A Digital Twin for Robotic Post Mortem Tissue Sampling Using Virtual Reality

Studying tissue samples obtained during autopsies is the gold standard when diagnosing the cause of death and for understanding disease pathophysiology. Recently, the interest in post mortem minimally invasive biopsies has grown which is a less destructiveapproach in comparison to an open autopsy and reduces the risk of infection. While manual biopsies under ultrasound guidance are more widely performed, robotic post mortem biopsies have been recently proposed. This approach can further reduce the risk of infection for physicians. However, planning of the procedure and control of the robot need to be efficient and usable. We explore a virtual reality setup with a digital twin to realize fully remote planning and control of robotic post mortem biopsies. The setup is evaluated with forensic pathologists in a usability study for three interaction methods. Furthermore, we evaluate clinical feasibility and evaluate the system with three human cadavers. Overall, 132 needle insertions were performed with an off-axis needle placement error of 5.30 $\pm$ 3.25 mm. Tissue samples were successfully biopsied and histopathologically verified. Users reported a very intuitive needle placement approach, indicating that the system is a promising, precise, and low-risk alternative to conventional approaches.