NRI: Advanced Biophotonics for Image-guided Robotic Surgery

描述（由申请人提供）：肿瘤组织的完全切除仍然是癌症患者生存的最重要因素之一。手术切除是最常见的一线癌症治疗。脑中的肿瘤切除是非常困难的，因为留下残留的肿瘤组织会导致生存率降低，而切除正常的健康脑组织会导致终身的神经功能缺损。脑外科手术需要非常高的灵活性、精确的导航和长时间的微精度切割;因此它是机器人辅助手术的理想候选者。然而，肿瘤切除术由于需要在颅骨上开一个小孔（锁孔），以及在术中难以区分正常组织和病变组织而变得复杂。允许外科医生在实时术中设置中直接可视化并准确区分肿瘤（癌症）与非肿瘤组织的微创机器人系统目前尚不可用，但却是NRI的理想gal。我们建议以团队方法克服影响机器人辅助手术的两个主要限制：无法（1）自动和（2）在具有先进光子学和新癌症生物标志物的微创术中环境中光学引导治疗。汉纳福德博士将领导RAVEN II开放式硬件和softvare机器人系统与基于激光的内窥镜成像的集成。一个机器人手臂将持有一个标准的手术工具切除/去除肿瘤，和一个新的扫描荧光和反射成像系统，以提供先进的光子在超小尺寸。一个由三名研究神经外科医生（Olson，Ellenbogen，Sekhar博士）组成的团队将帮助开发未来图像引导脑外科手术的临床相关模型和生物模型。PI，Seibel博士将提供一种新的多模式扫描光纤内窥镜（mmSFE）技术，该技术允许先进的激光成像，诊断和治疗生物光子学方法用于术中锁孔手术，以提高性能和安全性。

DESCRIPTION (provided by applicant): Complete resection of tumor tissue remains one of the most important factors for survival in patients with cancer. Surgical removal is the most common front-line cancer therapy. Tumor resection in the brain is exceptionally difficult because leaving residual tumor tissue leads to decreased survival and removing normal healthy brain tissue leads to life-long neurological deficits. Brain surgery requires a very high degree of dexterity, accurate navigation, and niicro-precision cutting over long durations; thus it is an idel candidate for robotically assisted surgery. However, tumor resection is compounded by the need to make a small opening (keyhole) in the skull, and the difficulty of distinguishing normal from diseased tissue in an intraoperative setting. A minimally-invasive robotic system that allows surgeons to directly visualize and accurately discriminate neoplastic (cancer) from non-neoplastic tissue in a real-time intra-operative setting is currently not available, but an ideal gal for NRI. We propose to overcome two major limitations affecting robotically-assisted surgery in a team approach: inability to (1) automatically and (2) optically guide treatments in a miriimally-invasive intraoperative environment with advanced photonics and new cancer biomarkers. Dr. Hannaford will lead the integration of the RAVEN II open hardware and softvvare robotic system with laser-based endoscopic imaging. A single robot arm will hold a standard surgical tool for resecting/removing tumor, and a novel scanning fluorescence and reflectance imaging system to provide the advanced photonics in an ultra-small size. A team of three research neurosurgeons (Drs. Olson, Ellenbogen, Sekhar) will help develop clinically relevant phantoms and biological models of future image-guided brain surgery. PI, Dr. Seibel will provide a new multi-modal scanning fiber endoscope (mmSFE) technology that allows advanced laser imaging, diagnostic, and therapeutic biophotonics approaches to intra-operative keyhole surgery for improved performance and safety.