Steerable Robotic Endoscopic Tools for Pediatric Neurosurgery

在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 最大限度地侵入;因此，所有外科专业都突飞猛进。开始于 在上个世纪，人们开始质疑是否可以通过最小限度的 这导致了腹腔镜手术和其他类型的微创手术的发展。 手术（MIS）。微创颅内手术（内窥镜神经外科手术）的应用带来了独特的问题 例如：a）需要最小化通过脑实质的侵入的数量，因为任何 器械移动越过脑实质将导致附带损伤，B）缺乏 大手术空间，和c）限制助理的访问。这些限制在 儿科人群，但人们可能会令人信服地认为，这些儿科患者的立场受益最多， MIS方法。目前在商业和研究中的可操纵内窥镜工具， 直径和缺乏双手三角测量能力。仪器设计的突破将 无疑提高了外科医生通过内窥镜手术治疗复杂疾病的能力。因此， 本项目的目标是设计、开发和评估模块化、可操纵和灵活的机器人内窥镜工具 具有高保真力反馈和固有形状感测能力，其可以通过两个- 通道MINOP内窥镜（常用于神经外科），并改善当前的工作流程 手术室因此，我们将在这个项目中实现两个具体目标： sp.目标1（格鲁吉亚技术）：开发手持式、模块化、可操纵的机器人内窥镜工具， 保真度力反馈和固有形状感测能力，在内窥镜检查期间可轻松互换 手术通过激光和其他微加工/精加工技术， 将实现在内窥镜工具的远端处的尺寸（凹口）和尺寸（10 - 100微米）以实现可操纵性。 sp.目标2（CHOA+格鲁吉亚Tech）：真实3D体模模型和人体尸体测试-A） 在临床相关的逼真3D体模模型中评价工具的可操控性和可触及范围：我们将使用 3-D打印创建各种大脑模型，描绘健康大脑的几何形状和解剖细节。 和患病的大脑; B）评估工具提示的功能：我们将测试操作和响应能力 我们的仪器和设计通过颅神经和血管解剖尸体头部。 这个高度创新和跨学科的项目结合了外科机器人技术的专业知识（德赛-BME， 格鲁吉亚理工学院）、微加工（Melkote-ME，格鲁吉亚理工学院）和神经外科（Chern-儿童保健 （CHOA））开发用于神经外科的可操纵内窥镜工具。在这方面的技术进步 该项目将大大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.