Introduction: Current minimally invasive neuroendoscopic approaches remain largely linear, relying on a direct path from the cranial entry point to the surgical workspace. Highly flexible, minimally invasive navigation within the intracranial space is an unmet challenge. Recent innovations in concentric tube robotics represent an exciting potential solution to this navigation challenge. Concentric tube robots are constructed from telescoping curved tubes with cross sections comparable to catheters and needles. Through translation and rotation of their individual tube segments, precise snake-like motions. These tube lumens are capable of delivering flexible endoscopic systems and a wide spectrum of wires and articulated tip-mounted tools. We present a novel concentric tube robot prototype capable of delivering multimodality fiber based surgical instrumentation to intracranial surgical targets.
Methods: Design specifications for a concentric tube robot capable of minimally invasive intracranial navigation were developed. From this design, a robot prototype was successfully manufactured. A series of navigation and point position accuracy tests were performed by the robot using randomly generated target points and trajectories within an ex vivo workspace.
Results: A novel concentric tube robotic platform was created consisting of four independently controllable concentric, pre-curved nitinol cannulas. Robotic control software was created to allow cannula steering via an intuitive graphical user interface and force-feedback controller. Point position accuracy and trajectory tracking studies under visual feedback guidance demonstrated robot precision to be within 1mm (root mean square error <1mm).
Conclusions: We have successfully developed a novel neurosurgical concentric tube robot system capable of precise, complex and non-linear motions. Serving as a highly controllable flexible working channel, this system stands to augment capabilities for delivering flexible imaging and surgical instrumentation via non-linear intracranial trajectories. Such concentric tube robotics could dramatically expand avenues for complex and minimally disruptive maneuvering within the intracranial space.
Patient Care: Through the design algorithms and manufacturing techniques for concentric tube robotics we have developed, we hope to create novel neurosurgical robotic technologies capable of dynamic intracranial navigation for more precise and minimally disruptive neurosurgery.
Learning Objectives: By the conclusion of this session, participants should be able to 1) learn the current state of intracranial surgical robotic systems and review their advantages and limitations, 2) understand the general design specifications of a novel neurosurgical robotic system for minimally invasive intracranial surgery, and 3) learn how concentric tube robotics applied to neurosurgery might open new avenues for complex intracranial navigation.