Design, Modeling, and Control of a Concentric Tube Robot for MR-Guided Intracerebral Hemorrhage Evacuation
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Gunderman, Anthony Lawrence
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Abstract
Intracerebral hemorrhage (ICH) is a type of hemorrhagic stroke that is caused by the rupture of a cerebral blood vessel. Recently, the Early Minimally Invasive Removal of Intracerebral Hemorrhage (ENRICH) trial has confirmed that minimally invasive surgery (MIS) can improve functional outcomes. While MIS offers advantages, challenges remain, including limited instrumentation dexterity and inadequate intraprocedural visualization. This work introduces the development, modeling, control, and evaluation of a minimally invasive MR-conditional concentric tube robot designed for the evacuation of intracerebral hemorrhages. Relevant technical contributions include the modeling and implementation of PRIME, a novel Pneumatic Radial Inflow Motor and Encoder designed for the actuation of MR-conditional robotic systems. After demonstrating the successful application of this motor, the design and modeling of ASPIHRE, A Surgical Platform for Intracerebral Hemorrhage Robotic Evacuation, utilizing PRIME is detailed. This system uses nylon tubes for the concentric tubes and torsional compensation is provided using the principle of virtual work. With the efficacy of ASPIHRE confirmed in phantom studies, the work proceeds to introduce NICE-Aiming, a Neurosurgical Interventional Configurable device for Effective-Aiming, that is to be used with ASPIHRE for ICH evacuation. In addition to the robotic system development, a fluidic model for closed-loop hematoma evacuation is developed for evacuation flow rate regulation with long pneumatic and hydraulic transmission lines. The performance of the system is then thoroughly assessed through ex vivo and in vivo evaluations - a clinical and literature first. Finally, following the hardware evaluation, ENLiTEN, an algorithm for Estimation of Steerable Needles using Lie Theory and Electromagnetic Navigation, is developed for state estimation (position and orientation) of follow-the-leader needles. While this research primarily focuses on enhancing clinical outcomes for ICH patients, the methodologies and models presented hold potential for broader applications in MR-guided and neurosurgical interventions, offering new avenues for surgeries and improving patient care of complex brain pathologies.
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2024-09-13
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Dissertation