Extending Reach, Accuracy, and Therapeutic Capabilities: A Soft Robot for Peripheral Early-Stage Lung Cancer

项目总结 本提案的重点是设计、开发和验证一种新型的软手术机器人，以解决关键的 肺癌领域内未得到满足的需求。肺癌是全世界最主要的癌症死因。 美国和全世界每年估计有180万人死亡，超过乳腺癌、前列腺癌 癌症和结肠癌加在一起。早期诊断和治疗是提高本病存活率的关键 肺癌。由于大约70%的肺结节位于肺的较深外围区域， 对组织进行足够的采样是具有挑战性的。传统的手动支气管镜检查能力有限。 由于管径较大，可接触较小的支气管壁。市场上可以买到的机器人支气管镜更容易 操作起来也更直观。然而，它们仍然存在远端灵巧性限制，深度探索仍然存在。 通过使用由临床医生手动推动的半柔性针来执行而不需要可视化。这 影响活检的准确性和精确度，并最终影响诊断结果，导致诊断和治疗的延误。 并增加肿瘤生长和扩散的风险。在这份提案中，我们将利用我们之前的开创性工作 小型化早期软式机械支气管镜的设计、制作及初步验证 肺癌的诊疗。这种以空气为动力的图像导引机器人是最小和最灵活的 和灵巧的机械支气管镜，允许在肺部更深的分支中导航和视觉反馈 在整个过程中。该系统以两个独立的工作渠道为特色，首次为 同时(即，在同一支气管镜检查过程中)诊断和治疗能力并加速 早期肺癌的治疗。优化软式机械支气管镜导航与稳定 基于计算机视觉算法的控制。我们将合并术前计划和术中数据，并 评估配准的准确性和精确度。我们将在机器人上开发一种机械稳定系统 提示，这将锚定周围的解剖结构，并与软件稳定协同工作。这将增强 机器人在呼吸和其他非自愿或意外运动中的病变跟踪能力和对抗能力 活检过程中的组织反作用力，以提高手术任务的准确性和精密度。我们将启用机器人 基于机器人多自由度软机器人微执行器的针具展开和转向驱动控制 小费。尖锐的弯曲角度和较大的冲程将使患者能够接触到难以触及的病变，而不会失去可见性。 我们将在体外和体外验证机器人，并与标准支气管镜检查进行比较。我们期待着 我们的技术具有更好的导航能力，更准确的仪器放置，减少程序 次数、更少的组织创伤、更好的诊断率、缩短的学习曲线和整体增强的程序 经验。我们的团队拥有外科专业知识，在这项研究中具有得天独厚的优势。 机器人学、软机器人学、医疗器械和介入肺病学，并有很长的近距离和 合作成果丰硕。

PROJECT SUMMARY This proposal focuses on the design, development, and validation of a novel soft surgical robot to address critical unmet needs within the world of lung cancer. Lung cancer is the leading cause of death from cancer in the United States and worldwide with an estimated 1.8 million deaths a year, more than breast cancer, prostate cancer, and colon cancer combined. Early diagnosis and therapy are essential to increase the survival rate of lung cancer. Because approximately 70% of lung nodules reside in the deeper peripheral region of the lung, adequate sampling of the tissue is challenging. Traditional manual bronchoscopes are limited in their ability to access small bronchi because of large diameters. Robotic bronchoscopes available on the market are easier and more intuitive to maneuver. However, they still present distal dexterity limitations and deep exploration is still performed without visualization by using semi-flexible needles that are pushed manually by the clinician. This affects biopsy accuracy and precision and ultimately diagnostic yield, causing delays in diagnosis and treatment and increasing the risk for tumor growth and spread. In this proposal, we will leverage our prior pioneering work on the design, fabrication, and preliminary validation of a miniaturized soft robotic bronchoscope for early-stage lung cancer diagnosis and treatment. This air-powered, image-guided robot is the smallest and most flexible and dexterous robotic bronchoscope, allowing navigation in branches deeper in the lung and visual feedback throughout the procedure. The system features two separate working channels to facilitate, for the first time, simultaneous (i.e., within the same bronchoscopy procedure) diagnostic and therapeutic capabilities and hasten early-stage lung cancer treatment. We will optimize the soft robotic bronchoscope navigation and stabilization control based on computer vision algorithms. We will merge pre-operative planning and intra-operative data and evaluate accuracy and precision in registration. We will develop a mechanical stabilization system at the robot tip, that will anchor to the surrounding anatomy and work in concert with software stabilization. This will enhance robot lesion tracking abilities during breathing and other involuntary or accidental movements and counteract tissue reaction forces during biopsy to improve surgical tasks’ accuracy and precision. We will enable robotic actuation control for needle tool deployment and steering via multi-DOF soft robotic micro actuators at the robot tip. Sharp bending angles and large strokes will enable access to hard-to-reach lesions without losing visualization. We will validate the robot in-vitro and ex-vivo and compare metrics with standard bronchoscopy. We anticipate our technology to have better navigational abilities, more accurate instrument placement, reduced procedure times, less tissue trauma, better diagnostic yield, shortened learning curve, and an overall enhanced procedural experience. Our team is uniquely positioned to achieve success of this study, possessing expertise in surgical robotics, soft robotics, medical devices, and interventional pulmonology, and having a long history of close and fruitful collaboration.