Steerable Robotic Endoscopic Tools for Pediatric Neurosurgery

在20世纪的大部分时间里，麻醉和感染控制的进步使外科医生能够 最大限度的侵入性；结果，所有的外科专业都突飞猛进。从接近尾声时开始 上个世纪，人们开始质疑是否可以通过最低限度的治疗达到同样的临床效果 侵入性方法，这导致了腹腔镜手术和其他类型的微创手术的发展 外科(信息系统)。管理信息系统在颅腔(内窥镜神经外科)中的应用带来了独特的问题 例如：a)需要最大限度地减少通过脑实质的违规行为的数量，因为 侵犯脑实质的器械的运动将导致附带损害，b)缺乏 大的手术空间，以及c)限制助手的出入。这些限制在 然而，人们可能会令人信服地辩称，这些儿科患者将从 管理信息系统方法。目前商业和研究中的可定向内窥镜工具的直径不小于2 mm 直径大，缺乏双手三角测量能力。仪器设计方面的突破将 无疑增加了外科医生通过内窥镜手术治疗复杂疾病的能力。因此，总体上， 该项目的目标是设计、开发和评估模块化的、可操纵的、灵活的机器人内窥镜工具 具有高保真度的力反馈和固有的形状传感功能，可通过两个 Channel MINOP内窥镜(神经外科常用)，并改进目前在 手术室。因此，我们将解决这一项目的两个具体目标： SP.目标1(佐治亚理工学院)：开发手持、模块化、可控制的机器人内窥镜工具，具有在线高 保真力反馈和固有的形状感知功能，在内窥镜检查中可轻松互换 做手术。通过激光和其他微加工/精加工技术，不同形状的高质量特征 将实现内窥镜工具远端的(凹槽)和尺寸(10-100微米)，以实现可操纵性。 SP.目标2(Choa+乔治亚理工学院)：真实感3D幻影模型和人体身体测试-A) 在临床相关的真实3D体模模型中评估工具的可控性和可达性：我们将使用 3-D打印创建各种大脑模型，描绘出两者的几何和解剖细节 B)评估工具提示的功能：我们将测试操作和响应 通过身体头部的脑神经和血管解剖，我们的器械和设计。 这个高度创新的跨学科项目结合了外科机器人技术(DESAI-BME， 佐治亚理工学院)、微机械加工(Melkote-ME、佐治亚理工学院)和神经外科(Chern-儿童保健 亚特兰大大学(CHOA))为神经外科开发可操纵的内窥镜工具。这方面的技术进步 该项目将显著提高外科医生通过内窥镜手术治疗复杂颅脑疾病的能力。

For much of the 20th century, advancements in anesthesia and infection control allowed surgeons to be maximally invasive; as a result, all surgical specialties advanced leaps and bounds. Starting towards the end of the last century, one started to question whether the same clinical results could be achieved through minimally invasive methods, which led to the development of laparoscopic surgery and other types of minimally invasive surgery (MIS). The applications of MIS in the cranial space (endoscopic neurosurgeries) pose unique problems such as: a) the need to minimize the number of transgressions through the brain parenchyma because any movements of the instruments that transgress the brain parenchyma would result in collateral damage, b) lack of large surgical spaces, and c) restricted access for the assistant. These restrictions are accentuated in the pediatric population, yet one may convincingly argue that these pediatric patients stand to benefit the most from the MIS methods. Current steerable endoscopic tools, in commercial and research, are not less than 2mm in diameter and lack bimanual triangulation capabilities. A breakthrough in instrumentation design will undoubtedly increase the ability of surgeons to treat complex diseases via endoscopic surgeries. Thus, the overall goal of this project is to design, develop, and evaluate modular, steerable, and flexible robotic endoscopic tools with high fidelity force feedback and intrinsic shape sensing capability that can be introduced through a two- channel MINOP endoscope (commonly used in neurosurgery) and to improve the current work-flow in the operating theater. We will thus address two specific aims in this project: Sp. Aim 1 (Georgia Tech): Develop hand-held, modular, steerable robotic endoscopic tools with in-line high fidelity force feedback and intrinsic shape sensing capability, that are easily interchangeable during endoscopic surgery. Through laser and other micromachining/finishing techniques, high quality features of different shapes (notches) and sizes (10-100 microns) at the distal end of endoscopic tools to achieve steerability, will be realized. Sp. Aim 2 (CHOA + Georgia Tech): Realistic 3D Phantom Model and Human Cadaver Testing - A) Evaluate the steerability and reach of the tools in a clinically relevant realistic 3D phantom model: We will use 3-D printing to create various models of the brain depicting the geometry and anatomic details of both healthy and diseased brains; B) Evaluate the functionalities of the tool tips: we will test the actions and responsiveness of our instruments and designs through cranial nerve and blood vessel dissections in cadaveric heads. This highly innovative and interdisciplinary project combines expertise in surgical robotics (Desai - BME, Georgia Tech), micromachining (Melkote - ME, Georgia Tech), and neurosurgery (Chern - Children's Healthcare of Atlanta (CHOA)) to develop steerable endoscopic tools for neurosurgery. Technological advancements in this project will significantly enhance the surgeon's ability to treat complex cranial diseases via endoscopic surgery.