Introduction: Current intracranial surgical approaches remain almost exclusively linear, using direct trajectories from cranial entry point to surgical target. Flexible, minimally invasive navigation within the intracranial space is an unmet challenge. Concentric tube robotics recently developed for neurosurgery open a way to meet this challenge. These robotic platforms are constructed from telescoping curved tubes with cross sections comparable to catheters and needles. Through the translation and rotation of their individual tube segments, precise snake-like motions can be achieved. We present a novel design and prototype concentric tube robot for non-linear navigation within the intraventricular space as a representative example of this technology.
Methods: Utilizing an MRI-derived 3D computer model of a hydrocephalic ventricle, a navigation challenge was chosen whereby the choroid fissure would be followed from the Foramen of Monro to ipsilateral temporal horn via a frontal Kocher’s point ventricular entry. Tube design algorithms previously developed by our group were used to arrive at optimal tube designs, and these were manufactured. A series of navigation and position accuracy tests were performed in an ex vivo 3D printed model of this hydrocephalic ventricle using the custom tube design loaded in our robotic platform.
Results: Design algorithms applied to the navigation challenge identified a 4-tube design, which was manufactured. Utilizing a 3D printed model of the hydrocephalic ventricle and our novel robotic control software, the cannula design successfully and accurately navigated from a Kocher’s Point ventricle entry to the temporal horn of the hydrocephalic ventricle.
Conclusions: We have recently developed a novel neurosurgical concentric tube robot system. As a representative task, we present successful navigation of a custom concentric cannula throughout a hydrocephalic ventricle. Through ongoing interative design of this prototype, concentric tube robotics stand to expand avenues for non-linear surgical approaches and minimally disruptive neurosurgery.
Patient Care: By working at the interface of engineering and neurosurgery, our goal is to develop the next generation of tools and approaches to improve minimally invasive neurosurgery for the benefit of the patients we care for.
Learning Objectives: To become familiar with concentric tube robot technology for use in neurosurgery, and the way in which this platform could be utilized for complex, non-linear navigation within the intracranial space.