Minimally invasive robot places flexible, steerable catheter into living brain
By the editors of HospiMedica International
Posted on October 24, 2022
In minimally invasive brain surgery, surgeons use deeply penetrating catheters to diagnose and treat disease. However, the catheters currently in use are stiff and difficult to place accurately without the aid of robotic navigation tools. The rigidity of the catheters combined with the complex and delicate structure of the brain means that the catheters can be difficult to place precisely, which poses risks for this type of surgery. Now, scientists have successfully placed a bio-inspired steerable catheter into an animal’s brain for the first time. Preliminary research tested the delivery and safety of the new implantable catheter design in two sheep to determine its potential for use in the diagnosis and treatment of brain diseases. If proven effective and safe for use in humans, the platform could simplify and reduce the risks associated with diagnosing and treating diseases in the deep and delicate recesses of the brain. This could help surgeons see deeper into the brain to diagnose disease, more accurately deliver treatments like drugs and laser ablation to tumors, and better deploy electrodes for deep brain stimulation in conditions such as Parkinson’s disease and epilepsy.
The platform developed by scientists at Imperial College London (London, UK) improves minimally invasive, or ‘keyhole’ surgery, where surgeons deploy tiny cameras and catheters through small incisions in the body. It includes a soft, flexible catheter to prevent damage to brain tissue when delivering treatment, and a robotic arm with artificial intelligence (AI) to help surgeons navigate the catheter through brain tissue . Inspired by the organs used by parasitic wasps to stealthily lay eggs in the tree bark, the catheter consists of four interlocking segments that slide over each other to allow flexible navigation.
Image: Left: Surgeon’s console with visual interface. Right: Steerable catheter driver mounted on a neurosurgical robot (Photo courtesy of Imperial College London)
It connects to a robotic platform that combines human input and machine learning to carefully direct the catheter to the disease site. Surgeons then deliver fiber optics through the catheter so they can see and navigate the tip along brain tissue via joystick control. The AI platform learns from surgeon input and contact forces in brain tissue to guide the catheter with pinpoint precision. Compared to traditional “open” surgical techniques, the new approach could potentially help reduce tissue damage during surgery and improve patient recovery times and length of postoperative hospital stays.
To test their platform, the researchers deployed the catheter into the brains of two live sheep that were given pain relief and monitored around the clock for a week for signs of pain or distress before being euthanized so that researchers can examine the structural impact of the catheter on brain tissue. They found no signs of pain, tissue damage or infection after the catheter was implanted.
“Our new, precise and minimally invasive platform improves on currently available technology and could improve our ability to safely and effectively diagnose and treat disease in people, if proven safe and effective,” said the main author, Professor Ferdinando Rodriguez y Baena, of the Department of Imperial. of Mechanical Engineering.
“Our findings could have major implications for minimally invasive and robotic brain surgery,” added lead author Dr Riccardo Secoli, also from Imperial’s Department of Mechanical Engineering. “We hope this will help improve the safety and efficiency of current neurosurgical procedures when precise deployment of treatment and diagnostic systems is required, for example in the context of localized gene therapy.”
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