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J Neurol Surg B Skull Base 2015; 76(02): 145-149
DOI: 10.1055/s-0034-1390401
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Endonasal Skull Base Tumor Removal Using Concentric Tube Continuum Robots: A Phantom Study

Philip J. Swaney
1   Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee, United States
,
Hunter B. Gilbert
1   Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee, United States
,
Robert J. Webster III
1   Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee, United States
2   Department of Otolaryngology, Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
3   Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Paul T. Russell III
2   Department of Otolaryngology, Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
3   Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Kyle D. Weaver
2   Department of Otolaryngology, Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
3   Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
› Author Affiliations
Further Information

Publication History

23 May 2014

21 July 2014

Publication Date:
07 November 2014 (online)

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Abstract

Objectives The purpose of this study is to experimentally evaluate the use of concentric tube continuum robots in endonasal skull base tumor removal. This new type of surgical robot offers many advantages over existing straight and rigid surgical tools including added dexterity, the ability to scale movements, and the ability to rotate the end effector while leaving the robot fixed in space. In this study, a concentric tube continuum robot was used to remove simulated pituitary tumors from a skull phantom.

Design The robot was teleoperated by experienced skull base surgeons to remove a phantom pituitary tumor within a skull. Percentage resection was measured by weight. Resection duration was timed.

Setting Academic research laboratory.

Main Outcome Measures Percentage removal of tumor material and procedure duration.

Results Average removal percentage of 79.8 ± 5.9% and average time to complete procedure of 12.5 ± 4.1 minutes (n = 20).

Conclusions The robotic system presented here for use in endonasal skull base surgery shows promise in improving the dexterity, tool motion, and end effector capabilities currently available with straight and rigid tools while remaining an effective tool for resecting the tumor.

Keywords

skull base - endoscopic - transnasal - pituitary - Cushing adenoma - surgical robotics - robot - concentric tube continuum robot - active cannula
 

  • References

  • 1 American Brain Tumor Association (ABTA). 2011. Available at: http://abta.org/brain-tumor-information/types-of-tumors/pituitary.html . Accessed March 8, 2011
    PubMedGoogle Scholar
  • 2 Matinfar M, Baird C, Batouli A, Clatterbuck R, Kazanzides P. Robot-assisted skull base surgery. IEEE/RSJ International Conference on Intelligent Robots and Systems; 2007: 865-870 . Available at: http://ieeexplore.ieee.org/xpl/articleDetails.jsp?arnumber=4399012
    PubMedGoogle Scholar
  • 3 Nimsky Ch, Rachinger J, Iro H, Fahlbusch R. Adaptation of a hexapod-based robotic system for extended endoscope-assisted transsphenoidal skull base surgery. Minim Invasive Neurosurg 2004; 47 (1) 41-46
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Burgner J, Rucker DC, Gilbert HB , et al. A telerobotic system for transnasal surgery. IEEE ASME Trans Mechatron 2014; 19 (3) 996-1006
    CrossrefPubMedGoogle Scholar
  • 5 Miroir M, Nguyen Y, Szewczyk J , et al. RobOtol: from design to evaluation of a robot for middle ear surgery. Available at: http://ieeexplore.ieee.org/xpl/login.jsp?tp=&arnumber=5650390 . IEEE/RSJ International Conference on Intelligent Robots and Systems; 2010:850–856
    PubMedGoogle Scholar
  • 6 Taylor R, Jensen P, Whitcomb L , et al. A steady-hand robotic system for microsurgical augmentation. Int J Robot Res 1999; 18 (12) 1201-1210
    CrossrefPubMedGoogle Scholar
  • 7 Simaan N, Xu K, Kapoor A , et al. Design and Integration of a telerobotic system for minimally invasive surgery of the throat. Int J Robot Res 2009; 28 (9) 1134-1153
    CrossrefPubMedGoogle Scholar
  • 8 Lanfranco AR, Castellanos AE, Desai JP, Meyers WC. Robotic surgery: a current perspective. Ann Surg 2004; 239 (1) 14-21
    Google Scholar
  • 9 Prasad SM, Prasad SM, Maniar HS, Chu C, Schuessler RB, Damiano Jr RJ. Surgical robotics: impact of motion scaling on task performance. J Am Coll Surg 2004; 199 (6) 863-868
    CrossrefPubMedGoogle Scholar
  • 10 Gosline AH, Vasilyev NV, Butler EJ , et al. Percutaneous intracardiac beating-heart surgery using metal MEMS tissue approximation tools. Int J Robot Res 2012; 31 (9) 1081-1093
    CrossrefPubMedGoogle Scholar
  • 11 Webster III RJ, Romano JM, Cowan NJ. Mechanics of precurved-tube continuum robots. IEEE Trans Robot 2009; 25 (1) 67-78
    CrossrefPubMedGoogle Scholar
  • 12 Dupont PE, Lock J, Itkowitz B, Butler E. Design and control of concentric-tube robots. IEEE Trans Robot 2010; 26 (2) 209-225
    CrossrefPubMedGoogle Scholar
  • 13 Gilbert H, Hendrick R, Remirez A, Webster III R. A robot for transnasal surgery featuring needle-sized tentacle-like arms. Expert Rev Med Devices 2014; 11 (1) 5-7
    CrossrefPubMedGoogle Scholar
  • 14 Rucker DC, Webster III RJ, Chirikjian GS, Cowan NJ. Equilibrium conformations of concentric-tube continuum robots. Int J Robot Res 2010; 29 (10) 1263-1280
    CrossrefPubMedGoogle Scholar
  • 15 Rucker DC, Jones BA, Webster III RJ. A geometrically exact model for externally loaded concentric-tube continuum robots. IEEE Trans Robot 2010; 26 (5) 769-780
    CrossrefPubMedGoogle Scholar
  • 16 Swaney PJ, Croom JM, Burgner J , et al. Design of a quadramanual robot for single-nostril skull base surgery. ASME Dynamic Systems and Control Conference/Vibration Control Conference; 2012:387–393
    PubMedGoogle Scholar
  • 17 Bekeny JR, Swaney PJ, Webster III RJ, Russell PT, Weaver KD. Forces applied at the skull base during transnasal endoscopic transsphenoidal pituitary tumor excision. J Neurol Surg B Skull Base 2013; 74 (6) 337-341
    PubMedGoogle Scholar
  • 18 Fahlbusch R, Ganslandt O, Buchfelder M, Schott W, Nimsky C. Intraoperative magnetic resonance imaging during transsphenoidal surgery. J Neurosurg 2001; 95 (3) 381-390
    CrossrefPubMedGoogle Scholar
  • 19 Gilbert HB, Swaney PJ, Burgner J, Weaver KD, Russell III T, Webster III RJ. A feasibility study on the use of concentric tube continuum robots for endonasal skull base tumor removal. Hamlyn Symposium on Medical Robotics; 2012
    PubMedGoogle Scholar
  • 20 Burgner J, Swaney PJ, Lathrop RA, Weaver KD, Webster III RJ. Debulking from within: a robotic steerable cannula for intracerebral hemorrhage evacuation. IEEE Trans Biomed Eng 2013; 60 (9) 2567-2575
    CrossrefPubMedGoogle Scholar
  • 21 Sun W, Torres LG, van den Berg J, Alterovitz R. Safe motion planning for imprecise robotic manipulators by minimizing probability of collision. International Symposium on Robotics Research; 2013
    PubMedGoogle Scholar
  • 22 Abbott JJ, Marayong P, Okamura AM. Haptic virtual fixtures for robot-assisted manipulation. Available at: http://www.eng.utah.edu/∼jabbott/pmwiki/uploads/Main/Abbott_RoboticsResearch07.pdf Springer Tracts in Advanced Robotics 2007; 28: 49-64
    PubMedGoogle Scholar