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Robotically Steered Needles: A Survey of Neurosurgical Applications and Technical Innovations

机译:机器人操纵的针:神经外科应用和技术创新的调查。

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摘要

This paper surveys both the clinical applications and main technical innovations related to steered needles, with an emphasis on neurosurgery. Technical innovations generally center on curvilinear robots that can adopt a complex path that circumvents critical structures and eloquent brain tissue. These advances include several needle-steering approaches, which consist of tip-based, lengthwise, base motion-driven, and tissue-centered steering strategies. This paper also describes foundational mathematical models for steering, where potential fields, nonholonomic bicycle-like models, spring models, and stochastic approaches are cited. In addition, practical path planning systems are also addressed, where we cite uncertainty modeling in path planning, intraoperative soft tissue shift estimation through imaging scans acquired during the procedure, and simulation-based prediction. Neurosurgical scenarios tend to emphasize straight needles so far, and span deep-brain stimulation (DBS), stereoelectroencephalography (SEEG), intracerebral drug delivery (IDD), stereotactic brain biopsy (SBB), stereotactic needle aspiration for hematoma, cysts and abscesses, and brachytherapy as well as thermal ablation of brain tumors and seizure-generating regions. We emphasize therapeutic considerations and complications that have been documented in conjunction with these applications.
机译:本文调查了与转向针相关的临床应用和主要技术创新,重点是神经外科。技术创新通常集中在曲线机器人上,该机器人可以采用复杂的路径来绕开关键结构和雄辩的脑组织。这些进步包括几种针头转向方法,包括基于尖端,纵向,基本运动驱动和以组织为中心的转向策略。本文还描述了用于转向的基础数学模型,其中引用了势场,非完整自行车样模型,弹簧模型和随机方法。此外,还讨论了实用的路径规划系统,我们在路径规划中引用了不确定性建模,通过在过程中获取的成像扫描进行术中软组织移位估计以及基于模拟的预测。迄今为止,神经外科手术往往会强调直针,并跨越深脑刺激(DBS),立体脑电图(SEEG),脑内药物递送(IDD),立体定向脑活检(SBB),针对血肿,囊肿和脓肿的立体定向针穿刺术,以及近距离治疗以及脑肿瘤和癫痫发作区域的热消融。我们强调与这些应用相关的治疗注意事项和并发症。

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