Optic Nerve Sheath Fenestration With a Multi-Arm Continuum Robot
Optic Nerve Sheath Fenestration With a Multi-Arm Continuum Robot
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DOI：
10.1109/lra.2020.3005129
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发表时间：
2020-06-25
影响因子：
5.2
通讯作者：
Bergeles C
中科院分区：
文献类型：
--
作者：
Mitros Z;Sadati S;Seneci C;Bloch E;Leibrandt K;Khadem M;da Cruz L;Bergeles C
本文介绍了一种用于眼眶深部介入手术的医疗机器人系统，重点是视神经鞘开窗术（ONSF）。ONSF是目前一种侵入性眼科手术方法，可以通过视神经上的切口降低视盘上潜在的致盲性颅内流体静压升高。该原型是一个多臂系统，能够灵巧地操纵和可视化的视神经区域，允许微创方法。每个臂是一个独立控制的同心管机器人，由一个定制的引导器准直，该引导器通过缝线固定在眼睛巩膜上。在这篇文章中，我们考虑机器人的末端执行器的设计，以达到/导航视神经根据临床要求的ONSF。设计了机器人的原型，并通过对猪视神经进行体外实验并将其刚度与人类进行比较来分析其穿透视神经的能力。该机器人成功部署在定制的逼真眼模中。我们的仿真研究和实验结果表明，机器人可以成功地导航到手术现场，并进行干预。
This article presents a medical robotic system for deep orbital interventions, with a focus on Optic Nerve Sheath Fenestration (ONSF). ONSF is a currently invasive ophthalmic surgical approach that can reduce potentially blinding elevated hydrostatic intracranial pressure on the optic disc via an incision on the optic nerve. The prototype is a multi-arm system capable of dexterous manipulation and visualization of the optic nerve area, allowing for a minimally invasive approach. Each arm is an independently controlled concentric tube robot collimated by a bespoke guide that is secured on the eye sclera via sutures. In this article, we consider the robot’s end-effector design in order to reach/navigate the optic nerve according to the clinical requirements of ONSF. A prototype of the robot was engineered, and its ability to penetrate the optic nerve was analysed by conducting ex vivo experiments on porcine optic nerves and comparing their stiffness to human ones. The robot was successfully deployed in a custom-made realistic eye phantom. Our simulation studies and experimental results demonstrate that the robot can successfully navigate to the operation site and carry out the intervention.