Steerable Robotic Endoscopic Tools for Pediatric Neurosurgery

用于小儿神经外科的可操纵机器人内窥镜工具

• 批准号: 10217219
• 负责人: JAYDEV P. DESAI
• 金额: $ 21.82万
• 依托单位: GEORGIA INSTITUTE OF TECHNOLOGY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10217219
• 关键词: 3-Dimensional; Address; Anatomy; Anesthesia procedures; Arachnoid mater; Articulation; Biopsy; Blood Vessels; Brain; Brain Diseases; Brain Neoplasms; Cadaver; Caliber; Cephalic; Cerebellum; Child health care; Childhood; Clinical; Complex; Cranial Nerves; Cyst; Development; Disease; Dissection; Distal; Electrocoagulation; Endoscopes; Engineering; Forcep; Geometry; Goals; Hand; Head; Health Expenditures; Hospitalization; Human; Hydrocephalus; Image; Infection Control; Laparoscopic Surgical Procedures; Lasers; Lifting; Light; Magnetic Resonance Imaging; Medical; Methods; Modeling; Motion; Movement; Neuroendoscopy; Neurosurgeon; Neurosurgical Procedures; Operative Surgical Procedures; Pathology; Patients; Pediatric Hospitals; Population; Printing; Procedures; Research; Robotics; Shapes; Source; Spinal Cord; Spine surgery; Surface; Surgeon; Surgical Specialties; System; Techniques; Testing; Training; Ventricular; Work; brain parenchyma; clinically relevant; design; flexibility; force feedback; improved; innovation; instrument; instrumentation; interest; minimally invasive; neurosurgery; notch protein; pediatric patients; phantom model; robot assistance; tool; tumor; undergraduate student; urologic

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.

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 最大程度地侵入；结果，所有外科专业都取得了长足的进步。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来获得相同的临床结果 侵入性方法，导致腹腔镜手术和其他类型的微创手术的发展 手术（MIS）。 MIS 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）需要尽量减少通过脑实质的越界次数，因为任何 超出脑实质的仪器运动会导致附带损害，b）缺乏 大型手术空间，以及 c) 限制助手的进入。这些限制在 儿科人群，但人们可能会令人信服地争辩说，这些儿科患者将从中受益最多 管理信息系统方法。目前商业和研究中的可操纵内窥镜工具的直径不小于 2mm 直径并且缺乏双手三角测量功能。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，总体 该项目的目标是设计、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的形状传感能力，可以通过两个 通道 MINOP 内窥镜（常用于神经外科）并改进当前的工作流程 手术室。因此，我们将在该项目中实现两个具体目标： Sp。目标 1（佐治亚理工学院）：开发手持式、模块化、可操纵的机器人内窥镜工具，具有在线高 保真度力反馈和固有形状传感能力，在内窥镜检查过程中可以轻松互换 外科手术。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 在内窥镜工具远端实现可操纵性的（凹口）和尺寸（10-100微米）将得以实现。 Sp。目标 2（CHOA + 佐治亚理工学院）：逼真的 3D 体模模型和人体尸体测试 - A) 在临床相关的真实 3D 模型中评估工具的可操纵性和范围：我们将使用 3D 打印可创建各种大脑模型，描绘健康人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 通过尸体头部的脑神经和血管解剖来了解我们的仪器和设计。 这个高度创新和跨学科的项目结合了手术机器人技术的专业知识（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（陈省身 - 儿童保健 亚特兰大（CHOA））开发用于神经外科的可操纵内窥镜工具。这方面的技术进步 该项目将显着提高外科医生通过内窥镜手术治疗复杂颅脑疾病的能力。