Surgical robot provides minimally invasive option for brain procedure

A surgical procedure to treat severe epilepsy involves drilling through the skull deep into the brain to destroy the small area where seizures originate.

Engineers at Vanderbilt University in Nashville considered whether it were possible to perform the operation in a less invasive way and decided that it was because the area of the brain involved is the hippocampus, a region in the bottom of the brain.

Their solution was to develop a robotic device that pushes through the cheek and enters the brain from underneath, which avoids having to drill through the skull and is much closer to the target area.

To do so meant developing a shape-memory alloy needle that can be precisely steered along a curving path and a robotic platform that can operate inside the magnetic field created by an MRI scanner.

The engineers have developed a working prototype, which was unveiled in a live demonstration at the Fluid Power Innovation and Research Conference in Nashville by David Comber, the graduate student in mechanical engineering who did much of the design work.

The 1.14mm nickel-titanium MRI-compatible needle operates like a mechanical pencil, with concentric tubes, some of which are curved, that allow the tip to follow a curved path into the brain. Using compressed air, a robotic platform controllably steers and advances the needle segments a millimetre at a time.

According to Comber, they have measured the accuracy of the system in the lab and found that it is better than 1.18mm, which is considered sufficient for such an operation. In addition, the needle is inserted in tiny, millimetre steps so the surgeon can track its position by taking successive MRI scans.

According to Associate Professor of Mechanical Engineering Eric Barth, who headed the project, the next stage in the surgical robot’s development is testing it with cadavers, estimating that it could be in operating rooms within the next decade.

Capabilities

‘I’ve done a lot of work in my career on the control of pneumatic systems,’ Barth said in a statement. ‘We knew we had this ability to have a robot in the MRI scanner, doing something in a way that other robots could not. Then we thought, ’What can we do that would have the highest impact?’‘

Associate Professor of Mechanical Engineering Robert Webster had simultaneously developed a system of steerable surgical needles. ‘The idea for this came about when Eric and I…figured that his expertise in pneumatics was perfect for the MRI environment and could be combined with the steerable needles I’d been working on,’ he said.

The engineers identified epilepsy surgery as a high-impact application through discussions with Associate Professor of Neurological Surgery Joseph Neimat.

They discovered that neuroscientists use the through-the-cheek approach to implant electrodes in the brain to track brain activity and identify the location where the epileptic fits originate. However, the straight needles they use can’t reach the source region, so they must drill through the skull and insert the needle used to destroy neurons through the top of the head.

Comber and Barth shadowed Neimat through brain surgeries to understand how their device would work in practice.

‘The systems we have now that let us introduce probes into the brain – they deal with straight lines and are only manually guided,’ Neimat said. ‘To have a system with a curved needle and unlimited access would make surgeries minimally invasive. We could do a dramatic surgery with nothing more than a needle stick to the cheek.’

The engineers have designed the system so that much of it can be made using 3D printing in order to keep costs down. This was achieved by collaborating with Jonathon Slightam and Vito Gervasi at the Milwaukee School of Engineering who specialise in novel applications for additive manufacturing.