Robotic Device Helps Diagnose, Treat Brain Diseases
'Keyhole surgery' is precise, minimally invasive, developers say
Scientists in the United Kingdom have developed a robotic device to aid the diagnosis and treatment of brain disorders, such as Parkinson’s.
The device — a soft, flexible catheter and an artificial intelligence (AI)-enabled robotic arm — could help neurosurgeons see deep brain structures and deliver treatments without damaging the brain’s intricate, delicate tissues.
“The brain is a fragile, complex web of tightly packed nerve cells that each have their part to play. When disease arises, we want to be able to navigate this delicate environment to precisely target those areas without harming healthy cells,” Ferdinando Rodriguez y Baena, PhD, professor of medical robotics at the Department of Medical Engineering, Imperial College London, said in a press release.
“Our new precise, minimally invasive platform improves on currently available technology and could enhance our ability to safely and effectively diagnose and treat disease in people if proven to be safe and effective,” Rodriguez y Baena added.
Preliminary findings of the study, “Modular robotic platform for precision neurosurgery with a bio-inspired needle: System overview and first in-vivo deployment,” were published in PLOS ONE.
Minimally invasive or keyhole surgery involves placing a camera and catheter (thin tube) containing specialized instruments through small holes in the body to perform surgical procedures. While these surgeries are associated with less trauma, shorter hospital stays and faster recovery times, catheters in use currently are rigid and difficult to place precisely without robotic navigation tools. The stiffness of the catheters also increases the risk of brain tissue damage.
“One of the key limitations of current MIS [minimally invasive surgery] is that if you want to get to a deep-seated site through a burr hole in the skull, you are constrained to a straight-line trajectory. The limitation of the rigid catheter is its accuracy within the shifting tissues of the brain, and the tissue deformation it can cause,” said Lorenzo Bello, MD, professor of neurosurgery and co-author of the study.
Imperial College scientists’ new device consists of a soft catheter with four interlocking segments that slide over one another for flexible navigation, and an AI-enabled robotic arm to help surgeons navigate the catheter through the brain. Once at the disease site, surgeons deliver optical fibers via the catheter to allow them to see and maneuver the tip along brain tissue using a joystick control. The AI platform learns from the surgeon’s input and contact forces within brain tissues to guide the catheter accurately.
Testing with sheep brains
The researchers tested the platform by inserting the catheter into the brains of two live sheep at the University of Milan’s Veterinary Medicine Campus. The sheep were given pain relief and monitored daily for a week for signs of pain or distress. Afterward, the researchers euthanized them and examined their brain tissues to see if the catheters caused damage. They found no signs of suffering, tissue damage, or infection.
“Our analysis showed that we implanted these new catheters safely, without damage, infection, or suffering. If we achieve equally promising results in humans, we hope we may be able to see this platform in the clinic within four years,” said Riccardo Secoli, PhD, lead author of the study.
“Our findings could have major implications for minimally invasive, robotically delivered brain surgery. We hope it will help to improve the safety and effectiveness of current neurosurgical procedures where precise deployment of treatment and diagnostic systems is required,” Secoli said.
The team is planning future studies to improve the efficiency and effectiveness of catheter placement and introduce additional sensing techniques, such as intraoperative ultrasound imaging, to measure tissue damage during surgery.
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