­Bimanual Neuroendoscopic Robot for Minimally Invasive Brain Surgery

Background

Over 380,000 intracranial neurosurgical procedures are performed annually in the United States to treat brain tumors, trauma, epilepsy, hydrocephalus, and vascular lesions. The invasiveness of open microsurgery, used for the majority of cases, damages healthy brain tissue resulting in neurological deficits, prolonged hospital stays, and increased costs including rehabilitation. Existing endoscopic technology is only used for about 1% of all lesions since it is effective for resecting small, relatively avascular intraventricular lesions, but not for the far more common larger, vascular lesions that extend into the parenchyma surrounding the ventricles.

Currently, no effective endoscopic technique exists for quickly identifying and occluding bleeding sites and the field is rapidly obscured by bloody CSF. Control of this bleeding requires suction/irrigation and application of cautery, which are bimanual tasks. Most endoscopes do not support bimanual manipulation since they have only a single instrument channel or operate where all instruments extend from the scope along straight parallel lines.

Technology Overview

This invention finds solutions to this problem. It incorporates two small robotic arms at the endoscope tip that enable the neurosurgeon to perform bimanual tasks at the tip of the endoscope. The patentable features in this invention include positioning robot arms very close to each other, separation of sterile and nonsterile components, modularity of design, robot arm designs, robotically steerable sheath, and capability to adapt robot for use in MRI scanner.

Applications

This invention is applicable to many different types of intracranial neurosurgical procedures such as:

• Brain tumors
• Trauma
• Epilepsy
• Hydrocephalus
• Vascular lesions

This robot can also be utilized for a much more extensive array of neurosurgeries due to its two robotic arms that allow for bimanual manipulation. Currently available endoscopic technology does not allow for this bimanual manipulation and therefore cannot be used to treat more than 1% of lesions, which are generally small, intraventricular, and relatively avascular. However, this invention can be used to treat the far more common larger, vascular lesions that extend into the parenchyma surrounding the ventricles. 

Advantages

• There are 380,000 neurosurgical procedures performed annually in the US, currently only about 1% can be treated endoscopically. This technology could increase this percentage to 10%, or about 38,000 cases per year.
• By avoiding the need for open surgery, this technology would reduce brain retraction and parenchymal injury, decreasing neurological deficits and hospitalization time.
• Though other neurosurgical robots exist, they are for different applications, meaning there are no direct competitors with this technology.
• Able to perform true bimanual tasks

Publications

• Butler EJ, Hammond-Oakley R, Chawarski S, Gosline AH, Codd P, Anor T, Madsen JR, Dupont PE, Lock J. Robotic Neuro-Endoscope with Concentric Tube Augmentation. Rep U S. 2012:10.1109/IROS.2012.6386022. doi: 10.1109/IROS.2012.6386022. PMID: 24232193; PMCID: PMC3825412.