Australas Phys Eng Sci Med
DOI 10.1007/s13246-012-0146-0
A robotic catheter system with real-time force feedback
and monitor
Nan Xiao • Jian Guo • Shuxiang Guo •
Takashi Tamiya
Received: 5 January 2011 / Accepted: 27 May 2012
Ó Australasian College of Physical Scientists and Engineers in Medicine 2012
Abstract This paper presents a robotic catheter system
with force sensors, monitor and a master–slave remote
control system. We developed micro force sensors and
applied them in the system to guarantee the operation
safety in intravascular neurosurgery applications, and
employed a camera to monitor the operation. Two kinds of
force information are obtained through force sensors when
the catheter contacted the blood vessel. The experiment
shows that the proposed force sensors-based catheter sys-
tem works well through force feedback and remote control.
The system can facilitates the operation and avoid potential
damages.
Keywords Robotic catheter mechanism  Force sensor 
Force monitoring
Introduction
Endovascular intervention is expected to become increas-
ingly popular in medical practice, both for diagnosis and
for surgery. However, as a new technology, it requires a lot
of skills in operation. In addition, the operation is carried
out inside the body, it is impossible to monitor it directly.
Much more skills and experience are required for doctors
to insert the catheter. In the operation, for example the
catheter is inserted through patients’ blood vessel. Mistakes
would hurt patients such as a serious vascular damage. An
experienced neurosurgery doctor can achieve a precision
N. Xiao (&)  J. Guo  S. Guo  T. Tamiya
Intelligent Mechanical Systems Engineering Department,
Kagawa University, 2217-20, Hayashi-cho, Takamatsu, Kagawa
761-0396, Japan
e-mail: xiao@eng.kangawa-u.ac.jp
about 2 mm in the surgery. However, the contact force
between the blood vessel and the catheter cannot be sensed.
During the operation an X-ray camera is used, and long
time operation will cause damage to the patient. Although
doctors wear protecting suits, it is very difficult to protect
doctors’ hands and faces from the radiation of the X-ray.
There are dangers of mingling or breaking the blood ves-
sels. To overcome these challenges, we need better tech-
nique and mechanisms to help and train doctors. Robotic
system has many advantages, such as higher precision, can
be controlled remotely etc. However, compared with hands
of human being, none of a robotic system could satisfy all
of the requirements of an endovascular intervention. Not
only because the machine is not as flexible as hands of
human being but also lacks of touch. In any case, robotic
catheter manipulation system could provide assistant to
surgeons in the operation, but it has a long way to go to
replace human being.
A lot of products and researches are reported in this
area. One of the popular products is a robotic catheter
placement system called Sensei robotic catheter system
supplied by Hansen Medical [1–3]. The Sensei system
provides the physician with more stability and more force
in catheter placement with the Artisan sheath compared to
manual techniques, allows for more precise manipulation
with less radiation exposure to the doctor, and is com-
mensurate with higher procedural complications to the
patient. Because of the sheath’s multiple degrees of free-
dom, force detection at the distal tip is very hard. Catheter
Robotics Inc. has developed a remote catheter system
called Amigo [4]. This system has a robotic sheath to steer
catheter which is controlled at a nearby work station, in a
manner similar to the Sensei system. The first human trail
of this system was in April, 2010 in Leicester, UK, where it
was used to ablate atrial flutter. Magnetecs Inc. produced
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 Australas Phys Eng Sci Med

AD/DA
IEEE 1394 Converter

position position Catheter

Phantom DSP manipulator
PC Communication
Omni & Sensors
force force

Remote control sub-system

Fig. 1 Schematic diagram of the system

their ‘catheter guidance control and imaging’ system [5]. (1) Stability movement of the catheter in blood vessel.
This system has four large magnets placed around the (2) The motion of catheter in the surgery.
table, with customised catheters containing magnets in the (3) Different speeds and step angle.
tip. The catheter is moved by the magnetic fields and is (4) Easiness of sterilization.
controlled at a nearby work station The Stereotaxis Inc. (5) Security of the operation.
developed a magnetic navigation system: the Stereotaxis
Niobe [6]. The system facilitates precise vector based
System design and configuration
navigation of magnetically enabled guide wires for percu-
taneous coronary intervention by using two permanent
Figure 1 shows the schematic diagram of the system. The
magnets located on opposite sides of the patient table to
system consists of two parts. One is the master side which
produce a controllable magnetic field. Thakui et al. [7]
is placed in the surgeon side. The master part is controlled
developed a kind of remote catheter navigation system.
by a PC, and a Phantom is used to get operator input and
This system allowed the user to operate a catheter manip-
display force feedback to the operator. The other part is the
ular with a real catheter. So surgeons’ operative skills
remote control system (slave). Surgeons get position of the
could be applied in this case. The disadvantage of this
catheter from monitors, and catheter manipulator is placed
system is lack of mechanical feedback. Fukuda and co-
in the slave side. Cameras are employed to monitor the
workers [8] at Nagoya University proposed a custom linear
status of the patient and DSA image will be sent to the
stepping mechanism, which simulates the surgeon’s hand
master side at the same time. Force sensors are installed at
movement. Regarding these products and researches, most
the end-tip of the catheter, force information will be sent to
concerns are still the safety. Force information of the
the master side in real-time. In the slave side a DSP is
catheter during the operation is very important to ensure
employed as the core controller, reference displacement
the safety of the surgery. However, measurement of the
will be send to the catheter manipulator and force will be
force on catheters is very hard to solve in these systems. A
get at the same time from sensors by using an AD con-
potential problem with a remote catheter control system is
verter. An internet based communication is built, therefore,
the lack of mechanical feedback that one would receive
in this case time delay between the master and slave should
from manually controlling a catheter [1, 9–15].
below 300 ms to keep the safety of the operation [18].
The remainder of the paper is organized as the follow-
Figure 2 shows the developed system.
ing. In ‘‘System development and implementation’’ section
system development and implementation will be intro-
duced. In ‘‘Simulations experiments and experimental
result’’ section simulation will be introduced and some
results will be provided. Finally, in the last section we draw
the conclusions.

System development and implementation

We developed a highly precise device which can achieve a

precision of 0.015 mm [16, 17], and more suitable in
configuration practical intravascular neurosurgery.
The concerns in the design are list as follows. Fig. 2 Photo of the developed system

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Fig. 3 Mechanism of the remote control sub-system, rotation support
Remote control sub-system
Figure 3 shows the remote control sub-system. In order to
insert a catheter two motions are demanded, one is axial
movement and the other one is radial movement. Figure 4
shows the catheter clamping and insertion mechanism of
the remote control sub-system. The catheter can pass
between the two wheels and the two wheels can be tight-
ened by the spring. The wheels are driven by a stepping
motor. Therefore, the catheter can be driven forward and
backward. Figure 3 shows the rolling support device. The
catheter can be rotated by the rotation gear which is driven
by a motor when the catheter is fixed by the two wheels.
Micro force sensors
Force information on the catheter is very important to
insure the safety of an operation. Doctors always want to
manage any details of an operation. The contact force
between blood vessel and the catheter is a key detail. As
stronger contact may break the blood vessel, the method of
getting the contact force information between the blood
vessel and the catheter is required. There are two kinds of
the contact force as shown in Fig. 5. One is generated when
the side of the catheter contacts to the blood vessel, and the
other one is generated when the end-tip contacts to the
blood vessel. Both of them could cause damage during the
operation.
To measure the contact force in the side of the catheter,
a force sensor is developed. The dimension of the force
sensor is 4 9 2 9 0.5 mm. Three sensors are installed in
the catheter as shown in Fig. 6. The sensors are made of the
sensitive material. Calibration experiments were carried
out to get the characteristic equations. The calibration
results and the curves were fitted by MATLAB curve fit-
ting tool box. Cubic polynomial which is described with
Eq. 1 is adopted to describe the curve and the coefficients
of the equation are given in Table 1.
Fig. 4 Mechanism of the remote control sub-system, inserting
support: a front view and b rear view
To measure the end-tip contact force of the catheter a
micro optical force sensor was used, meanwhile, the optical
fibre force sensor was served as guide wire to lead the
catheter for inserting and rotating. The FOP-M optical fibre
force sensor of FISO Technologies Inc. was used this time
in our research.
f ¼ ci3 v3 þ ci2 v2 þ ci1 v þ ci0 ði ¼ 1; 2; 3Þ ð1Þ
where c is the coefficients as shown in Table 1, v is voltage
output by sensors.
Controller
In the research a Phantom Omni is employed as the con-
troller. Phantom Omni is a haptic device which can output
force under a three-dimensional coordinate system. The
Phantom Omni has six joints. That means it has six degrees
of freedom. However, the robotic catheter operating system
needs only two degrees of freedom to control its motions.
In this research, the displacement along z axis of the handle
in the phantom is used to drive the catheter to go forward
and backward, the displacement along x axis of the handle
in the phantom is used to drive the catheter to roll, and the
coordinate system is shown in Fig. 7. When force
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Fig. 5 Comparison of safety

between two situations (without
force sensors and with force
sensors)

Fig. 7 Coordinate system at the Phantom Omni

When catheter is rotating, the Phantom Omni output

Fig. 6 Force sensors installed on the catheter
force is as follows:
*
Table 1 Calibration results F ¼ Arot  i þ 0  j þ 0  k ð4Þ
Coefficient Sensor 1 Sensor 2 Sensor 3 fmax ¼ max ðf1 ; f2 ; f3 Þ ð5Þ

ci1 -0.4762 -0.1874 -0.03155 0 ðfmax \ C1 Þ
Ar ¼ ð6Þ
ci2 2.075 1.368 0.2049 G  fmax ðfmax [ C1 Þ
ci1 -2.97 -3.406 -1.15 *
where F is the output force of the Phantom Omni, Arot is
ci0 1.668 3.25 2.145
the amplitude of the output force in rotation direction and
which is defined by Eq. 6, f1 ; f2 ; f3 are force from side
sensor 1, 2 and 3, f4 is the force from the optic fiber sensor
information is sent to the Phantom, the Phantom will out-
G is the gain coefficient, and C1 is a defined threshold.
put a haptic feedback to the user. Equations 2–6 show the
force model which are used to output force to the user.
Safety considerations
When catheter is inserting, the Phantom Omni output
force is as follows:
Software was developed to monitor the force information.
*
F ¼ 0  i þ 0  j þ Ains k ð2Þ Figure 8 shows the interface of the software. In this study
 three force sensors are used, so there are three progress bars
0 ðf4 \C0 Þ
Ains ¼ ð3Þ placed on this panel. Each progress bar shows a force from
G  f4 ðf4 [ C0 Þ
a force sensor. Also a colour bar is used; it shows the
*
where F is the output force of the Phontom Omni, Ains is danger range of the force. If a force is in the range of green
the amplitude of the output force in insertion direction and (below 0.5 N), it means safe; if in the range of yellow
which is defined by Eq. 3, G is the gain coefficient and C0 (0.5–1 N), it means the force needs some attention; if in the
is a defined threshold. range of red (1–1.5 N), it means the force is too large that it

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Fig. 8 Force monitoring
program
Fig. 9 Process of the
simulation
hurt patient. At the same time, forces feedback is sent to
the user through a haptic device. In our research, the haptic
device is used as the controller so if the force exceeds the
safe limit the controller would be locked immediately.
Then safety of an operation is guaranteed. This system, not
only allow users to see the force but also to feel it.
Simulation experiments and experimental result
Operating simulation
A simulation experiment was carried out in vitro. In this
paper, we locate two parts of the system in out laboratory;
communication between the controller and remote sub-sys-
tem was realized by a LAN communication, time delay was
about 10 ms. A rubber tube was used to imitate a blood vessel
which has a branch and an aneurysm which is shown in
Fig. 6. The target of the operation is the aneurysm. A catheter
should be driven to the target then break it. Figure 10 shows
the process of the simulation. At the beginning the catheter
was inserted into the blood vessel. When the catheter got to
the corner as shown in Fig. 9a, the catheter should turn to the
target but it missed. So the catheter returned and rolled then
turned to the right direction as shown in Fig. 9b and c.
Finally, the catheter reached the target Fig. 9d. The contact
force measured by sensors was displayed on the monitor and
felt through the handle of Phantom Omni.
Results
During the simulation of an operation, contact force between
the catheter and the tube was measured and displayed. There
are three force sensors are installed on the catheter. Figure 10
shows the contact force when the catheter through the branch
of the tube. The yellow curve is the force measured by the
sensor 1 which is placed on the most front of the catheter, the
green line is the force measured by sensor 2 and gray line is
the force measured by sensor 3. Sensor 1 contacted to the
wall of the tube firstly. Sensor 2 contacted to the wall of the
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Fig. 10 Side contact force
Fig. 11 End-tip contact force
Fig. 12 Output force of the
Phantom Omni
catheter after sensor 1 through the branch, and then the
contact force was detected and displayed. The curves had got
fluctuations on the peak of the signal. Figure 11 shows the
contact force measured by the optical fiber sensor. At the
same time these force were sent to the doctor side, displayed
on the screen and outputted by the Phantom Omni, the force
is shown in Fig. 12.
From the experiment and the results we could find that
the catheter can be sent to the place, and the contact force
on the catheter can be measured through force sensors and
outputted by using the haptic device.
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Conclusions and future work
In this paper, a novel catheter system with monitor and
micro force sensors is presented. We developed a high
precision remote catheter system to help doctor in intra-
vascular neurosurgery. In this system, two kinds of force
sensors are used on the catheter, which monitor the force in
real-time while the catheter is in operation. We also sim-
ulated in vitro to evaluate the operability of the developed
catheter system. The experimental results show that the
catheter with micro force sensors work well which can
Australas Phys Eng Sci Med
measure the contact force between the catheter and the
blood vessel, and improve operability.
In the future, the force sensor will be improved both in
precision and stability. And new kinds of materials will be
adopted to develop new sensors. Additionally, mechanism
with good operability will be improved.
Acknowledgments This research is supported by Kagawa Univer-
sity Characteristic Prior Research fund 2011.
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