I-Corps: Device for subdural hematoma visualization and access during evacuation

I-Corps项目更广泛的影响/商业潜力是开发硬膜下血肿清除（清除）装置。硬膜下血肿是最常见的外科治疗的神经系统疾病，发生由于创伤性脑损伤和慢性老年人。每年有超过10万例血肿病例接受神经外科治疗。随着人口老龄化和频繁使用抗凝剂，这一发病率预计会增加。干预措施可分为被动引流疏散和主动引流疏散。主动引流术需要患者待在手术室，并导致更高的疏散率。被动引流手术在床边进行，由于手术的侵入性较小，这对老年人有益，但它不如主动引流手术有效。该技术拟用于床边，可实现微创硬膜下血肿清除手术，将复发率和术后并发症降至最低。此外，如果在重症监护病房（ICU）使用，与在手术室进行的手术相比，该手术可能会降低医院和患者的成本。I-Corps项目的基础是开发一种微创硬膜下血肿清除工具，利用神经内窥镜和主动吸痰提供最大程度的硬膜下血肿清除。该套件包括一个“潜望镜”装置，专门用于在疏散过程中最大化硬膜下血肿的可视化和访问。这项技术可以使外科医生以一种非侵入性的方式看到并清除血肿，从而改进手术。目前的系统要么侵入性太强，要么不能有效地清除硬膜下血肿。由于手术后的并发症，侵入性手术可能是危险的，特别是对于65岁以上的患者。另外，微创手术提供较少的血肿可见性，通常没有主动吸引。这些手术条件导致高复发率，患者在几个月后再次出现表面血肿。该技术将用于重症监护病房，如果成功，可能会减少复发率、术后并发症以及医院和患者的总费用。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

The broader impact/commercial potential of this I-Corps project is the development of a subdural hematoma removal (evacuation) device. Subdural hematoma is the most common surgically treated neurological disease, occurring due to traumatic brain injury and chronically in older populations. Over 100,000 hematoma cases undergo neurosurgical intervention every year. This incidence rate is expected to increase with an aging population with frequent anticoagulant usage. Interventions can be categorized as passive drainage evacuation and active drainage evacuation. Active drainage requires the patient to be in the operating room and results in higher evacuation rates. Passive drainage procedures are done at the bedside, which is beneficial for the aging population due to the less invasive nature of the procedure, but it is not nearly as effective as active drainage procedures. Intended to be used at the bedside, the proposed technology may allow for a minimally invasive subdural hematoma evacuation procedure that minimizes recurrence rates and postoperative complications. Additionally, if employed in the intensive care unit (ICU), the procudure may result in lower hospital and patient costs compared with procedures done in the operating room. This I-Corps project is based on the development of a minimally invasive subdural hematoma evacuation kit that provides maximal subdural hematoma evacuation by taking advantage of neuroendoscopy and active suction. The kit includes a ”periscope” device that is specially designed to maximize subdural hematoma visualization and access during evacuation. This technology may allow the surgeon to visualize and remove the hematoma in a non-invasive manner, resulting in an improved procedure. Current systems are either too invasive or not effective at evacuating the subdural hematoma. Invasive procedures can be dangerous, especially for patients over 65 years old, due to complications after surgery. Alternatively, the minimally invasive procedures provide less visualization of the hematoma and often no active suction. These operative conditions result in high recurrence rates, with the patient returning a few months later with a resurfaced hematoma. The proposed technology is intended to be used in the intensive care unit and, if successful, may have the ability to decrease recurrences, postoperative complications, and total hospital and patient costs.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.