Highly Articulated Robotic Needle Achieves Distributed Ablation of Liver Tissue

摘要

Robotic needle steering will improve percutaneous radio-frequency ablation (RFA) in the liver by performing distributed ablations without requiring multiple punctures of the liver capsule, thus enabling the treatment of large or multifocal tumors. However, state-of-the-art asymmetric-tip robotic needle steering systems do not yet achieve clinically relevant curvature. This work presents the design and development of a highly articulated needle that enables distributed RFA in liver tissue under ultrasound (US) image guidance. Our new needle design attains the target curvature required for liver procedures while meeting important clinical requirements, such as the use of fixed diameter needle introducers, presence of a free needle working channel, robustness for repeated insertions, and conductivity for the delivery of RF current for tissue ablation. The new needle tip includes two important design features: A tendon-actuated Nitinol asymmetric flexure joint, which allows for an active amplification of the needle steering force, and a steel back-bevel tip profile, which decreases the risk of needle jamming. The needle's resulting curvature was evaluated in both phantom and ex vivo liver tissues using segmented US images. The average radius of minimum curvature in ex vivo liver tissue was found to be 33.6 mm, the smallest reported to date. Furthermore, RFA in ex vivo porcine liver tissue tests were performed to demonstrate that distributed ablation with a single puncture of the liver capsule is possible via robotic needle steering.