Tip design for safety of steerable needles for robot-controlled brain insertion

Abstract

Background
Current practice in neurosurgical needle insertion is limited by the straight trajectories inherent in rigid probes. One technique allowing curvilinear trajectories involves flexible bevel-tipped needles, which bend during insertion because of their asymmetry. In the brain, safety will require avoidance of the sharp tips often used in laboratory studies, in favor of a more rounded profile. Steering performance, on the other hand, requires maximal asymmetry. Design of safe bevel-tipped brain needles, thus, involves management of this trade-off by adjusting needle gage, bevel angle, and fillet (or tip) radius to arrive at a design that is suitably asymmetrical while producing strain, strain rate, and stress below the levels that would damage brain tissue.

Methods
Designs with a variety of values of needle radius, bevel angle, and fillet radius were evaluated in finite-element simulations of simultaneous insertion and rotation. Brain tissue was modeled as a hyperelastic, linear viscoelastic material. Based on the literature available, safety thresholds of 0.19 strain, 10 s−1 strain rate, and 120 kPa stress were used. Safe values of needle radius, bevel angle, and fillet radius were selected, along with an appropriate velocity envelope for safe operation. The resulting needle was fabricated and compared with a Sedan side-cutting brain biopsy needle in a study in the porcine model in vivo (N=3).

Results
The prototype needle selected was 1.66 mm in diameter, with a bevel angle of 10° and a fillet radius of 0.25 mm. Upon examination of postoperative computed tomography and histological images, no differences in tissue trauma or hemorrhage were noted between the prototype needle and the Sedan needle.

Conclusion
The study indicates a general design technique for safe bevel-tipped brain needles based on the comparison with relevant damage thresholds for strain, strain rate, and stress. The full potential of the technique awaits the determination of more exact safety thresholds.