Steering Flexible Needles in Soft Tissue

描述(由申请人提供)：微创外科技术在改善患者护理、降低感染风险和缩短康复时间方面取得了巨大成功。该项目旨在通过开发一种将细长、灵活的针头插入人体并从外部引导它们的技术来进一步降低侵入性。这种方法将通过提高医生在不增加患者创伤的情况下在人体内准确操作的能力，潜在地改进从化疗和放射治疗到活组织采集和肿瘤切除的广泛程序。基于机器人学的新兴方法和在R21探索性拨款下获得的非常令人鼓舞的结果，我们提议设计、制作和评估一个工作系统，该系统将引导柔性针穿过可变形的组织和绕过内部障碍物，以精确地到达指定的3D目标。这项研究计划将通过集成的针设计和建模、术前可视化和针的运动规划以及图像引导的术中针控制，显著促进我们对针疗法的理解和实践。科学和工程上的进步将在一系列临床前试验中达到顶峰，这些试验使用体模和自然的体外和体内模型进行成像(荧光透视、超声波和核磁共振)。这项研究的设计、分析和实验将确定柔性针转向的优点和缺点，目的是改善目前的临床应用，并导致新的超微创手术程序。该项目的结果可以通过降低患者康复时间、感染率和治疗成本来显著改善公共卫生。通过提高微创手术的灵活性和准确性，预期的结果不仅将改善现有手术的结果，还将使经皮手术能够用于目前需要开放手术的许多情况。

DESCRIPTION (provided by applicant): Minimally invasive surgical techniques have been highly successful in improving patient care, reducing risk of infection, and decreasing recovery times. This project aims to further reduce invasiveness by developing a technique to insert thin, flexible needles into the human body and steer them from outside. This approach will potentially improve a wide range of procedures, from chemotherapy and radiotherapy to biopsy collection and tumor ablation, by enhancing physicians' abilities to accurately maneuver inside the human body without additional trauma to the patient. Building on emerging methods in robotics and highly encouraging results obtained under an R21 exploratory grant, we propose to design, prototype, and evaluate a working system that will steer flexible needles through deformable tissue and around internal obstacles to precisely reach specified 3D targets. This research program will significantly advance our understanding and practice of needle therapies through integrated needle design and modeling, preoperative visualization and needle motion planning, and image-guided intraoperative needle control. The scientific and engineering advances will culminate in a set of pre-clinical trials with imaging (fluoroscopy, ultrasound, and MRI) using phantom and natural ex vivo and in vivo models. The designs, analyses, and experiments of this study will determine the merits and weaknesses of flexible needle steering, with the goals of improving current clinical applications and leading to new ultra-minimally invasive surgical procedures. The results of this project could significantly improve public health by lowering patient recovery times, infection rates, and treatment costs. By increasing the dexterity and accuracy of minimally invasive procedures, anticipated results will not only improve outcomes of existing procedures, but also enable percutaneous procedures for many conditions that currently require open surgery.