Tendons, concentric tubes, and a bevel tip: Three steerable robots in one transoral lung access system

Abstract

Lung cancer is the most deadly form of cancer, and survival depends on early-stage diagnosis and treatment. Transoral access is preferable to traditional between-the-ribs needle insertion because it is less invasive and reduces risk of lung collapse. Yet many sites in the peripheral zones of the lung or distant from the bronchi cannot currently be accessed transorally, due to the relatively large diameter and lack of sufficient steerablity of current instrumentation. To remedy this, we propose a new robotic system that uses a tendon-actuated device (bronchoscope) as a first stage for deploying a concentric tube robot, which itself is a vehicle through which a bevel steered needle can be introduced into the soft tissue of the lung outside the bronchi. In this paper we present the various components of the system and the workflow we envision for deploying the robot to a target using image guidance. We describe initial validation experiments in which we puncture ex vivo bronchial wall tissue and also target a nodule in a phantom with an average final tip error of 0.72 mm.

Soft pop-up mechanisms for micro surgical tools: Design and characterization of compliant millimeter-scale articulated structures

“…Distal actuation approaches still lack viable technologies due to challenges for scalability and safety of the materials, currents and voltages needed [9]. A promising approach has been proposed by Webster et al where active cannulas are used in combination with conventional endoscopes for transurethral prostate surgery [10] and transoral lung surgery [11]. Recent studies have focused on increasing the amount of articulation achievable at the instrument tip, [11] as well as integrating sensing capabilities [12] for these systems.…”

“…A promising approach has been proposed by Webster et al where active cannulas are used in combination with conventional endoscopes for transurethral prostate surgery [10] and transoral lung surgery [11]. Recent studies have focused on increasing the amount of articulation achievable at the instrument tip, [11] as well as integrating sensing capabilities [12] for these systems. The Pop-up book MEMS manufacturing paradigm creates three dimensional microstructures and devices, based on the folding of multilayer rigid-flex laminates [13].…”

Motion planning for a three-stage multilumen transoral lung access system

“…To enable safe and effective lung biopsies for definitive early stage lung cancer diagnosis, a new multilumen transoral lung access system is being developed [5]. This new device provides the benefits of the transoral approach (e.g., low risk of pneuomothorax since the pulmonary pleura is not punctured) while enabling access to peripheral lung nodules.…”

Design and evaluation of a continuum robot with extendable balloons

“…With utilization of newly developed compliant matters and fabrication techniques and utilizing these matters in continuum robots, they can be enabled to tolerate very high strains and extreme configurations . Backbones can be axially extended by utilizing different mechanisms, for example by actuating antagonistic tendons that are placed about the longitudinal axis (Chirikjian and Burdick, 1994) with the option of spring loading (Tonapi et al, 2015) or having telescopic precurved concentric tubes along the backbone and rotating them independently (Swaney et al, 2015). A locally actuated backbone continuum robot design is the closest to the biological continuum structures (Walker, 2013).…”