Toward Transoral Peripheral Lung Access: Combining Continuum Robots and Steerable Needles.
Toward Transoral Peripheral Lung Access: Combining Continuum Robots and Steerable Needles.
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DOI：
10.1142/s2424905x17500015
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发表时间：
2017-03-01
期刊：
影响因子：
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通讯作者：
Webster, Robert J 3rd
中科院分区：
文献类型：
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作者：
Swaney, Philip J;Mahoney, Arthur W;Webster, Robert J 3rd
肺癌是最致命的癌症，部分原因是接触结节进行诊断和治疗存在挑战。经口入路优于经皮入路，因为它具有较低的肺塌陷风险，但由于当前支气管镜器械的限制，目前许多部位无法经口到达。为此，我们提出了一种新的机器人系统，用于图像引导的经支气管镜肺部手术。该系统使用支气管镜在气道和支气管中导航到所需目标附近的位置，使用同心管机器人移动穿过支气管壁并瞄准目标，并使用具有磁跟踪功能的斜尖可操纵针在闭环控制下穿过肺组织到达目标。在这项工作中，我们说明了我们系统的工作流程，并在模型实验中展示了准确的目标。离体猪肺实验表明，我们的可操纵针可以调整以在肺组织中实现明显的曲率。最后，我们使用基于患者病例的两种场景来展示我们的系统的靶向结果。在这些实验中，模型是根据患者特定的计算机断层扫描信息创建的，我们的系统用于定位可疑结节的位置，说明我们的系统能够到达传统上经口腔无法到达的部位。
Lung cancer is the most deadly form of cancer in part because of the challenges associated with accessing nodules for diagnosis and therapy. Transoral access is preferred to percutaneous access since it has a lower risk of lung collapse, yet many sites are currently unreachable transorally due to limitations with current bronchoscopic instruments. Toward this end, we present a new robotic system for image-guided trans-bronchoscopic lung access. The system uses a bronchoscope to navigate in the airway and bronchial tubes to a site near the desired target, a concentric tube robot to move through the bronchial wall and aim at the target, and a bevel-tip steerable needle with magnetic tracking to maneuver through lung tissue to the target under closed-loop control. In this work, we illustrate the workflow of our system and show accurate targeting in phantom experiments. Ex vivo porcine lung experiments show that our steerable needle can be tuned to achieve appreciable curvature in lung tissue. Lastly, we present targeting results with our system using two scenarios based on patient cases. In these experiments, phantoms were created from patient-specific computed tomography information and our system was used to target the locations of suspicious nodules, illustrating the ability of our system to reach sites that are traditionally inaccessible transorally.