Multi-port Neuroendoscope for Robotic Intraventricular Procedures

About 20% of brain surgeries are performed to remove lesions located inside or adjacent to the brain’s ventricles [1]. Using endoscopes, neurosurgeons can navigate their instruments through the ventricles to reach these lesions with less damage to healthy brain tissue than occurs in open surgery. Current endoscopes, however, are restricted by several factors. First, the tools emerge parallel to the endoscope, precluding many of the two-handed surgical techniques of open surgery that are used to dissect tissue and stop bleeding. Second, most neurosurgeons use straight rigid endoscopes that can only image and deploy tools from their tips and so cannot negotiate around corners without causing significant brain retraction injury. While a few neurosurgeons have mastered flexible endoscopes, these instruments typically provide only a single instrument channel. A recently proposed solution to the first problem deploys concentric tube robots from the endoscope working channels to enable dexterous bimanual manipulation (Fig. 1) [2, 3] The contribution of this paper is to provide a solution to the second problem by introducing the concept of multiple imaging/tool ports on a single endoscope. In this approach, imaging ports can be positioned not only at the instrument tip, but also anywhere and at any angle along the endoscope body. If the imaging and illumination is accomplished using chip cameras and LED’s, many imaging ports can be supported in a given diameter instrument while also producing an instrument that is much lighter and easier to manipulate than a standard rigid endoscope.