Early-stage research looked at the delivery and safety of the new implantable steerable catheter design in two sheep to see if it could be used to find and treat brain disorders.
The platform could make it easier to find and treat diseases in the deep, fragile parts of the brain and reduce the risks involved, if it can be shown to work and be safe to use on people.
It might make it easier for surgeons to look deeper inside the brain to detect disease, more precisely administer medications and laser ablation to tumors, and more effectively use electrodes for deep brain stimulation in disorders like Parkinson’s and epilepsy.
The European effort was directed by senior author Professor Ferdinando Rodriguez y Baena of Imperial’s Department of Mechanical Engineering, who stated: “The brain is a delicate, intricate network of closely spaced nerve cells, each of which serves a specific purpose. When disease strikes, we want to be able to precisely target the areas where it is happening without hurting healthy cells.
If it works and is safe, “this new precise, minimally invasive platform could improve our ability to find and treat diseases in people in a safe and effective way.”
The research results are published in PLOS ONE. They were made as part of the EDEN2020 project, which stands for Enhanced Delivery Ecosystem for Neurosurgery in 2020.
Surgical secrecy
The platform improves on current minimally invasive surgery, or “keyhole,” in which doctors insert tiny cameras and catheters through superficial bodily incisions.
It has a soft, flexible catheter to avoid hurting brain tissue while giving treatment and a robotic arm with artificial intelligence (AI) to help surgeons guide the catheter through brain tissue.
The catheter’s design was inspired by the organs parasitic wasps use to covertly lay their eggs in tree bark. It has four interlocking segments that glide over one another to provide flexible navigation.
It links to a robotic platform that carefully guides the catheter to the illness location using a combination of human input and machine learning. Then, the surgeon inserts optical fibers into the catheter so they can view and use a joystick to steer the tip through brain tissue.
The AI platform uses the surgeon’s input and contact forces in the brain tissues to learn how to precisely guide the catheter.
The new approach could eventually help reduce damage to tissue during surgery, speed up recovery, and shorten hospital stays after surgery compared to traditional “open” surgical techniques.
Deeply penetrating catheters are used by surgeons during minimally invasive brain surgery to identify and cure illness. However, without the assistance of robotic navigational instruments, catheters in use today are inflexible and challenging to position accurately. Catheters can be challenging to insert precisely due to their rigidity and the complex, fragile anatomy of the brain, which increases the dangers associated with this kind of surgery.
At the University of Milan’s Veterinary Medicine Campus, the researchers implanted the catheter in the brains of two live sheep to test their platform. The sheep were given pain medication and watched for indications of pain or distress for a week before being put to death so that researchers could investigate the structural effects of the catheter on brain tissue.
Following catheter installation, they looked for signs of pain, tissue damage, or infection but found none.
Mechanical engineering professor and lead author Dr. Riccardo Secoli of Imperial College London said, “Our investigation revealed that we successfully implanted these novel steerable catheter without causing harm, infection, or discomfort. We think that this platform will be used in the clinic in four years if we find similar positive results in humans.
“Our discoveries might have significant effects on robotically assisted, less invasive brain surgery. In the case of localized gene therapy, for example, it should help to increase the safety and efficacy of current neurosurgical operations where precision deployment of treatment and diagnostic devices is necessary.
co-author of the work from the University of Milan, Professor Lorenzo Bello One of the main drawbacks of existing MIS is that you can only travel in a straight path through a burr hole in the skull if you want to reach a deep-seated spot. The stiff catheter’s precision in the movable brain tissues and the potential for tissue deformation are its limitations. We have recently discovered that our steerable catheter can get around the majority of these issues. “
This study was supported through the EU’s Horizon 2020 program.
