Reopening the Central Airway With Needle-Size Tentacle Manipulators

Project Summary AbstractThe objective of this proposal is to perform proof of concept experiments on a new hand held surgical instrument that provides dexterity at the tip of a rigid bronchoscopeThis approach is less invasive than traditional open surgeryand will be safer than the current rigid bronchoscopic approachwhich lacks dexterity in port delivered instrumentsOur new system will feature needle sized manipulators deployed through the bronchoscopeandapos s port and will enable lateral tool motion for independent tissue manipulationlaser aimingand visualizationwhich we hypothesize will make central airway obstruction surgery more accurate and ef cientClinical signi cance comes from the many patients affected by central airway obstructionoverper year in the USA aloneas well as the severity for individual patientssince lack of an adequate airway is fatalExisting surgical approaches are challenging because instruments deployed through bronchoscope ports lack lateral dexterityand consequently complication rates are highof patients will have complications including broken teethcervical spine injuryhemorrhageand even deathInnovation comes from using elastic interactions in curved tubes to create needle size manipulators that can bend and elongateThis enables us to make manipulators small enough to pass through the port in a clinical bronchoscope to provide tentacle like dexterity at its tipOur system will also be innovative because it will be therst commercial robotic system designed for central airway surgeryand because it will be a small hand held tool rather than a largecomplicated system in which the surgeon sits at a console remote from the patient and teleoperates a large multi arm robot that surrounds the patientOur new hand held paradigm is advantageous from both a work ow and cost perspectivebecause it is compact with dramatically fewer mechanical and electronic componentsand so has the potential to be an order of magnitude less expensive than the surgical robots on the market todayOur approach in Aimis to create a hand held unit that clips onto the back of the bronchoscope and enables the surgeon to control our proposed needle sizedtentacle like instrumentsAccomplishing this will require hardware adaptations to an existing concentric tube actuation unit prototype developed in an academic laboratorytechnology that will be transferred to Virtuoso Surgical via this projectas well as the design and manufacturing of tubes customized for the requirements of central airway obstruction surgeryIn Aimwe experimentally validate the feasibility of removing central airway obstructions in anthropomorphic phantoms and an ex vivo insuf ated porcine lung modelThe end result of this Phase I STTR project will be experimental validation of the feasibility of resecting central airway tumors with our new hand held robot paradigmThis will set the stage for the development of a sterilizablebiocompatible product in the context of a follow on Phase II project NarrativePublic Health Relevance Central airway obstruction affects overpatients per year in the USA aloneand current surgical approaches are invasivewith approximatelyof patients suffering complications including neck injuryhemorrhageand even deathdue to lack of instrument dexterityWe propose to create new needle sizedtentacle like instruments that will enable the surgeon to dexterously manipulate surgical tools in the central airway endoscopicallyThis system promises to increase the accuracy and ef ciency of surgery and thereby reduce complication rates for patients with central airway obstructions