title: Tendons, Concentric Tubes, and a Bevel Tip: Three Steerable Robots in One Transoral Lung Access System.
abstract: Lung cancer is the most deadly form of cancer, and survival depends on early-stage diagnosis and treatment. Transoral access is preferable to traditional between-the-ribs needle insertion because it is less invasive and reduces risk of lung collapse. Yet many sites in the peripheral zones of the lung or distant from the bronchi cannot currently be accessed transorally, due to the relatively large diameter and lack of sufficient steerablity of current instrumentation. To remedy this, we propose a new robotic system that uses a tendon-actuated device (bronchoscope) as a first stage for deploying a concentric tube robot, which itself is a vehicle through which a bevel steered needle can be introduced into the soft tissue of the lung outside the bronchi. In this paper we present the various components of the system and the workflow we envision for deploying the robot to a target using image guidance. We describe initial validation experiments in which we puncture ex vivo bronchial wall tissue and also target a nodule in a phantom with an average final tip error of 0.72 mm.
authors.affiliation: Mechanical Engineering at Vanderbilt University, Nashville, TN 37235, USA.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Swaney
authors.affiliation: Mechanical Engineering at Vanderbilt University, Nashville, TN 37235, USA.
authors.forename: Arthur W
authors.initials: AW
authors.lastname: Mahoney
authors.affiliation: Mechanical Engineering at Vanderbilt University, Nashville, TN 37235, USA.
authors.forename: Andria A
authors.initials: AA
authors.lastname: Remirez
authors.affiliation: Mechanical Engineering at Vanderbilt University, Nashville, TN 37235, USA.
authors.forename: Erik
authors.initials: E
authors.lastname: Lamers
authors.affiliation: Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37235, USA.
authors.forename: Bryan I
authors.initials: BI
authors.lastname: Hartley
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Feins
authors.affiliation: Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Ron
authors.initials: R
authors.lastname: Alterovitz
authors.affiliation: Mechanical Engineering at Vanderbilt University, Nashville, TN 37235, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Webster