Preliminary research tested the delivery and safety of the new implantable catheter design in two sheep to determine its potential for use in the diagnosis and treatment of brain diseases.
If proven effective and safe for use in humans, the platform could simplify and reduce the risks associated with diagnosing and treating diseases in the deep and delicate recesses of the brain.
This could help surgeons see deeper into the brain to diagnose disease, more accurately deliver treatments like drugs and laser ablation to tumors, and better deploy electrodes for deep brain stimulation in conditions such as Parkinson’s disease and epilepsy.
Lead author Professor Ferdinando Rodriguez y Baena, from Imperial’s Department of Mechanical Engineering, led the European effort and said: “The brain is a fragile and complex network of tightly packed nerve cells that each have their own role to play. When disease strikes, we want to be able to navigate this delicate environment to precisely target these areas without harming healthy cells.
“Our new, precise and minimally invasive platform improves on currently available technology and could improve our ability to safely and effectively diagnose and treat disease in people, if proven safe and effective. »
Developed as part of the Enhanced Delivery Ecosystem for Neurosurgery in 2020 (EDEN2020) project, the results are published in PLOS ONE.
stealth surgery
The platform improves on existing minimally invasive or “keyhole” surgery, where surgeons deploy tiny cameras and catheters through small incisions in the body.
It includes a soft, flexible catheter to prevent damage to brain tissue when delivering treatment, and a robotic arm with artificial intelligence (AI) to help surgeons navigate the catheter through brain tissue .
Inspired by the organs used by parasitic wasps to stealthily lay eggs in tree bark, the catheter consists of four interlocking segments that slide past each other to allow flexible navigation.
It connects to a robotic platform that combines human input and machine learning to carefully direct the catheter to the disease site. Surgeons then deliver fiber optics through the catheter so they can see and navigate the tip along brain tissue via joystick control.
The AI platform learns from surgeon input and contact forces in brain tissue to guide the catheter with pinpoint precision.
Compared to traditional “open” surgical techniques, the new approach could potentially help reduce tissue damage during surgery and improve patient recovery times and length of postoperative hospital stays.
In minimally invasive brain surgery, surgeons use deeply penetrating catheters to diagnose and treat disease. However, the catheters currently in use are stiff and difficult to place accurately without the aid of robotic navigation tools. The rigidity of the catheters combined with the complex and delicate structure of the brain means that the catheters can be difficult to place precisely, which poses risks for this type of surgery.
To test their platform, the researchers deployed the catheter into the brains of two live sheep at the University of Milan’s veterinary medicine campus. The sheep received pain relief and were monitored around the clock for a week for signs of pain or distress before being euthanized so researchers could examine the catheter’s structural impact on brain tissue. .
They found no signs of pain, tissue damage or infection after the catheter was implanted.
Lead author Dr Riccardo Secoli, also from Imperial’s mechanical engineering department, said: “Our analysis showed that we implanted these new catheters safely, without damage, infection or suffering. If we get such promising results in humans, we hope we may be able to see this platform in the clinic within four years.
“Our findings could have major implications for minimally invasive and robotic brain surgery. We hope it will help improve the safety and efficiency of current neurosurgical procedures when precise deployment of treatment and diagnostic systems is needed, for example in the context of a localized gene. therapy. »
Professor Lorenzo Bello, co-author of the study from the University of Milan, said: “One of the main limitations of current GIS is that if you want to access a deep site through a burr hole in the skull, you are constrained to a straight line trajectory. The limitation of the rigid catheter is its accuracy in moving brain tissue and the tissue deformation it can cause. We have now discovered that our steerable catheter can overcome most of these limitations.
This study was funded by the European Horizon 2020 program.
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