Concentric Tube Robot-Assisted Intracerebral Hemorrhage Evacuation: Validation in an Ovine Model

Area of Science:

• Neurosurgery
• Medical Robotics
• Biomedical Engineering

Background:

• Intracerebral hemorrhage (ICH) is a severe stroke type causing millions of deaths globally.
• Minimally invasive surgery (MIS) shows promise for lobar ICH treatment, but faces challenges in tool dexterity and visualization.
• Previous research developed a platform for MR-guided ICH evacuation using a concentric tube robot (CTR).

Purpose of the Study:

• To present the first in vivo intracerebral hemorrhage evacuation using an MR-guided concentric tube robot (CTR).
• To detail the experimental workflow and a novel clot production method for ICH models.

Main Methods:

• Utilized a three degree of freedom (DoF) CTR, mounted on a 4-DoF stereotactic frame.
• Employed two non-metallic, pneumatically actuated concentric tubes for the robot.
• Developed a novel clot production method for both ex vivo and in vivo ICH models.

Main Results:

• Successfully performed the first in vivo ICH evacuation using an MR-guided CTR system.
• Demonstrated the feasibility of the experimental workflow and the novel clot production method.
• Evaluated the evacuation outcomes in the in vivo model.

Conclusions:

• The MR-guided CTR platform enables successful in vivo intracerebral hemorrhage evacuation.
• This robotic approach addresses dexterity and visualization challenges in MIS for ICH.
• The developed clot model and workflow are suitable for evaluating ICH evacuation techniques.