VINE Catheter: Soft, Tip-extending, Robotic Catheters with Shape Control for Endovascular Surgery

项目摘要 血管内手术（ES）日益增强或取代脑、肝 心脏和血管疾病，由于其改善的临床结果，更快的恢复时间，并改善更多- 总体比率。这些手术通常通过将血管内设备插入腹股沟或手臂来进行 以及通过轴向加载和工具基座的旋转的组合导航到远端动脉， 利用弯曲的尖端来插入预期的位置和血管。尽管血管内治疗有许多益处， 手术，血管解剖，特别是老年患者，他们代表了大部分接受手术的患者， 这种手术可能表现出过度的弯曲和严重的成角，导致高风险、时间密集的 这些程序只能由选定的经过专业培训的专家执行。数量较少 专家的缺乏导致获得必要治疗的机会有限，患者被迫等待或旅行， 接受治疗或根本不接受治疗。因此，迫切需要新的血管内机器人 安全、有效的手术工具，使更多的外科医生能够成功地在具有挑战性的解剖结构中导航。 为了满足这一需求，一种新的软机器人方法称为VINE-血管内部导航， 扩展-将被使用。当用压力流体加压时，这些VINE通过其尖端的延伸部分在人- 这与植物的生长方式类似，创造出具有复杂曲率的形状。这些VINE本质上更安全 由于其柔软的结构，代表了一种根本不同的运动方式。的总体目标 这项工作的目的是为了描述这种特性，并改进用于ES的VINE的设计，包括形状控制 方法，并验证其有效性和安全性。中心假设是这种新的形状控制方法 并且通过尖端延伸的导航使得VINE能够安全有效地穿过脉管系统。中央 假设将通过追求三个具体目标进行测试：（1）表征和细化小规模，预成型和 用于ES的可操纵VINE设计，（2）评估VINE在台式模型中的有效性，以及（3）验证 整个VINE系统在猪体内的研究。这项工作将是实现长期目标的第一步。 目标是创建一个软机器人导管插入系统，可由大量外科医生操作，以增加进入 高质量的外科治疗 这项工作是创新的，因为拟议的葡萄藤是第一个外翻，机器人导管形状控制， 代表着对现状的实质性背离，目前的现状依赖于推动半刚性工具， 从它们的近端。这项工作的预期贡献是一个初步的软，尖端延伸机器人系统 能够安全有效地绕过急转弯并通过血管系统的弯曲路径， 这是非常重要的，因为它最终将导致更多的人获得高质量的微创手术。

PROJECT SUMMARY Endovascular surgeries (ES) increasingly augment or replace traditional open surgical treatment of brain, liver, heart, and vascular diseases due to their improved clinical outcomes, faster recovery times, and improved mor- tality rates. These surgeries are commonly performed by inserting endovascular equipment into the groin or arm and navigating to distal arteries through a combination of axial loading and rotation of the base of the tools, utilizing the curved tips to deflect into intended locations and vessels. Despite the many benefits of endovascular surgeries, vascular anatomy, particularly for elderly patients who represent a large portion of those undergoing such procedures, can demonstrate excessive tortuosity and severe angulation, leading to high-risk , time-intensive procedures that can only be performed by a select number of expertly trained specialists. The small number of specialists results in limited access to necessary treatment, and patients are forced to either wait and travel for treatment or to not receive treatment at all. There is therefore a critical need for new endovascular robotic surgical tools that are safe, e↵ective, and that enable more surgeons to successfully navigate challenging anatomies. To address this need, a new soft-robotic approach called VINE – Vascular Internal Navigation by Extension – will be used. When pressurized with fluid, these VINEs navigate via extension at their tip in a man- ner analogous to how plants grow, creating shapes with complex curvatures. These VINEs are inherently safer due to their soft structure and represent a fundamentally di↵erent method of movement. The overall objective of this work is to characterize the behavior and refine the design of the VINE for ES, including the shape control methods, and to validate its e"cacy and safety. The central hypothesis is that this new method of shape control and navigation via tip-extension enables VINEs to safely and e↵ectively traverse the vasculature. The central hypothesis will be tested by pursuing three specific aims: (1) characterize and refine small-scale, pre-shaped and steerable VINE designs for ES, (2) evaluate VINE e"cacy in bench-top models, and (3) validate the safety of the entire VINE system in an in vivo pig study. This work will serve as a first step towards achieving the long-term goal of creating a soft robotic catheterization system, operable by a large number of surgeons, to increase access to high-quality surgical treatment. This work is innovative in that the proposed VINE is the first everting, robotic catheter with shape control and represents a substantive departure from the status quo, which currently relies on pushing semi-rigid instruments from their proximal end. The expected contribution of this work is a preliminary soft, tip-extending robotic system capable of safely and e↵ectively navigating around acute turns and through winding paths of the vasculature, which is significant since it will ultimately lead to increased access to high-quality minimally invasive procedures.