Minimally invasive autopsies help understanding diseases
Autopsies can play an important role in understanding diseases. Particularly for novel and potentially lethal infections it is often unclear which organs are affected and why some patients may die. Yet, open autopsies are also a time-consuming procedure often opposed by family members of the deceased. Employing methods from robotics and artificial intelligence (AI), a team of researchers at Hamburg University of Technology (TUHH) and Medical Center Hamburg-Eppendorf (UKE) collaborate to realize minimally invasive autopsies.
Prof. Benjamin Ondruschka and his team at the Institute of Legal Medicine at UKE have been forerunners of using modern medical imaging for postmortem diagnosis. However, ultimately it is the analysis of tissue which allows understanding the causes of death. Hence, a full open autopsy remains the gold standard procedure.
However, the recent COVID pandemic has demonstrated both the value and the limitations of open autopsies. While autopsies were instrumental in understanding whether and how COVID caused death, there were also initial doubts regarding risks for the staff and often the families of the deceased remained reluctant agreeing to the procedure.
This motivated a joint project with researchers at TUHH’s Institute of Medical Technology and Intelligent Systems with the objective to leverage robotics and AI to realize minimally invasive autopsies. Using a robot to guide the placement of biopsy needles we demonstrated feasibility of precise tissue sampling from various organs and regions. Interestingly, the system can be used through body bags, further reducing the risk of infections during autopsies.
Illustration of the initial planning step to identify suitable robot trajectories.
Over the past two years, the system has been integrated with the setup at the Institute of Legal Medicine and extended to embed additional sensors within the needle. This allows for further improvements in the system’s accuracy, e.g., by estimating forces at the needle tip or tissue ruptures during needle insertion. Future work will address advanced in-situ analysis of tissues, also allowing for further insights into tissue interfaces as studied within the Interdisciplinary Competence Center for Interface Research (ICCIR), another joint research effort of TUHH and UKE.
In a preliminary study, ten target structures in thorax and abdomen have been considered .
Workflow of robot assisted minimally invasive autopsies. Based on CT images the target is identified and robot trajectories are planned. Subsequently the robot inserts the needle through the body bag and a tissue sample is taken.
Maximilian Neidhardt, Alexander Schlaefer Institute of Medical Technology and Intelligent Systems E: firstname.lastname@example.org, email@example.com T: +49 40 42878 3250
 M. Neidhardt et al., "Robotic Tissue Sampling for Safe Post-Mortem Biopsy in Infectious Corpses," in IEEE Transactions on Medical Robotics and Bionics, vol. 4, no. 1, pp. 94-105, Feb. 2022, doi: 10.1109/TMRB.2022.3146440.