Continuum Robot with Follow the Leader Motion for Endoscopic Third Ventriculostomy and Tumor Biopsy

Date Published:

2019 Apr 29


[Background] In a combined endoscopic third ventriculostomy (ETV) and endoscopic tumor biopsy (ETB) procedure, an optimal tool trajectory is mandatory to minimize trauma to surrounding cerebral tissue. [Objective] This paper presents wire-driven multi-section robot with push-pull driving wire. The robot is tested to attain follow-the-leader (FTL) motion to place surgical instruments through narrow passages while minimizing the trauma to tissues. [Methods] A wire-driven continuum robot with six sub-sections was developed and its kinematic model to achieve FTL motion was proposed. An accuracy test to assess the robot's ability to attain FTL motion along a set of elementary curved trajectory was performed. We also used hydrocephalus ventricular model created from human subject data to generate five ETV/ETB trajectory and conducted a study assessing the accuracy of the FTL motion along these clinically desirable trajectories. [Results] In the test with elementary curved paths, the maximal deviation of the robot was increased from 0.47 mm at 30 degrees turn to 1.78 mm at 180 degrees in a simple C-shaped curve. S-shaped FTL motion had lesser deviation ranging from 0.16 mm to 0.18 mm. In the phantom study, the greatest tip-deviation was 1.45 mm, and the greatest path deviation was 1.23 mm. [Conclusion] We present the application of a continuum robot with FTL motion to perform a combined ETV/ETB procedure. The validation study using human subject data indicated that the accuracy of FTL motion is relatively high. It is expected that may be useful combined ETV and ETB.