Design Optimization of a Soft Robotic Manipulator for Intraventricular Hemorrhage Evacuation

Intraventricular hemorrhage (IVH) is bleeding inside the ventricular system of the brain. IVH evacuation is performed to remove blood products and relieve pressure. However, the procedure is challenging as the neurosurgeon must insert an endoscope through the brain cortex into the ventricle, potentially damaging the surrounding tissue due to the tilting required for visualization beyond a straight trajectory. As shown in Fig 1, when bleeding occurs in the temporal horn of the lateral ventricle, Kaufman’s point entry is used to access the bleeding site with a limited working window[1]. Several continuum robots, capable of performing snake-like motions, have been developed for intraventric- ular neuroendoscopic procedures [2]. They aim to facili- tate multiple intraventricular operations through a single incision. These robots primarily utilize tendon-driven and concentric tube designs. However, their metallic and rigid structures make them unsuited for magnetic resonance imaging (MRI) and can damage brain tissue. Soft robotic manipulators with pneumatic actuation have gained significant interest in minimally invasive surgery over the past decade. This type of robot poses benefits such as compliance with the surrounding envi- ronments, and MRI compatibility. This paper considers designing a soft robotic manip- ulator with pneumatic actuation for blood evacuation in a patient with IVH using Kocher’s point entry (Fig 1). The advantages of employing this trajectory over the conventional Kaufman’s point are: i) it avoids damage to the frontal cortex, ii) eliminates cosmetic scars on the patient’s face, and iii) the same incision can be used to access the third ventricle via the foramen of monro [1]. Notable works on design optimization for continuum robots in neurosurgery include [3]–[5] which were for extensible concentric tube robots. This work presents a design optimization approach for an inex- tensible soft manipulator based on piecewise constant curvature kinematics using anatomical data from a group of 40 patients.