Title
Debulking From Within: A Robotic Steerable Cannula for Intracerebral Hemorrhage Evacuation
Abstract
New approaches to intracerebral hemorrhage management are motivated by its high incidence and 40% mortality rate. Surgery is sometimes attempted to decompress the brain, although patient outcomes are similar regardless of whether surgery occurs. We hypothesize that surgical decompression is not more effective because current open surgical techniques disrupt healthy brain tissue to access the clot formed by the hemorrhage, offsetting the benefits of surgery. To address this, we propose a less invasive needle-based approach in which the clot is debulked from within using a superelastic, precurved aspiration cannula that is deployed from a needle. The tip of this aspiration cannula is controlled by coordinated insertion and retraction of the cannula and needle, as well as axial rotation of the cannula. We describe the design of a sterilizable and biocompatible robot that can control the three degrees of freedom of the needle and cannula. Image guidance is achieved by adapting an approach originally developed for brain biopsy. We provide an optimization method for the selection of the precurvatures of one or more sequentially used aspiration cannulas to maximize hemorrhage evacuation, based on preoperative medical image data. In vitro experiments demonstrate the feasibility of evacuating 83-92% of hemorrhage volume, depending on the number of tubes and deployment method used.
Year
DOI
Venue
2013
10.1109/TBME.2013.2260860
Biomedical Engineering, IEEE Transactions
Keywords
DocType
Volume
biological tissues,biomedical equipment,brain,computerised tomography,image sequences,medical image processing,medical robotics,needles,optimisation,surgery,axial rotation,biocompatible robot,brain biopsy,debulking,degree-of-freedom,healthy brain tissue,image guidance,intracerebral hemorrhage evacuation,invasive needle-based approach,mortality rate,needle,optimization,precurved aspiration cannula,preoperative medical image data,robotic steerable cannula,sterilizable robot,superelastic cannula,surgery,Active cannula,concentric tube robot,continuum robot,minimally invasive neurosurgery,robot-assisted surgery
Journal
60
Issue
ISSN
Citations 
9
0018-9294
22
PageRank 
References 
Authors
1.40
11
5
Name
Order
Citations
PageRank
Jessica Burgner1739.06
Philip J. Swaney2826.84
Ray A. Lathrop3445.59
Kyle D. Weaver4605.57
Robert J. Webster51258110.68