx.doi.org/10.1109/jas.2019.1911660.

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34

Chow, Chi Wing, Syeda Asma Haider, Krish Ragunath, Guruprasad P. Aithal, Martin W. James, Jacobo Ortiz-Fernandez-Sordo, Aloysious Dominic Aravinthan, and Suresh Vasan Venkatachalapathy. "Comparison of the reverse bevel versus Franseen type endoscopic ultrasound needle." World Journal of Gastrointestinal Endoscopy 12, no. 9 (September 16, 2020): 266–75. http://dx.doi.org/10.4253/wjge.v12.i9.266.

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35

Sparks, C. J., G. E. Rudkin, K. Agiomea, and J. R. Faarondo. "Inguinal Field Block for Adult Inguinal Hernia Repair Using a Short-Bevel Needle. Description and Clinical Experience in Solomon Islands and an Australian Teaching Hospital." Anaesthesia and Intensive Care 23, no. 2 (April 1995): 143–48. http://dx.doi.org/10.1177/0310057x9502300202.

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One of the limitations of an inguinal field block is that it does not reliably produce complete anaesthesia. The purpose of this study was to describe a modified short-bevel needle technique, facilitating correct needle placement, for inguinal hernia repair. Anaesthetists from two different institutions performed the described infiltration blocks. Prospective data were collected from these groups, each having 30 patients. We evaluated the safety and reliability of the described block. Of the 60 patients, two were “failed” blocks, requiring conversion to general anaesthesia. There were no other major intraoperative or recovery room complications. Results of the modified inguinal field block showed a 97% ability to achieve a “fair” block or better. Intraoperative and postoperative data showed high surgeon and patient satisfaction for the block. The described block using a short-bevel needle is recommended as a suitable method for adult patients undergoing inguinal hernia repair.
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36

Terzano, Michele, Daniele Dini, Ferdinando Rodriguez y Baena, Andrea Spagnoli, and Matthew Oldfield. "An adaptive finite element model for steerable needles." Biomechanics and Modeling in Mechanobiology 19, no. 5 (March 9, 2020): 1809–25. http://dx.doi.org/10.1007/s10237-020-01310-x.

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Abstract Penetration of a flexible and steerable needle into a soft target material is a complex problem to be modelled, involving several mechanical challenges. In the present paper, an adaptive finite element algorithm is developed to simulate the penetration of a steerable needle in brain-like gelatine material, where the penetration path is not predetermined. The geometry of the needle tip induces asymmetric tractions along the tool–substrate frictional interfaces, generating a bending action on the needle in addition to combined normal and shear loading in the region where fracture takes place during penetration. The fracture process is described by a cohesive zone model, and the direction of crack propagation is determined by the distribution of strain energy density in the tissue surrounding the tip. Simulation results of deep needle penetration for a programmable bevel-tip needle design, where steering can be controlled by changing the offset between interlocked needle segments, are mainly discussed in terms of penetration force versus displacement along with a detailed description of the needle tip trajectories. It is shown that such results are strongly dependent on the relative stiffness of needle and tissue and on the tip offset. The simulated relationship between programmable bevel offset and needle curvature is found to be approximately linear, confirming empirical results derived experimentally in a previous work. The proposed model enables a detailed analysis of the tool–tissue interactions during needle penetration, providing a reliable means to optimise the design of surgical catheters and aid pre-operative planning.
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37

Maruyama, Masaaki. "Long-Tapered Double Needle Used to Reduce Needle Stick Nerve Injury." Regional Anesthesia: The Journal of Neural Blockade in Obstetrics, Surgery, & Pain Control 22, no. 2 (March 1997): 157–60. http://dx.doi.org/10.1136/rapm-00115550-199722020-00009.

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Background and ObjectivesNeedle trauma may cause peripheral nerve injuries during performance of peripheral nerve block.MethodsFour types of 21-gauge needles for regional anesthesia were compared: a beveled nerve block needle (Quincke type); a short-tapered needle with a side orifice (Whitacre type); a long-tapered needle with a side orifice (Sprotte type); and a long-tapered double needle combining an inner pencil-point fine needle with an outer truncated conical needle (a new type). This new needle was developed to reduce the potential for nerve injury while retaining a suitable flow rate of anesthetic solution and the ability to inject the solution precisely at the point of paresthesia elicited by the tip. Each type of needle was used to produce puncture injuries to rabbit sciatic nerves. Eighteen specimens were studied within each needle group. The beveled needle was used to produce two different types of nerve injuries by inserting it either transverse or longitudinal to the nerve fibers. Each histologic specimen of the nerve with the needle puncture was surfacestained with hematoxylin-eosin and Bodian's method. Subsequently, the number of damaged axons was histomorphologically counted and statistically evaluated.ResultsBoth long-tapered needles produced significantly fewer transected axons than the beveled needle inserted with the bevel longitudinal to the nerve fibers.ConclusionThe long-tapered needles produced the least number of transected nerve fibers after sciatic nerve puncture.
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Gonçalves, Aparecido Carlos, Sidnei Cavassana, Fábio R. Chavarette, Roberto Outa, Samuel J. Casarin, and Adalberto Vieira Corazza. "Variation of the Penetration Effort in an Artificial Tissue by Hypodermic Needles." Journal of Healthcare Engineering 2020 (September 22, 2020): 1–12. http://dx.doi.org/10.1155/2020/8822686.

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Fear of injection-related pain is a drawback to injectable therapy. Hypodermic injections are a cause for great anxiety and reduced adherence to the subcutaneous application of insulin for glycemic control in diabetics or in the treatment of multiple sclerosis, increasing the risk of complications and mortality. Injured or sick people have to undergo several daily injections, forcing them to rotate the veins and regions used to recover from the trauma caused by the perforation of the skin, tissue, muscles, veins, and arteries. People who suffer from type 1 diabetes mellitus (DM1) need to have their glycemic control 3 to 5 times a day and to take insulin up to 3 times a day. In both cases, the patient needs to perforate the skin. To quantify the pain perceived by the patients depends on the evaluation of each patient and therefore is subjective. This study aims to understand the application and self-application of hypodermic injections and decrease pain during its application and the phobia of the patient, following the reasoning that the lower the effort to penetrate the needle, the less trauma in the tissue and therefore the pain provoked. For that, it was analyzed how some of the characteristics of the needle can influence the sensation of pain in the injection. The needle penetration effort was measured in an artificial tissue (substitute skin model) for different cannula diameters, roughness, depth of penetration, lubrication, and angles of the perforating tip bevel. This study aimed to find alternatives to facilitate the application and self-application of hypodermic injections, increase safety and comfort, and reduce the pain intensity perceived by the patient. To do this, the bevel of needles used repeatedly was analyzed in the profile projector and SEM to verify the loss of the profile or the formation of burrs that could hamper the penetration or traumatize the tissue during the reuse of needles. It has also been mechanically analyzed, which can be done to prevent that the needles used in the subcutaneous application do not inadvertently reach the muscle. The greater penetration effort observed in the needles with greater angle of the bevel is responsible for the patient’s perception of pain.
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39

Zhang, Bo, Fangxin Chen, Miao Yang, Linxiang Huang, Zhijiang Du, Lining Sun, and Wei Dong. "Real-Time Curvature Detection of a Flexible Needle with a Bevel Tip." Sensors 18, no. 7 (June 27, 2018): 2057. http://dx.doi.org/10.3390/s18072057.

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40

Candiotti, Keith, Yiliam Rodriguez, Pushpa Koyyalamudi, Luciana Curia, Kristopher L. Arheart, and David J. Birnbach. "The Effect of Needle Bevel Position on Pain for Subcutaneous Lidocaine Injection." Journal of PeriAnesthesia Nursing 24, no. 4 (August 2009): 241–43. http://dx.doi.org/10.1016/j.jopan.2009.04.003.

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41

Li, Annie D. R., Yang Liu, Jeffrey Plott, Lei Chen, Jeffrey S. Montgomery, and Albert Shih. "Multi-Bevel Needle Design Enabling Accurate Insertion in Biopsy for Cancer Diagnosis." IEEE Transactions on Biomedical Engineering 68, no. 5 (May 2021): 1477–86. http://dx.doi.org/10.1109/tbme.2021.3054922.

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42

Yu, Andrew J., and Matthew W. Smuck. "Poster 244: Influence of Needle Type on the Incidence of Intravascular Injection During Lumbosacral Transforaminal Epidural Injections: A Comparison of Short Bevel and Long Bevel Needles." Archives of Physical Medicine and Rehabilitation 89, no. 11 (November 2008): e99. http://dx.doi.org/10.1016/j.apmr.2008.09.244.

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43

Mitrea, Nicoleta, Daniela Mosoiu, Julie Vosit-Steller, and Liliana Rogozea. "Evaluation of the optimal positioning of subcutaneous butterfly when administering injectable opioids in cancer patients." Medicine and Pharmacy Reports 89, no. 4 (October 28, 2016): 486–92. http://dx.doi.org/10.15386/cjmed-660.

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Background and aims. The increasing number of cancer patients, together with the development of new palliative care services in Romania, warrants the evaluation of nursing strategies meant to improve the level of comfort of patients who are suffering from advanced cancer.The main objective of the study was to evaluate the optimal positioning of the subcutaneous (sc) butterfly, in accordance with its resistance in the insertion tissue, the local complications that may occur, and the evaluation of the time of resistance at the insertion site (puncture) with the daily frequency of injectable opioid administration.Methods. A prospective experimental pilot study was designed and conducted between January and May 2011. Patients admitted to the Hospice Casa Sperantei (Brasov, Romania) with moderate or severe cancer pain, who were receiving subcutaneously opioids, over the age of 18, with normal body index ranging from 18.5 – 22.0, were assigned randomly to one of two groups, after signing the informed consent. In group one, the butterfly was positioned with the needle bevel up – this was considered to be the control group as this modality of inserting the needle is considered standard practice; in group two the butterfly was positioned with the needle bevel down – experimental group. The drugs used for pain relief were sc tramadol for moderate pain and sc morphine for severe pain.Results. Our research supported the hypothesis that the occurrence of local complications coincides with the decrease of sc butterfly resistance in time at the place of insertion, and the sc butterfly has a higher rate of resistance in time at the insertion site if the frequency of injectable opioids administration is lower (twice per day).Conclusion. The positioning of the butterflies with the bevel down (experimental group) is associated with a longer resistance in time at the site of insertion, and causes fewer local complications compared to the sc butterflies positioned with the bevel up (control group).
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44

Yousefi, Hashem, and Mehdi Fallahnezhad. "Multi-Objective Higher Order Polynomial Networks to Model Insertion Force of Bevel-Tip Needles." International Journal of Natural Computing Research 5, no. 3 (July 2015): 54–70. http://dx.doi.org/10.4018/ijncr.2015070103.

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Needle insertion has been a very popular minimal invasive surgery method in cancer detection, soft tissue properties recognition and many other surgical operations. Its applications were observed in brain biopsy, prostate brachytherapy and many percutaneous therapies. In this study the authors would like to provide a model of needle force in soft tissue insertion. This model has been developed using higher order polynomial networks. In order to provide a predictive model one-dimensional force sensed on enacting end of bevel-tip needles. The speeds of penetration for quasi-static processes have chosen to be in the range of between 5 mm/min and 300 mm/min. Second and third orders of polynomials employed in the network which contains displacement and speed as their main affecting parameters in the simplified model. Results of fitting functions showed a reliable accuracy in force-displacement graph.
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45

Richardson, Michael G., and Richard N. Wissler. "The Effects of Needle Bevel Orientation During Epidural Catheter Insertion in Laboring Parturients." Anesthesia & Analgesia 88, no. 2 (February 1999): 352–56. http://dx.doi.org/10.1213/00000539-199902000-00024.

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46

Richardson, Michael G., and Richard N. Wissler. "The Effects of Needle Bevel Orientation During Epidural Catheter Insertion in Laboring Parturients." Anesthesia & Analgesia 88, no. 2 (February 1999): 352–56. http://dx.doi.org/10.1097/00000539-199902000-00024.

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47

Rizza, S., E. Dall'amico, F. Rizzi, M. Gesualdo, F. Cravero, C. De Angelis, P. Cortegoso Valdivia, and L. Venezia. "Franseen-tip needle versus 20-gauge forward-bevel needle: diagnostic performance and histological acquisition capability in a retrospective comparison." Pancreatology 20 (November 2020): S102. http://dx.doi.org/10.1016/j.pan.2020.07.175.

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48

Dau, M., I. Buttchereit, C. Ganz, B. Frerich, E. N. Anisimova, M. Daubländer, and P. W. Kämmerer. "Influence of needle bevel design on injection pain and needle deformation in dental local infiltration anaesthesia – randomized clinical trial." International Journal of Oral and Maxillofacial Surgery 46, no. 11 (November 2017): 1484–89. http://dx.doi.org/10.1016/j.ijom.2017.06.013.

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49

YAO, QIN, and XUMING ZHANG. "DUTY-CYCLED SPINNING BASED 3D MOTION CONTROL APPROACH FOR BEVEL-TIPPED FLEXIBLE NEEDLE INSERTION." Journal of Mechanics in Medicine and Biology 18, no. 07 (November 2018): 1840017. http://dx.doi.org/10.1142/s0219519418400171.

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Flexible needle has been widely used in the therapy delivery because it can advance along the curved lines to avoid the obstacles like important organs and bones. However, most control algorithms for the flexible needle are still limited to address its motion along a set of arcs in the two-dimensional (2D) plane. To resolve this problem, this paper has proposed an improved duty-cycled spinning based three-dimensional (3D) motion control approach to ensure that the beveled-tip flexible needle can track a desired trajectory to reach the target within the tissue. Compared with the existing open-loop duty-cycled spinning method which is limited to tracking 2D trajectory comprised of few arcs, the proposed closed-loop control method can be used for tracking any 3D trajectory comprised of numerous arcs. Distinctively, the proposed method is independent of the tissue parameters and robust to such disturbances as tissue deformation. In the trajectory tracking simulation, the designed controller is tested on the helical trajectory, the trajectory generated by rapidly-exploring random tree (RRT) algorithm and the helical trajectory. The simulation results show that the mean tracking error and the target error are less than 0.02[Formula: see text]mm for the former two kinds of trajectories. In the case of tracking the helical trajectory, the mean tracking error target error is less than 0.5[Formula: see text]mm and 1.5[Formula: see text]mm, respectively. The simulation results prove the effectiveness of the proposed method.
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50

Koontz, Nicholas A., Richard H. Wiggins, Gregory J. Stoddard, and Lubdha M. Shah. "Do Superior or Inferior Interlaminar Approach or Bevel Orientation Predispose to Nonepidural Needle Penetration?" American Journal of Roentgenology 209, no. 4 (October 2017): 895–903. http://dx.doi.org/10.2214/ajr.17.18111.

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